Does Jefferson Hospital have an emergency room?

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

Where is Jefferson Hospital?

565 Coal Valley Road, Jefferson Hills, PA 15025, in Allegheny County, Pennsylvania.

What is the phone number of Jefferson Hospital?

(412) 469-5000, as listed by Medicare (CMS).

What is the Medicare star rating of Jefferson Hospital?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Jefferson Hospital — Jefferson Hills, PA

Quick answers

Does Jefferson Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Jefferson Hospital. In a medical emergency, call 911.
Where is Jefferson Hospital?: 565 Coal Valley Road, Jefferson Hills, PA 15025, in Allegheny County, Pennsylvania.
What is the phone number of Jefferson Hospital?: (412) 469-5000, as listed by Medicare (CMS).
What is the Medicare star rating of Jefferson Hospital?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][8]

Bariatric and Metabolic
Cancer
Cardiovascular
Emergency Care
Imaging
Labor and Delivery
Neuroscience
Neurosurgery
Orthopaedics
Psychiatry and Behavioral Health
Physical Therapy and Rehabilitation
Occupational Therapy
Speech Therapy
Sleep Medicine
Women's Health
Wound Healing
Otolaryngology (ENT)
Allergy and Immunology
Diabetes and Endocrine Health
Digestive Health
Ophthalmology
Plastic Surgery
Critical Care
Obesity
Osteoporosis clinic
Psychiatry and mental health
Sleep disorders
Spine center
Stroke center

Conditions treated^[4][5][8]

Back pain
Depression
Anxiety
Autism
Heart failure
Arrhythmias
Heart attack
Osteoporosis
Parkinson's disease and movement disorders
Nonhealing wounds
Lymphedema
Obesity
Sleep apnea
Restless leg syndrome
Stroke
Concussion
Hearing loss
Sinus infections

Treatments^[5][8]

Radiation therapy
Brachytherapy for prostate cancer
Chemotherapy infusion
Hyperbaric oxygen therapy
Partial hospitalization program
Medication management
Wakefulness testing
Virtual ICU monitoring

Procedures^[4][5][6]

Major cardiac surgery
Joint replacement
Back and neck surgery
Gastric bypass
Sleeve gastrectomy
Gastric banding
Gastric balloon
Hybrid cardiac procedures and implantable devices

Programs and centers^[4][5][8]

AHN Cardiovascular Institute at Jefferson Hospital
AHN Cancer Institute at Jefferson
AHN Neuroscience Institute at Jefferson
Orthopaedic Institute at Jefferson Hospital
Osteoporosis Clinic (Own the Bone)
AHN Bariatric and Metabolic Institute at Jefferson
AHN Spine Center at Jefferson
AHN Women and Infants Center at Jefferson
Psychiatry and Behavioral Health Institute at Jefferson
Sleep Disorders Center
Advanced Wound Healing Center
Primary Stroke Center
AHN LifeFlight helipad
Own the Bone program (osteoporosis)

Emergency care (hospital website)^[4][5][8]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center

Visiting and practical information

Visiting	AHN policy: two visitors per patient, 9 a.m.-9 p.m.; check in with security and show ID; 24/7 support persons for labor and pediatrics^[9]
Patient portal	AHN MyChart

Recognition^[4][5][6]

Magnet with Distinction recognition, 2026 (American Nurses Credentialing Center)
Accredited Primary Stroke Center
Gold Seal of Approval for Advanced Total Hip and Knee Replacement (The Joint Commission)
Gold Seal of Approval for Perinatal Care Certification (The Joint Commission)
Blue Distinction Center+ for Spine Surgery
Gold Safe Sleep Champion (Cribs for Kids National Safe Sleep Hospital Certification)
Keystone 10 designation for Quality Improvement in Breastfeeding
Keystone 10 Designation for breastfeeding support (AHN Women and Infants Center at Jefferson)

Doctors and clinicians (1,145)

1,145 doctors and other clinicians list Jefferson Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 1,121 more: the button below opens the full list.

Other emergency rooms nearby

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

UPMC McKeesport Hospital4.9 mi · McKeesport, PA · Acute Care Hospital
St Clair Hospital8.0 mi · Pittsburgh, PA · Acute Care Hospital
Magee Womens Hospital of UPMC Health System8.3 mi · Pittsburgh, PA · Acute Care Hospital
UPMC Presbyterian Shadyside8.6 mi · Pittsburgh, PA · Acute Care Hospital
UPMC Mercy8.9 mi · Pittsburgh, PA · Acute Care Hospital

Other hospitals nearby

Select Specialty Hospital - McKeesport, Inc4.9 mi · McKeesport, PA · Long-Term Acute Care Hospital
Select Specialty Hospital - Pittsburgh/Upmc8.6 mi · Pittsburgh, PA · Long-Term Acute Care Hospital

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

The Rehabilitation Center at Jefferson Hills0.2 mi · Jefferson Hills, PA · 3 of 5 stars
Southwestern Manor Nursing and Rehabilitation0.7 mi · Pittsburgh, PA · 1 of 5 stars
Rose Meadows Health & Rehab Center3.6 mi · Pittsburgh, PA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Sivitz Jewish Hospice7.7 mi · Pittsburgh, PA
Affinity Care of Pittsburgh, LLC.7.9 mi · Pittsburgh, PA
Viaquest Hospice, LLC8.9 mi · Monongahela, PA · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Advantage Home Health Services, LLC3.0 mi · Pittsburgh, PA
Golden Home Healthcare Pittsburgh3.0 mi · Pittsburgh, PA
Adapting Life Home Health Care LLC4.3 mi · Pittsburgh, PA

All home health agencies in the state →

Dialysis facilities

FKC Clairton1.7 mi · Clairton, PA · 3 of 5 stars
DaVita Jefferson Dialysis3.0 mi · Pittsburgh, PA · 2 of 5 stars
DaVita McKeesport West Dialysis5.0 mi · McKeesport, PA · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Greater Pittsburgh Surgery LLC1.7 mi · Jefferson Hills, PA
Associates Surgery Centers, LLC3.5 mi · West Mifflin, PA
Southwestern Ambulatory Surgery Center3.5 mi · Pittsburgh, PA

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

Cornerstone Care Dental Center of West Mifflin0.7 mi · West Mifflin, PA · Community health center
Cornerstone Care Community Health Center of Clairton3.2 mi · Clairton, PA · Community health center
SHHC Brentwood4.2 mi · Pittsburgh, PA · Community health center

Clinics and urgent care

Medexpress Urgent Care, PC - Pennsylvania3.0 mi · Pleasant Hills, PA · Urgent care center
University of Pittsburgh Physicians3.0 mi · Pleasant Hills, PA · Urgent care center
Online Care Group Pa-Pc3.5 mi · West Mifflin, PA · Urgent care center

Pharmacies

Pleasant Hills Apothecary1.7 mi · Clairton, PA · Community/retail pharmacy
Pleasant Hills RX LLC1.7 mi · Clairton, PA · Community/retail pharmacy
Giant Eagle Inc3.0 mi · Pittsburgh, PA · Community/retail pharmacy

Assisted living nearby

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

Arden Courts (Jefferson Hills)1.7 mi · Jefferson Hills, PA
Heartful Hands LLC1.7 mi · Clariton, PA
Celebration Villa of South Hills3.0 mi · Pittsburgh, PA
Overlook Green3.0 mi · Pittsburgh, PA

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	73%National average: 72%
Would definitely recommend the hospital	73%National average: 71%
Nurses “always” communicated well	82%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	78%National average: 74%
Area around the room “always” quiet at night	51%National average: 60%
Completed surveys	608Response rate: 26%

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)	0.095Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.214Better than the national benchmark
Surgical site infections after colon surgery	1.072No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.608No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.271Better 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 patients	12.7%
Deaths within 30 days: heart failure patients	10%
Deaths within 30 days: pneumonia patients	17.4%
Deaths within 30 days: COPD patients	9.4%
Deaths within 30 days: stroke patients	11.2%
Deaths within 30 days: coronary bypass surgery (CABG)	2.3%
Serious complications (patient safety indicator PSI-90)	1.17No different from the national rate
Complications after hip or knee replacement	3.8%

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 attack	14.6%
Readmitted within 30 days: heart failure	20.7%
Readmitted within 30 days: pneumonia	16.5%
Readmitted within 30 days: COPD	19.4%
Readmitted within 30 days: coronary bypass surgery	10.8%
Readmitted within 30 days: hip or knee replacement	5.7%

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)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	170 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	68%National average: 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 Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as Jefferson Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 14 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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$230	$43.70	$20.80 – $246.75
New patient office visit (about 30–44 minutes): 10 of 39 insurance plan rates American Health Plans — American Health Plans Medicare: $84.27 Amerihealth — Amerihealth Caritas CHC Medicaid: $78.66 Amerihealth — Amerihealth Caritas D-SNP Medicare: $56.96 Amerihealth — Amerihealth Caritas HC Medicaid: $78.66 Amerihealth — Amerihealth Caritas Medicare (NY): $56.96 Cigna — Cigna Commercial: $130.57 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $75 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $75
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC NEW PT VISIT LEVEL 3	$643	$520.83	$20.80 – $246.75
New patient office visit (about 30–44 minutes): 10 of 31 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $78.66 Amerihealth — Amerihealth Caritas D-SNP Medicare: $56.96 Amerihealth — Amerihealth Caritas HC Medicaid: $78.66 Amerihealth — Amerihealth Caritas Medicare (NY): $56.96 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $75 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $75 Geisinger — Geisinger CHIP: $78.66 Geisinger — Geisinger Medicaid HC: $78.66
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) In the file: HC NEW PT VISIT LEVEL 3	$643	$520.83	$56.96 – $246.75
New patient office visit (about 30–44 minutes): 10 of 30 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $78.66 Amerihealth — Amerihealth Caritas D-SNP Medicare: $56.96 Amerihealth — Amerihealth Caritas HC Medicaid: $78.66 Amerihealth — Amerihealth Caritas Medicare (NY): $56.96 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $75 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $75 Geisinger — Geisinger CHIP: $78.66 Geisinger — Geisinger Medicaid HC: $78.66
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$374	$71.06	$20.80 – $374.85
New patient office visit (about 45–59 minutes): 10 of 39 insurance plan rates American Health Plans — American Health Plans Medicare: $137.24 Amerihealth — Amerihealth Caritas CHC Medicaid: $131.04 Amerihealth — Amerihealth Caritas D-SNP Medicare: $94.89 Amerihealth — Amerihealth Caritas HC Medicaid: $131.04 Amerihealth — Amerihealth Caritas Medicare (NY): $94.89 Cigna — Cigna Commercial: $212.43 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $129 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $129
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC NEW PT VISIT LEVEL 4	$750	$607.50	$20.80 – $374.85
New patient office visit (about 45–59 minutes): 10 of 31 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $131.04 Amerihealth — Amerihealth Caritas D-SNP Medicare: $94.89 Amerihealth — Amerihealth Caritas HC Medicaid: $131.04 Amerihealth — Amerihealth Caritas Medicare (NY): $94.89 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $129 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $129 Geisinger — Geisinger CHIP: $131.04 Geisinger — Geisinger Medicaid HC: $131.04
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) In the file: HC NEW PT VISIT LEVEL 4	$750	$607.50	$92 – $374.85
New patient office visit (about 45–59 minutes): 10 of 30 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $131.04 Amerihealth — Amerihealth Caritas D-SNP Medicare: $94.89 Amerihealth — Amerihealth Caritas HC Medicaid: $131.04 Amerihealth — Amerihealth Caritas Medicare (NY): $94.89 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $129 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $129 Geisinger — Geisinger CHIP: $131.04 Geisinger — Geisinger Medicaid HC: $131.04
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$509	$96.71	$20.80 – $472.50
New patient office visit (about 60–74 minutes): 10 of 39 insurance plan rates American Health Plans — American Health Plans Medicare: $186.67 Amerihealth — Amerihealth Caritas CHC Medicaid: $170.43 Amerihealth — Amerihealth Caritas D-SNP Medicare: $123.42 Amerihealth — Amerihealth Caritas HC Medicaid: $170.43 Amerihealth — Amerihealth Caritas Medicare (NY): $123.42 Cigna — Cigna Commercial: $288.80 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $110 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $110 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $110 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $110
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: HC NEW PT VISIT LEVEL 5	$857	$694.17	$20.80 – $472.50
New patient office visit (about 60–74 minutes): 10 of 31 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $170.43 Amerihealth — Amerihealth Caritas D-SNP Medicare: $123.42 Amerihealth — Amerihealth Caritas HC Medicaid: $170.43 Amerihealth — Amerihealth Caritas Medicare (NY): $123.42 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $110 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $110 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $110 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $110 Geisinger — Geisinger CHIP: $170.43 Geisinger — Geisinger Medicaid HC: $170.43
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) In the file: HC NEW PT VISIT LEVEL 5	$857	$694.17	$110 – $472.50
New patient office visit (about 60–74 minutes): 10 of 30 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $170.43 Amerihealth — Amerihealth Caritas D-SNP Medicare: $123.42 Amerihealth — Amerihealth Caritas HC Medicaid: $170.43 Amerihealth — Amerihealth Caritas Medicare (NY): $123.42 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $110 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $110 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $110 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $110 Geisinger — Geisinger CHIP: $170.43 Geisinger — Geisinger Medicaid HC: $170.43
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$185	$35.15	$20.80 – $192.21
Established patient office visit (about 20–29 minutes): 10 of 39 insurance plan rates American Health Plans — American Health Plans Medicare: $67.79 Amerihealth — Amerihealth Caritas CHC Medicaid: $50.75 Amerihealth — Amerihealth Caritas D-SNP Medicare: $36.75 Amerihealth — Amerihealth Caritas HC Medicaid: $50.75 Amerihealth — Amerihealth Caritas Medicare (NY): $36.75 Cigna — Cigna Commercial: $104.94 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $75 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $75
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC ESTAB PT VISIT LEVEL 3	$643	$520.83	$20.80 – $192.21
Established patient office visit (about 20–29 minutes): 10 of 31 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $50.75 Amerihealth — Amerihealth Caritas D-SNP Medicare: $36.75 Amerihealth — Amerihealth Caritas HC Medicaid: $50.75 Amerihealth — Amerihealth Caritas Medicare (NY): $36.75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $75 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $75 Geisinger — Geisinger CHIP: $50.75 Geisinger — Geisinger Medicaid HC: $50.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) In the file: HC ESTAB PT VISIT LEVEL 3	$643	$520.83	$36.75 – $192.21
Established patient office visit (about 20–29 minutes): 10 of 30 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $50.75 Amerihealth — Amerihealth Caritas D-SNP Medicare: $36.75 Amerihealth — Amerihealth Caritas HC Medicaid: $50.75 Amerihealth — Amerihealth Caritas Medicare (NY): $36.75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $75 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $75 Geisinger — Geisinger CHIP: $50.75 Geisinger — Geisinger Medicaid HC: $50.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$272	$51.68	$20.80 – $271.52
Established patient office visit (about 30–39 minutes): 10 of 39 insurance plan rates American Health Plans — American Health Plans Medicare: $99.81 Amerihealth — Amerihealth Caritas CHC Medicaid: $78.91 Amerihealth — Amerihealth Caritas D-SNP Medicare: $57.14 Amerihealth — Amerihealth Caritas HC Medicaid: $78.91 Amerihealth — Amerihealth Caritas Medicare (NY): $57.14 Cigna — Cigna Commercial: $154.75 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $129 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $129
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC ESTAB PT VISIT LEVEL 4	$750	$607.50	$20.80 – $271.52
Established patient office visit (about 30–39 minutes): 10 of 31 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $78.91 Amerihealth — Amerihealth Caritas D-SNP Medicare: $57.14 Amerihealth — Amerihealth Caritas HC Medicaid: $78.91 Amerihealth — Amerihealth Caritas Medicare (NY): $57.14 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $129 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $129 Geisinger — Geisinger CHIP: $78.91 Geisinger — Geisinger Medicaid HC: $78.91
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) In the file: HC ESTAB PT VISIT LEVEL 4	$750	$607.50	$57.14 – $271.52
Established patient office visit (about 30–39 minutes): 10 of 30 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $78.91 Amerihealth — Amerihealth Caritas D-SNP Medicare: $57.14 Amerihealth — Amerihealth Caritas HC Medicaid: $78.91 Amerihealth — Amerihealth Caritas Medicare (NY): $57.14 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $129 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $129 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $129 Geisinger — Geisinger CHIP: $78.91 Geisinger — Geisinger Medicaid HC: $78.91
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$260	$49.40	$72.93 – $294
Office consultation with a specialist (moderate): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $100.72 Amerihealth — Amerihealth Caritas D-SNP Medicare: $72.93 Amerihealth — Amerihealth Caritas HC Medicaid: $100.72 Amerihealth — Amerihealth Caritas Medicare (NY): $72.93 Cigna — Cigna Commercial: $140.53 Geisinger — Geisinger CHIP: $100.72 Geisinger — Geisinger Medicaid HC: $100.72 Highmark — Highmark Blue High Performance: $103.98 Highmark — Highmark Community Blue: $103.98 Highmark — Highmark Connect Blue: $103.98
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	Not listed in the file	Not listed in the file	$72.93 – $294
Office consultation with a specialist (moderate): 10 of 23 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $100.72 Amerihealth — Amerihealth Caritas D-SNP Medicare: $72.93 Amerihealth — Amerihealth Caritas HC Medicaid: $100.72 Amerihealth — Amerihealth Caritas Medicare (NY): $72.93 Cigna — Cigna Commercial: $140.53 Geisinger — Geisinger CHIP: $100.72 Geisinger — Geisinger Medicaid HC: $100.72 Highmark — Highmark Blue High Performance: $103.98 Highmark — Highmark Community Blue: $103.98 Highmark — Highmark Connect Blue: $103.98
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · modifier 00 In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	Not listed in the file	Not listed in the file	$72.93 – $294
Office consultation with a specialist (moderate): rates for 1 insurance plan United Healthcare — United Healthcare Of OH Medicaid: $184.69
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$397	$75.43	$111.24 – $432.60
Office consultation with a specialist (moderate to high): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $153.61 Amerihealth — Amerihealth Caritas D-SNP Medicare: $111.24 Amerihealth — Amerihealth Caritas HC Medicaid: $153.61 Amerihealth — Amerihealth Caritas Medicare (NY): $111.24 Cigna — Cigna Commercial: $213.81 Geisinger — Geisinger CHIP: $153.61 Geisinger — Geisinger Medicaid HC: $153.61 Highmark — Highmark Blue High Performance: $158.36 Highmark — Highmark Community Blue: $158.36 Highmark — Highmark Connect Blue: $158.36
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	Not listed in the file	Not listed in the file	$111.24 – $432.60
Office consultation with a specialist (moderate to high): 10 of 23 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $153.61 Amerihealth — Amerihealth Caritas D-SNP Medicare: $111.24 Amerihealth — Amerihealth Caritas HC Medicaid: $153.61 Amerihealth — Amerihealth Caritas Medicare (NY): $111.24 Cigna — Cigna Commercial: $213.81 Geisinger — Geisinger CHIP: $153.61 Geisinger — Geisinger Medicaid HC: $153.61 Highmark — Highmark Blue High Performance: $158.36 Highmark — Highmark Community Blue: $158.36 Highmark — Highmark Connect Blue: $158.36
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · modifier 00 In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	Not listed in the file	Not listed in the file	$111.24 – $432.60
Office consultation with a specialist (moderate to high): rates for 1 insurance plan United Healthcare — United Healthcare Of OH Medicaid: $297.25
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$276	$52.44	$32 – $655.05
Preventive checkup, new patient, age 18–39: 10 of 22 insurance plan rates Cigna — Cigna Commercial: $149.16 Highmark — Highmark Blue High Performance: $99.23 Highmark — Highmark Community Blue: $99.23 Highmark — Highmark Connect Blue: $99.23 Highmark — Highmark Indemnity: $99.23 Highmark — Highmark Managed Care: $99.23 Highmark — Highmark My Blue Access: $99.23 Highmark — Highmark My Direct Blue: $99.23 Highmark — Highmark Performance Blue: $99.23 Highmark — Highmark Social Mission Indemnity: $99.23
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	Not listed in the file	Not listed in the file	$76.68 – $304.50
Preventive checkup, new patient, age 18–39: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $149.16 Highmark — Highmark Blue High Performance: $99.23 Highmark — Highmark Community Blue: $99.23 Highmark — Highmark Connect Blue: $99.23 Highmark — Highmark Indemnity: $99.23 Highmark — Highmark Managed Care: $99.23 Highmark — Highmark My Blue Access: $99.23 Highmark — Highmark My Direct Blue: $99.23 Highmark — Highmark Performance Blue: $99.23 Highmark — Highmark Social Mission Indemnity: $99.23
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier TG In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	Not listed in the file	Not listed in the file	$32 – $655.05
Preventive checkup, new patient, age 18–39: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $476.40 Amerihealth — Amerihealth Medicaid CHC: $655.05 Amerihealth — Amerihealth Medicaid HC: $655.05 Geisinger — Geisinger CHIP: $635.20 Geisinger — Geisinger Medicaid HC: $635.20 Highmark Wholecare — Highmark Wholecare Medicaid HC: $547.86 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $595.50 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $456.55 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $456.55 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $456.55
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$334	$63.46	$32 – $655.05
Preventive checkup, new patient, age 40–64: 10 of 22 insurance plan rates Cigna — Cigna Commercial: $180.82 Highmark — Highmark Blue High Performance: $120.30 Highmark — Highmark Community Blue: $120.30 Highmark — Highmark Connect Blue: $120.30 Highmark — Highmark Indemnity: $120.30 Highmark — Highmark Managed Care: $120.30 Highmark — Highmark My Blue Access: $120.30 Highmark — Highmark My Direct Blue: $120.30 Highmark — Highmark Performance Blue: $120.30 Highmark — Highmark Social Mission Indemnity: $120.30
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	Not listed in the file	Not listed in the file	$92.99 – $351.75
Preventive checkup, new patient, age 40–64: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $180.82 Highmark — Highmark Blue High Performance: $120.30 Highmark — Highmark Community Blue: $120.30 Highmark — Highmark Connect Blue: $120.30 Highmark — Highmark Indemnity: $120.30 Highmark — Highmark Managed Care: $120.30 Highmark — Highmark My Blue Access: $120.30 Highmark — Highmark My Direct Blue: $120.30 Highmark — Highmark Performance Blue: $120.30 Highmark — Highmark Social Mission Indemnity: $120.30
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier TG In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	Not listed in the file	Not listed in the file	$32 – $655.05
Preventive checkup, new patient, age 40–64: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $476.40 Amerihealth — Amerihealth Medicaid CHC: $655.05 Amerihealth — Amerihealth Medicaid HC: $655.05 Geisinger — Geisinger CHIP: $635.20 Geisinger — Geisinger Medicaid HC: $635.20 Highmark Wholecare — Highmark Wholecare Medicaid HC: $547.86 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $595.50 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $456.55 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $456.55 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $456.55
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM	$199	$37.81	$56 – $931.56
Emergency room visit (moderate): 10 of 63 insurance plan rates Aetna — Aetna Better Health CHIP: $67.98 Aetna — Aetna Commercial: $648.89 Aetna — Aetna Medicare: $277.03 American Health Plans — American Health Plans Medicare: $266.37 Amerihealth — Amerihealth Caritas CHC Medicaid: $82.14 Amerihealth — Amerihealth Caritas D-SNP Medicare: $279.69 Amerihealth — Amerihealth Caritas HC Medicaid: $82.14 Amerihealth — Amerihealth Caritas Medicare (NY): $59.48 Amerihealth — Amerihealth Medicaid CHC: $56 Amerihealth — Amerihealth Medicaid HC: $56
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC ED VISIT LEVEL 3	$1,578	$1,278.18	$56 – $931.56
Emergency room visit (moderate): 10 of 58 insurance plan rates Aetna — Aetna Better Health CHIP: $67.98 Aetna — Aetna Commercial: $648.89 Aetna — Aetna Medicare: $277.03 American Health Plans — American Health Plans Medicare: $266.37 Amerihealth — Amerihealth Caritas CHC Medicaid: $82.14 Amerihealth — Amerihealth Caritas D-SNP Medicare: $279.69 Amerihealth — Amerihealth Caritas HC Medicaid: $82.14 Amerihealth — Amerihealth Caritas Medicare (NY): $59.48 Amerihealth — Amerihealth Medicaid CHC: $56 Amerihealth — Amerihealth Medicaid HC: $56
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: HC ED VISIT LEVEL 3	$1,578	$1,278.18	$57.92 – $124.76
Emergency room visit (moderate): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $82.14 Amerihealth — Amerihealth Caritas D-SNP Medicare: $59.48 Amerihealth — Amerihealth Caritas HC Medicaid: $82.14 Amerihealth — Amerihealth Caritas Medicare (NY): $59.48 Geisinger — Geisinger CHIP: $82.14 Geisinger — Geisinger Medicaid HC: $82.14 Highmark — Highmark Blue High Performance: $89.75 Highmark — Highmark Community Blue: $89.75 Highmark — Highmark Connect Blue: $89.75 Highmark — Highmark Indemnity: $89.75
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$340	$64.60	$80 – $1,432.62
Emergency room visit (moderately high): 10 of 63 insurance plan rates Aetna — Aetna Better Health CHIP: $114.40 Aetna — Aetna Commercial: $997.90 Aetna — Aetna Medicare: $426.03 American Health Plans — American Health Plans Medicare: $409.65 Amerihealth — Amerihealth Caritas CHC Medicaid: $138.23 Amerihealth — Amerihealth Caritas D-SNP Medicare: $100.10 Amerihealth — Amerihealth Caritas HC Medicaid: $138.23 Amerihealth — Amerihealth Caritas Medicare (NY): $100.10 Amerihealth — Amerihealth Medicaid CHC: $80 Amerihealth — Amerihealth Medicaid HC: $80
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC ED VISIT LEVEL 4	$2,427	$1,965.87	$80 – $1,432.62
Emergency room visit (moderately high): 10 of 58 insurance plan rates Aetna — Aetna Better Health CHIP: $114.40 Aetna — Aetna Commercial: $997.90 Aetna — Aetna Medicare: $426.03 American Health Plans — American Health Plans Medicare: $409.65 Amerihealth — Amerihealth Caritas CHC Medicaid: $138.23 Amerihealth — Amerihealth Caritas D-SNP Medicare: $100.10 Amerihealth — Amerihealth Caritas HC Medicaid: $138.23 Amerihealth — Amerihealth Caritas Medicare (NY): $100.10 Amerihealth — Amerihealth Medicaid CHC: $80 Amerihealth — Amerihealth Medicaid HC: $80
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: HC ED VISIT LEVEL 4	$2,427	$1,965.87	$98.57 – $229.18
Emergency room visit (moderately high): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $138.23 Amerihealth — Amerihealth Caritas D-SNP Medicare: $100.10 Amerihealth — Amerihealth Caritas HC Medicaid: $138.23 Amerihealth — Amerihealth Caritas Medicare (NY): $100.10 Geisinger — Geisinger CHIP: $138.23 Geisinger — Geisinger Medicaid HC: $138.23 Highmark — Highmark Blue High Performance: $152.71 Highmark — Highmark Community Blue: $152.71 Highmark — Highmark Connect Blue: $152.71 Highmark — Highmark Indemnity: $152.71
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$493	$93.67	$80 – $2,062.70
Emergency room visit (high): 10 of 63 insurance plan rates Aetna — Aetna Better Health CHIP: $166.49 Aetna — Aetna Commercial: $1,436.79 Aetna — Aetna Medicare: $613.41 American Health Plans — American Health Plans Medicare: $589.81 Amerihealth — Amerihealth Caritas CHC Medicaid: $201.17 Amerihealth — Amerihealth Caritas D-SNP Medicare: $145.68 Amerihealth — Amerihealth Caritas HC Medicaid: $201.17 Amerihealth — Amerihealth Caritas Medicare (NY): $145.68 Amerihealth — Amerihealth Medicaid CHC: $80 Amerihealth — Amerihealth Medicaid HC: $80
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC ED VISIT LEVEL 5	$3,495	$2,830.95	$80 – $2,062.70
Emergency room visit (high): 10 of 58 insurance plan rates Aetna — Aetna Better Health CHIP: $166.49 Aetna — Aetna Commercial: $1,436.79 Aetna — Aetna Medicare: $613.41 American Health Plans — American Health Plans Medicare: $589.81 Amerihealth — Amerihealth Caritas CHC Medicaid: $201.17 Amerihealth — Amerihealth Caritas D-SNP Medicare: $145.68 Amerihealth — Amerihealth Caritas HC Medicaid: $201.17 Amerihealth — Amerihealth Caritas Medicare (NY): $145.68 Amerihealth — Amerihealth Medicaid CHC: $80 Amerihealth — Amerihealth Medicaid HC: $80
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: HC ED VISIT LEVEL 5	$3,495	$2,830.95	$142.82 – $333.04
Emergency room visit (high): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $201.17 Amerihealth — Amerihealth Caritas D-SNP Medicare: $145.68 Amerihealth — Amerihealth Caritas HC Medicaid: $201.17 Amerihealth — Amerihealth Caritas Medicare (NY): $145.68 Geisinger — Geisinger CHIP: $201.17 Geisinger — Geisinger Medicaid HC: $201.17 Highmark — Highmark Blue High Performance: $221.19 Highmark — Highmark Community Blue: $221.19 Highmark — Highmark Connect Blue: $221.19 Highmark — Highmark Indemnity: $221.19

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: CHG BASIC METABOLIC PANEL CALCIUM TOTAL	$26	$4.94	$4.10 – $28.39
Basic metabolic panel (blood test): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $11.23 Aetna — Aetna Commercial: $20.61 Aetna — Aetna Medicare: $8.80 American Health Plans — American Health Plans Medicare: $8.46 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.88 Amerihealth — Amerihealth Medicaid CHC: $9.36 Amerihealth — Amerihealth Medicaid HC: $9.36 Cigna — Cigna Commercial: $9.14 Cigna — Cigna Medicare: $6.51 Devoted Medicare — Devoted Health Medicare Advantage: $8.71
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: HC BMP TOTAL CALCIUM	$72	$58.32	$4.10 – $23.10
Basic metabolic panel (blood test): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $11.23 Aetna — Aetna Commercial: $20.61 Aetna — Aetna Medicare: $8.80 American Health Plans — American Health Plans Medicare: $8.46 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.88 Amerihealth — Amerihealth Medicaid CHC: $9.36 Amerihealth — Amerihealth Medicaid HC: $9.36 Cigna — Cigna Commercial: $9.14 Cigna — Cigna Medicare: $6.51 Devoted Medicare — Devoted Health Medicare Advantage: $8.71
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) In the file: HC BMP TOTAL CALCIUM	$72	$58.32	$5.59 – $23.10
Basic metabolic panel (blood test): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $5.59 Highmark — Highmark Community Blue: $5.59 Highmark — Highmark Connect Blue: $5.59 Highmark — Highmark Indemnity: $5.59 Highmark — Highmark Managed Care: $5.59 Highmark — Highmark My Blue Access: $5.59 Highmark — Highmark My Direct Blue: $5.59 Highmark — Highmark Performance Blue: $5.59 Highmark — Highmark Social Mission Indemnity: $5.59 Highmark — Highmark Social Mission Managed Care: $5.59
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: CHG COMPREHENSIVE METABOLIC PANEL	$32	$6.08	$5.12 – $37.24
Comprehensive metabolic panel (blood test): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $14.03 Aetna — Aetna Commercial: $25.72 Aetna — Aetna Medicare: $10.98 American Health Plans — American Health Plans Medicare: $10.56 Amerihealth — Amerihealth Caritas D-SNP Medicare: $11.09 Amerihealth — Amerihealth Medicaid CHC: $11.69 Amerihealth — Amerihealth Medicaid HC: $11.69 Cigna — Cigna Commercial: $11.40 Cigna — Cigna Medicare: $8.13 Devoted Medicare — Devoted Health Medicare Advantage: $10.88
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HC COMPREHENSIVE METABOLIC PNL	$90	$72.90	$5.12 – $29.40
Comprehensive metabolic panel (blood test): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $14.03 Aetna — Aetna Commercial: $25.72 Aetna — Aetna Medicare: $10.98 American Health Plans — American Health Plans Medicare: $10.56 Amerihealth — Amerihealth Caritas D-SNP Medicare: $11.09 Amerihealth — Amerihealth Medicaid CHC: $11.69 Amerihealth — Amerihealth Medicaid HC: $11.69 Cigna — Cigna Commercial: $11.40 Cigna — Cigna Medicare: $8.13 Devoted Medicare — Devoted Health Medicare Advantage: $10.88
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) In the file: HC COMPREHENSIVE METABOLIC PNL	$90	$72.90	$6.97 – $29.40
Comprehensive metabolic panel (blood test): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $6.97 Highmark — Highmark Community Blue: $6.97 Highmark — Highmark Connect Blue: $6.97 Highmark — Highmark Indemnity: $6.97 Highmark — Highmark Managed Care: $6.97 Highmark — Highmark My Blue Access: $6.97 Highmark — Highmark My Direct Blue: $6.97 Highmark — Highmark Performance Blue: $6.97 Highmark — Highmark Social Mission Indemnity: $6.97 Highmark — Highmark Social Mission Managed Care: $6.97
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: CHG OBSTETRIC PANEL	$144	$27.36	$12 – $116.47
Obstetric blood test panel: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $14.40 Aetna — Aetna Commercial: $116.47 Aetna — Aetna Medicare: $49.72 American Health Plans — American Health Plans Medicare: $47.81 Amerihealth — Amerihealth Caritas D-SNP Medicare: $50.20 Amerihealth — Amerihealth Medicaid CHC: $12 Amerihealth — Amerihealth Medicaid HC: $12 Cigna — Cigna Commercial: $51.63 Cigna — Cigna Medicare: $36.81 Devoted Medicare — Devoted Health Medicare Advantage: $49.24
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: HC OBSTETRIC PANEL	$409	$331.29	$12 – $116.47
Obstetric blood test panel: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $14.40 Aetna — Aetna Commercial: $116.47 Aetna — Aetna Medicare: $49.72 American Health Plans — American Health Plans Medicare: $47.81 Amerihealth — Amerihealth Caritas D-SNP Medicare: $50.20 Amerihealth — Amerihealth Medicaid CHC: $12 Amerihealth — Amerihealth Medicaid HC: $12 Cigna — Cigna Commercial: $51.63 Cigna — Cigna Medicare: $36.81 Devoted Medicare — Devoted Health Medicare Advantage: $49.24
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) In the file: HC OBSTETRIC PANEL	$409	$331.29	$12 – $57.46
Obstetric blood test panel: 10 of 18 insurance plan rates Highmark — Highmark Blue High Performance: $31.56 Highmark — Highmark Community Blue: $31.56 Highmark — Highmark Connect Blue: $31.56 Highmark — Highmark Indemnity: $31.56 Highmark — Highmark Managed Care: $31.56 Highmark — Highmark My Blue Access: $31.56 Highmark — Highmark My Direct Blue: $31.56 Highmark — Highmark Performance Blue: $31.56 Highmark — Highmark Social Mission Indemnity: $31.56 Highmark — Highmark Social Mission Managed Care: $31.56
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: CHG LIPID PANEL	$40	$7.60	$6.49 – $36.75
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $16.80 Aetna — Aetna Commercial: $32.62 Aetna — Aetna Medicare: $13.93 American Health Plans — American Health Plans Medicare: $13.39 Amerihealth — Amerihealth Caritas D-SNP Medicare: $14.06 Amerihealth — Amerihealth Medicaid CHC: $14 Amerihealth — Amerihealth Medicaid HC: $14 Cigna — Cigna Commercial: $14.46 Cigna — Cigna Medicare: $10.31 Devoted Medicare — Devoted Health Medicare Advantage: $13.79
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HC LIPID PANEL	$115	$93.15	$6.49 – $36.75
Cholesterol panel (lipid panel): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $16.80 Aetna — Aetna Commercial: $32.62 Aetna — Aetna Medicare: $13.93 American Health Plans — American Health Plans Medicare: $13.39 Amerihealth — Amerihealth Caritas D-SNP Medicare: $14.06 Amerihealth — Amerihealth Medicaid CHC: $14 Amerihealth — Amerihealth Medicaid HC: $14 Cigna — Cigna Commercial: $14.46 Cigna — Cigna Medicare: $10.31 Devoted Medicare — Devoted Health Medicare Advantage: $13.79
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) In the file: HC LIPID PANEL	$115	$93.15	$8.83 – $36.75
Cholesterol panel (lipid panel): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $8.83 Highmark — Highmark Community Blue: $8.83 Highmark — Highmark Connect Blue: $8.83 Highmark — Highmark Indemnity: $8.83 Highmark — Highmark Managed Care: $8.83 Highmark — Highmark My Blue Access: $8.83 Highmark — Highmark My Direct Blue: $8.83 Highmark — Highmark Performance Blue: $8.83 Highmark — Highmark Social Mission Indemnity: $8.83 Highmark — Highmark Social Mission Managed Care: $8.83
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: CHG RENAL FUNCTION PANEL	$26	$4.94	$4.20 – $38.05
Kidney function panel: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $11.52 Aetna — Aetna Commercial: $21.14 Aetna — Aetna Medicare: $9.03 American Health Plans — American Health Plans Medicare: $8.68 Amerihealth — Amerihealth Caritas D-SNP Medicare: $9.11 Amerihealth — Amerihealth Medicaid CHC: $9.60 Amerihealth — Amerihealth Medicaid HC: $9.60 Cigna — Cigna Commercial: $9.37 Cigna — Cigna Medicare: $6.68 Devoted Medicare — Devoted Health Medicare Advantage: $8.94
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HC RENAL FUNCTION PANEL	$74	$59.94	$4.20 – $24.15
Kidney function panel: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $11.52 Aetna — Aetna Commercial: $21.14 Aetna — Aetna Medicare: $9.03 American Health Plans — American Health Plans Medicare: $8.68 Amerihealth — Amerihealth Caritas D-SNP Medicare: $9.11 Amerihealth — Amerihealth Medicaid CHC: $9.60 Amerihealth — Amerihealth Medicaid HC: $9.60 Cigna — Cigna Commercial: $9.37 Cigna — Cigna Medicare: $6.68 Devoted Medicare — Devoted Health Medicare Advantage: $8.94
Kidney function panel CPT 80069 · Inpatient (hospital stay) In the file: HC RENAL FUNCTION PANEL	$74	$59.94	$5.73 – $24.15
Kidney function panel: 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $5.73 Highmark — Highmark Community Blue: $5.73 Highmark — Highmark Connect Blue: $5.73 Highmark — Highmark Indemnity: $5.73 Highmark — Highmark Managed Care: $5.73 Highmark — Highmark My Blue Access: $5.73 Highmark — Highmark My Direct Blue: $5.73 Highmark — Highmark Performance Blue: $5.73 Highmark — Highmark Social Mission Indemnity: $5.73 Highmark — Highmark Social Mission Managed Care: $5.73
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: CHG HEPATIC FUNCTION PANEL	$24	$4.56	$3.96 – $28.33
Liver function panel: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $10.84 Aetna — Aetna Commercial: $19.90 Aetna — Aetna Medicare: $8.50 American Health Plans — American Health Plans Medicare: $8.17 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.58 Amerihealth — Amerihealth Medicaid CHC: $9.03 Amerihealth — Amerihealth Medicaid HC: $9.03 Cigna — Cigna Commercial: $8.82 Cigna — Cigna Medicare: $6.29 Devoted Medicare — Devoted Health Medicare Advantage: $8.42
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HC HEPATIC FUNCTION PANEL	$70	$56.70	$3.96 – $23.10
Liver function panel: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $10.84 Aetna — Aetna Commercial: $19.90 Aetna — Aetna Medicare: $8.50 American Health Plans — American Health Plans Medicare: $8.17 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.58 Amerihealth — Amerihealth Medicaid CHC: $9.03 Amerihealth — Amerihealth Medicaid HC: $9.03 Cigna — Cigna Commercial: $8.82 Cigna — Cigna Medicare: $6.29 Devoted Medicare — Devoted Health Medicare Advantage: $8.42
Liver function panel CPT 80076 · Inpatient (hospital stay) In the file: HC HEPATIC FUNCTION PANEL	$70	$56.70	$5.39 – $23.10
Liver function panel: 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $5.39 Highmark — Highmark Community Blue: $5.39 Highmark — Highmark Connect Blue: $5.39 Highmark — Highmark Indemnity: $5.39 Highmark — Highmark Managed Care: $5.39 Highmark — Highmark My Blue Access: $5.39 Highmark — Highmark My Direct Blue: $5.39 Highmark — Highmark Performance Blue: $5.39 Highmark — Highmark Social Mission Indemnity: $5.39 Highmark — Highmark Social Mission Managed Care: $5.39
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HC URINE AUTO W MICROSCOPY	$28	$22.68	$1.54 – $9.45
Urine test (automated, with microscope): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $3.60 Aetna — Aetna Commercial: $7.72 Aetna — Aetna Medicare: $3.30 American Health Plans — American Health Plans Medicare: $3.17 Amerihealth — Amerihealth Caritas D-SNP Medicare: $3.33 Amerihealth — Amerihealth Medicaid CHC: $3 Amerihealth — Amerihealth Medicaid HC: $3 Cigna — Cigna Commercial: $3.42 Cigna — Cigna Medicare: $2.44 Devoted Medicare — Devoted Health Medicare Advantage: $3.27
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) In the file: HC URINE AUTO W MICROSCOPY	$28	$22.68	$2.09 – $9.45
Urine test (automated, with microscope): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $2.09 Highmark — Highmark Community Blue: $2.09 Highmark — Highmark Connect Blue: $2.09 Highmark — Highmark Indemnity: $2.09 Highmark — Highmark Managed Care: $2.09 Highmark — Highmark My Blue Access: $2.09 Highmark — Highmark My Direct Blue: $2.09 Highmark — Highmark Performance Blue: $2.09 Highmark — Highmark Social Mission Indemnity: $2.09 Highmark — Highmark Social Mission Managed Care: $2.09
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	Not listed in the file	Not listed in the file	$3 – $7.09
Urine test (automated, with microscope): rates for 2 insurance plans Cigna — Cigna Commercial: $3.15 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center Commercial: $7.09
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$10	$1.90	$1.69 – $13.57
Urine test (manual, without microscope): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $4.28 Aetna — Aetna Commercial: $8.48 Aetna — Aetna Medicare: $3.62 American Health Plans — American Health Plans Medicare: $3.48 Amerihealth — Amerihealth Caritas D-SNP Medicare: $3.65 Amerihealth — Amerihealth Medicaid CHC: $3.57 Amerihealth — Amerihealth Medicaid HC: $3.57 Cigna — Cigna Commercial: $3.76 Cigna — Cigna Medicare: $2.68 Devoted Medicare — Devoted Health Medicare Advantage: $3.58
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HC URINALYSIS DIPSTICK WO MICRO POC	$29	$23.49	$1.69 – $8.48
Urine test (manual, without microscope): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $4.28 Aetna — Aetna Commercial: $8.48 Aetna — Aetna Medicare: $3.62 American Health Plans — American Health Plans Medicare: $3.48 Amerihealth — Amerihealth Caritas D-SNP Medicare: $3.65 Amerihealth — Amerihealth Medicaid CHC: $3.57 Amerihealth — Amerihealth Medicaid HC: $3.57 Cigna — Cigna Commercial: $3.76 Cigna — Cigna Medicare: $2.68 Devoted Medicare — Devoted Health Medicare Advantage: $3.58
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) In the file: HC URINALYSIS DIPSTICK WO MICRO POC	$29	$23.49	$2.30 – $7.35
Urine test (manual, without microscope): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $2.30 Highmark — Highmark Community Blue: $2.30 Highmark — Highmark Connect Blue: $2.30 Highmark — Highmark Indemnity: $2.30 Highmark — Highmark Managed Care: $2.30 Highmark — Highmark My Blue Access: $2.30 Highmark — Highmark My Direct Blue: $2.30 Highmark — Highmark Performance Blue: $2.30 Highmark — Highmark Social Mission Indemnity: $2.30 Highmark — Highmark Social Mission Managed Care: $2.30
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$6	$1.14	$1.09 – $12.44
Urine test (automated, without microscope): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $3.72 Aetna — Aetna Commercial: $5.48 Aetna — Aetna Medicare: $2.34 American Health Plans — American Health Plans Medicare: $2.25 Amerihealth — Amerihealth Caritas D-SNP Medicare: $2.36 Amerihealth — Amerihealth Medicaid CHC: $3.10 Amerihealth — Amerihealth Medicaid HC: $3.10 Cigna — Cigna Commercial: $2.43 Cigna — Cigna Medicare: $1.73 Devoted Medicare — Devoted Health Medicare Advantage: $2.32
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HC URINE AUTO WO MICROSCOPY	$19	$15.39	$1.09 – $6.30
Urine test (automated, without microscope): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $3.72 Aetna — Aetna Commercial: $5.48 Aetna — Aetna Medicare: $2.34 American Health Plans — American Health Plans Medicare: $2.25 Amerihealth — Amerihealth Caritas D-SNP Medicare: $2.36 Amerihealth — Amerihealth Medicaid CHC: $3.10 Amerihealth — Amerihealth Medicaid HC: $3.10 Cigna — Cigna Commercial: $2.43 Cigna — Cigna Medicare: $1.73 Devoted Medicare — Devoted Health Medicare Advantage: $2.32
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) In the file: HC URINE AUTO WO MICROSCOPY	$19	$15.39	$1.49 – $6.30
Urine test (automated, without microscope): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $1.49 Highmark — Highmark Community Blue: $1.49 Highmark — Highmark Connect Blue: $1.49 Highmark — Highmark Indemnity: $1.49 Highmark — Highmark Managed Care: $1.49 Highmark — Highmark My Blue Access: $1.49 Highmark — Highmark My Direct Blue: $1.49 Highmark — Highmark Performance Blue: $1.49 Highmark — Highmark Social Mission Indemnity: $1.49 Highmark — Highmark Social Mission Managed Care: $1.49
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$56	$10.64	$8.91 – $50.40
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $29.23 Aetna — Aetna Commercial: $44.80 Aetna — Aetna Medicare: $19.13 American Health Plans — American Health Plans Medicare: $18.39 Amerihealth — Amerihealth Caritas D-SNP Medicare: $19.31 Amerihealth — Amerihealth Medicaid CHC: $24.36 Amerihealth — Amerihealth Medicaid HC: $24.36 Cigna — Cigna Commercial: $19.86 Cigna — Cigna Medicare: $14.16 Devoted Medicare — Devoted Health Medicare Advantage: $18.94
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC PSA TOTAL	$165	$133.65	$8.91 – $50.40
PSA (prostate specific antigen) blood test: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $29.23 Aetna — Aetna Commercial: $44.80 Aetna — Aetna Medicare: $19.13 American Health Plans — American Health Plans Medicare: $18.39 Amerihealth — Amerihealth Caritas D-SNP Medicare: $19.31 Amerihealth — Amerihealth Medicaid CHC: $24.36 Amerihealth — Amerihealth Medicaid HC: $24.36 Cigna — Cigna Commercial: $19.86 Cigna — Cigna Medicare: $14.16 Devoted Medicare — Devoted Health Medicare Advantage: $18.94
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) In the file: HC PSA TOTAL	$165	$133.65	$12.13 – $50.40
PSA (prostate specific antigen) blood test: 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $12.13 Highmark — Highmark Community Blue: $12.13 Highmark — Highmark Connect Blue: $12.13 Highmark — Highmark Indemnity: $12.13 Highmark — Highmark Managed Care: $12.13 Highmark — Highmark My Blue Access: $12.13 Highmark — Highmark My Direct Blue: $12.13 Highmark — Highmark Performance Blue: $12.13 Highmark — Highmark Social Mission Indemnity: $12.13 Highmark — Highmark Social Mission Managed Care: $12.13
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: CHG ASSAY OF THYROID STIMULATING HORMONE TSH	$50	$9.50	$8.14 – $52.35
Thyroid stimulating hormone (TSH) test: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $27.85 Aetna — Aetna Commercial: $40.92 Aetna — Aetna Medicare: $17.47 American Health Plans — American Health Plans Medicare: $16.80 Amerihealth — Amerihealth Caritas D-SNP Medicare: $17.64 Amerihealth — Amerihealth Medicaid CHC: $23.21 Amerihealth — Amerihealth Medicaid HC: $23.21 Cigna — Cigna Commercial: $18.14 Cigna — Cigna Medicare: $12.94 Devoted Medicare — Devoted Health Medicare Advantage: $17.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC THYROID STIMULATING HORMONE	$143	$115.83	$8.14 – $46.20
Thyroid stimulating hormone (TSH) test: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $27.85 Aetna — Aetna Commercial: $40.92 Aetna — Aetna Medicare: $17.47 American Health Plans — American Health Plans Medicare: $16.80 Amerihealth — Amerihealth Caritas D-SNP Medicare: $17.64 Amerihealth — Amerihealth Medicaid CHC: $23.21 Amerihealth — Amerihealth Medicaid HC: $23.21 Cigna — Cigna Commercial: $18.14 Cigna — Cigna Medicare: $12.94 Devoted Medicare — Devoted Health Medicare Advantage: $17.30
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) In the file: HC THYROID STIMULATING HORMONE	$143	$115.83	$11.09 – $46.20
Thyroid stimulating hormone (TSH) test: 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $11.09 Highmark — Highmark Community Blue: $11.09 Highmark — Highmark Connect Blue: $11.09 Highmark — Highmark Indemnity: $11.09 Highmark — Highmark Managed Care: $11.09 Highmark — Highmark My Blue Access: $11.09 Highmark — Highmark My Direct Blue: $11.09 Highmark — Highmark Performance Blue: $11.09 Highmark — Highmark Social Mission Indemnity: $11.09 Highmark — Highmark Social Mission Managed Care: $11.09
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$24	$4.56	$3.76 – $25.55
Complete blood count (CBC) with differential: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $7.20 Aetna — Aetna Commercial: $18.93 Aetna — Aetna Medicare: $8.08 American Health Plans — American Health Plans Medicare: $7.77 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.16 Amerihealth — Amerihealth Medicaid CHC: $6 Amerihealth — Amerihealth Medicaid HC: $6 Cigna — Cigna Commercial: $8.39 Cigna — Cigna Medicare: $5.98 Devoted Medicare — Devoted Health Medicare Advantage: $8
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HC CBC AUTO W AUTO DIFF	$67	$54.27	$3.76 – $22.05
Complete blood count (CBC) with differential: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $7.20 Aetna — Aetna Commercial: $18.93 Aetna — Aetna Medicare: $8.08 American Health Plans — American Health Plans Medicare: $7.77 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.16 Amerihealth — Amerihealth Medicaid CHC: $6 Amerihealth — Amerihealth Medicaid HC: $6 Cigna — Cigna Commercial: $8.39 Cigna — Cigna Medicare: $5.98 Devoted Medicare — Devoted Health Medicare Advantage: $8
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) In the file: HC CBC AUTO W AUTO DIFF	$67	$54.27	$5.13 – $22.05
Complete blood count (CBC) with differential: 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $5.13 Highmark — Highmark Community Blue: $5.13 Highmark — Highmark Connect Blue: $5.13 Highmark — Highmark Indemnity: $5.13 Highmark — Highmark Managed Care: $5.13 Highmark — Highmark My Blue Access: $5.13 Highmark — Highmark My Direct Blue: $5.13 Highmark — Highmark Performance Blue: $5.13 Highmark — Highmark Social Mission Indemnity: $5.13 Highmark — Highmark Social Mission Managed Care: $5.13
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CHG BLOOD COUNT COMPLETE AUTOMATED	$20	$3.80	$3.13 – $17.85
Complete blood count (CBC), automated: 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $9.02 Aetna — Aetna Commercial: $15.76 Aetna — Aetna Medicare: $6.73 American Health Plans — American Health Plans Medicare: $6.47 Amerihealth — Amerihealth Caritas D-SNP Medicare: $6.79 Amerihealth — Amerihealth Medicaid CHC: $7.52 Amerihealth — Amerihealth Medicaid HC: $7.52 Cigna — Cigna Commercial: $6.99 Cigna — Cigna Medicare: $4.98 Devoted Medicare — Devoted Health Medicare Advantage: $6.66
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HC CBC AUTO WO DIFF	$55	$44.55	$3.13 – $17.85
Complete blood count (CBC), automated: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $9.02 Aetna — Aetna Commercial: $15.76 Aetna — Aetna Medicare: $6.73 American Health Plans — American Health Plans Medicare: $6.47 Amerihealth — Amerihealth Caritas D-SNP Medicare: $6.79 Amerihealth — Amerihealth Medicaid CHC: $7.52 Amerihealth — Amerihealth Medicaid HC: $7.52 Cigna — Cigna Commercial: $6.99 Cigna — Cigna Medicare: $4.98 Devoted Medicare — Devoted Health Medicare Advantage: $6.66
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) In the file: HC CBC AUTO WO DIFF	$55	$44.55	$4.27 – $17.85
Complete blood count (CBC), automated: 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $4.27 Highmark — Highmark Community Blue: $4.27 Highmark — Highmark Connect Blue: $4.27 Highmark — Highmark Indemnity: $4.27 Highmark — Highmark Managed Care: $4.27 Highmark — Highmark My Blue Access: $4.27 Highmark — Highmark My Direct Blue: $4.27 Highmark — Highmark Performance Blue: $4.27 Highmark — Highmark Social Mission Indemnity: $4.27 Highmark — Highmark Social Mission Managed Care: $4.27
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: CHG PROTHROMBIN TIME	$12	$2.28	$2.08 – $11.55
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $4.80 Aetna — Aetna Commercial: $10.45 Aetna — Aetna Medicare: $4.46 American Health Plans — American Health Plans Medicare: $4.29 Amerihealth — Amerihealth Caritas D-SNP Medicare: $4.50 Amerihealth — Amerihealth Medicaid CHC: $4 Amerihealth — Amerihealth Medicaid HC: $4 Cigna — Cigna Commercial: $4.63 Cigna — Cigna Medicare: $3.30 Devoted Medicare — Devoted Health Medicare Advantage: $4.42
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC PROTHROMBIN TIME	$37	$29.97	$2.08 – $11.55
Blood clotting time test (prothrombin time, PT): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $4.80 Aetna — Aetna Commercial: $10.45 Aetna — Aetna Medicare: $4.46 American Health Plans — American Health Plans Medicare: $4.29 Amerihealth — Amerihealth Caritas D-SNP Medicare: $4.50 Amerihealth — Amerihealth Medicaid CHC: $4 Amerihealth — Amerihealth Medicaid HC: $4 Cigna — Cigna Commercial: $4.63 Cigna — Cigna Medicare: $3.30 Devoted Medicare — Devoted Health Medicare Advantage: $4.42
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC PROTHROMBIN TIME POC	$37	$29.97	$2.08 – $11.55
Blood clotting time test (prothrombin time, PT): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $4.80 Aetna — Aetna Commercial: $10.45 Aetna — Aetna Medicare: $4.46 American Health Plans — American Health Plans Medicare: $4.29 Amerihealth — Amerihealth Caritas D-SNP Medicare: $4.50 Amerihealth — Amerihealth Medicaid CHC: $4 Amerihealth — Amerihealth Medicaid HC: $4 Cigna — Cigna Commercial: $4.63 Cigna — Cigna Medicare: $3.30 Devoted Medicare — Devoted Health Medicare Advantage: $4.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$18	$3.42	$2.91 – $20
Blood clotting test (partial thromboplastin time, PTT): 10 of 56 insurance plan rates Aetna — Aetna Better Health CHIP: $9 Aetna — Aetna Commercial: $14.64 Aetna — Aetna Medicare: $6.25 American Health Plans — American Health Plans Medicare: $6.01 Amerihealth — Amerihealth Caritas D-SNP Medicare: $6.31 Amerihealth — Amerihealth Medicaid CHC: $7.50 Amerihealth — Amerihealth Medicaid HC: $7.50 Cigna — Cigna Commercial: $6.49 Cigna — Cigna Medicare: $4.63 Devoted Medicare — Devoted Health Medicare Advantage: $6.19
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC THROMBOPLASTIN TIME (APTT)	$51	$41.31	$2.91 – $20
Blood clotting test (partial thromboplastin time, PTT): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $9 Aetna — Aetna Commercial: $14.64 Aetna — Aetna Medicare: $6.25 American Health Plans — American Health Plans Medicare: $6.01 Amerihealth — Amerihealth Caritas D-SNP Medicare: $6.31 Amerihealth — Amerihealth Medicaid CHC: $7.50 Amerihealth — Amerihealth Medicaid HC: $7.50 Cigna — Cigna Commercial: $6.49 Cigna — Cigna Medicare: $4.63 Devoted Medicare — Devoted Health Medicare Advantage: $6.19
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) In the file: HC THROMBOPLASTIN TIME (APTT)	$51	$41.31	$3.97 – $20
Blood clotting test (partial thromboplastin time, PTT): 10 of 19 insurance plan rates Highmark — Highmark Blue High Performance: $3.97 Highmark — Highmark Community Blue: $3.97 Highmark — Highmark Connect Blue: $3.97 Highmark — Highmark Indemnity: $3.97 Highmark — Highmark Managed Care: $3.97 Highmark — Highmark My Blue Access: $3.97 Highmark — Highmark My Direct Blue: $3.97 Highmark — Highmark Performance Blue: $3.97 Highmark — Highmark Social Mission Indemnity: $3.97 Highmark — Highmark Social Mission Managed Care: $3.97

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL	$113	$21.47	$32.93 – $424.14
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $140.10 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $192.64 Amerihealth — Amerihealth Medicaid HC: $192.64 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: HC CT HEAD/BRAIN WO CNTRST	$1,465	$1,186.65	$47.75 – $335.11
CT scan of the head or brain, without contrast: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $140.10 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $192.64 Amerihealth — Amerihealth Medicaid HC: $192.64 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) In the file: HC CT HEAD/BRAIN WO CNTRST	$1,465	$1,186.65	$88.46 – $212.91
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $134.51 Highmark — Highmark Community Blue: $134.51 Highmark — Highmark Connect Blue: $134.51 Highmark — Highmark Indemnity: $134.51 Highmark — Highmark Managed Care: $134.51 Highmark — Highmark My Blue Access: $134.51 Highmark — Highmark My Direct Blue: $134.51 Highmark — Highmark Performance Blue: $134.51 Highmark — Highmark Social Mission Indemnity: $134.51 Highmark — Highmark Social Mission Managed Care: $134.51
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$305	$57.95	$73.50 – $1,969.98
MRI of the brain, before and after contrast: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $406.80 Aetna — Aetna Commercial: $836.93 Aetna — Aetna Medicare: $357.31 American Health Plans — American Health Plans Medicare: $343.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $360.74 Amerihealth — Amerihealth Medicaid CHC: $559.35 Amerihealth — Amerihealth Medicaid HC: $559.35 Cigna — Cigna Commercial: $800.99 Cigna — Cigna Medicare: $367.62 Devoted Medicare — Devoted Health Medicare Advantage: $353.87
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HC MRI BRAIN W/WO CNTRST	$5,089	$4,122.09	$160.38 – $1,125.43
MRI of the brain, before and after contrast: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $406.80 Aetna — Aetna Commercial: $836.93 Aetna — Aetna Medicare: $357.31 American Health Plans — American Health Plans Medicare: $343.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $360.74 Amerihealth — Amerihealth Medicaid CHC: $559.35 Amerihealth — Amerihealth Medicaid HC: $559.35 Cigna — Cigna Commercial: $800.99 Cigna — Cigna Medicare: $367.62 Devoted Medicare — Devoted Health Medicare Advantage: $353.87
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) In the file: HC MRI BRAIN W/WO CNTRST	$5,089	$4,122.09	$266.06 – $671
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $405.19 Highmark — Highmark Community Blue: $405.19 Highmark — Highmark Connect Blue: $405.19 Highmark — Highmark Indemnity: $405.19 Highmark — Highmark Managed Care: $405.19 Highmark — Highmark My Blue Access: $405.19 Highmark — Highmark My Direct Blue: $405.19 Highmark — Highmark Performance Blue: $405.19 Highmark — Highmark Social Mission Indemnity: $405.19 Highmark — Highmark Social Mission Managed Care: $405.19
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$29	$5.51	$8.58 – $277.47
Chest X-ray, 2 views: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $28.37 Aetna — Aetna Commercial: $206.34 Aetna — Aetna Medicare: $88.09 American Health Plans — American Health Plans Medicare: $84.71 Amerihealth — Amerihealth Caritas D-SNP Medicare: $88.94 Amerihealth — Amerihealth Medicaid CHC: $39.01 Amerihealth — Amerihealth Medicaid HC: $39.01 Cigna — Cigna Commercial: $197.48 Cigna — Cigna Medicare: $90.64 Devoted Medicare — Devoted Health Medicare Advantage: $87.25
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HC XR CHEST 2V	$575	$465.75	$23.76 – $277.47
Chest X-ray, 2 views: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $28.37 Aetna — Aetna Commercial: $206.34 Aetna — Aetna Medicare: $88.09 American Health Plans — American Health Plans Medicare: $84.71 Amerihealth — Amerihealth Caritas D-SNP Medicare: $88.94 Amerihealth — Amerihealth Medicaid CHC: $39.01 Amerihealth — Amerihealth Medicaid HC: $39.01 Cigna — Cigna Commercial: $197.48 Cigna — Cigna Medicare: $90.64 Devoted Medicare — Devoted Health Medicare Advantage: $87.25
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) In the file: HC XR CHEST 2V	$575	$465.75	$27.31 – $60.19
Chest X-ray, 2 views: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $40.80 Highmark — Highmark Community Blue: $40.80 Highmark — Highmark Connect Blue: $40.80 Highmark — Highmark Indemnity: $40.80 Highmark — Highmark Managed Care: $40.80 Highmark — Highmark My Blue Access: $40.80 Highmark — Highmark My Direct Blue: $40.80 Highmark — Highmark Performance Blue: $40.80 Highmark — Highmark Social Mission Indemnity: $40.80 Highmark — Highmark Social Mission Managed Care: $40.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$36	$6.84	$10.25 – $335.11
X-ray of the lower spine, at least 4 views: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $43.94 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $60.42 Amerihealth — Amerihealth Medicaid HC: $60.42 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HC XR SPINE LUMBOSACRAL MIN 4V	$694	$562.14	$36 – $335.11
X-ray of the lower spine, at least 4 views: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $43.94 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $60.42 Amerihealth — Amerihealth Medicaid HC: $60.42 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) In the file: HC XR SPINE LUMBOSACRAL MIN 4V	$694	$562.14	$42.14 – $88.68
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $63.01 Highmark — Highmark Community Blue: $63.01 Highmark — Highmark Connect Blue: $63.01 Highmark — Highmark Indemnity: $63.01 Highmark — Highmark Managed Care: $63.01 Highmark — Highmark My Blue Access: $63.01 Highmark — Highmark My Direct Blue: $63.01 Highmark — Highmark Performance Blue: $63.01 Highmark — Highmark Social Mission Indemnity: $63.01 Highmark — Highmark Social Mission Managed Care: $63.01
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$197	$37.43	$57.76 – $1,007.07
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $307.38 Aetna — Aetna Commercial: $566.47 Aetna — Aetna Medicare: $241.84 American Health Plans — American Health Plans Medicare: $232.54 Amerihealth — Amerihealth Caritas D-SNP Medicare: $244.17 Amerihealth — Amerihealth Medicaid CHC: $422.65 Amerihealth — Amerihealth Medicaid HC: $422.65 Cigna — Cigna Commercial: $542.14 Cigna — Cigna Medicare: $248.82 Devoted Medicare — Devoted Health Medicare Advantage: $239.52
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HC MRI LUMB SPINE WO CNTRST	$2,756	$2,232.36	$108.55 – $761.74
MRI of the lower back (lumbar spine), without contrast: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $307.38 Aetna — Aetna Commercial: $566.47 Aetna — Aetna Medicare: $241.84 American Health Plans — American Health Plans Medicare: $232.54 Amerihealth — Amerihealth Caritas D-SNP Medicare: $244.17 Amerihealth — Amerihealth Medicaid CHC: $422.65 Amerihealth — Amerihealth Medicaid HC: $422.65 Cigna — Cigna Commercial: $542.14 Cigna — Cigna Medicare: $248.82 Devoted Medicare — Devoted Health Medicare Advantage: $239.52
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) In the file: HC MRI LUMB SPINE WO CNTRST	$2,756	$2,232.36	$159.94 – $400.37
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $243.44 Highmark — Highmark Community Blue: $243.44 Highmark — Highmark Connect Blue: $243.44 Highmark — Highmark Indemnity: $243.44 Highmark — Highmark Managed Care: $243.44 Highmark — Highmark My Blue Access: $243.44 Highmark — Highmark My Direct Blue: $243.44 Highmark — Highmark Performance Blue: $243.44 Highmark — Highmark Social Mission Indemnity: $243.44 Highmark — Highmark Social Mission Managed Care: $243.44
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CHG CT PELVIS W/CONTRAST MATERIAL	$153	$29.07	$45.07 – $596.38
CT scan of the pelvis, with contrast: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $168.11 Aetna — Aetna Commercial: $417.19 Aetna — Aetna Medicare: $178.11 American Health Plans — American Health Plans Medicare: $171.26 Amerihealth — Amerihealth Caritas D-SNP Medicare: $179.82 Amerihealth — Amerihealth Medicaid CHC: $231.15 Amerihealth — Amerihealth Medicaid HC: $231.15 Cigna — Cigna Commercial: $399.27 Cigna — Cigna Medicare: $183.25 Devoted Medicare — Devoted Health Medicare Advantage: $176.40
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HC CT PELVIS W CNTRST	$2,452	$1,986.12	$79.94 – $561
CT scan of the pelvis, with contrast: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $168.11 Aetna — Aetna Commercial: $417.19 Aetna — Aetna Medicare: $178.11 American Health Plans — American Health Plans Medicare: $171.26 Amerihealth — Amerihealth Caritas D-SNP Medicare: $179.82 Amerihealth — Amerihealth Medicaid CHC: $231.15 Amerihealth — Amerihealth Medicaid HC: $231.15 Cigna — Cigna Commercial: $399.27 Cigna — Cigna Medicare: $183.25 Devoted Medicare — Devoted Health Medicare Advantage: $176.40
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) In the file: HC CT PELVIS W CNTRST	$2,452	$1,986.12	$188.61 – $443.34
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $290.89 Highmark — Highmark Community Blue: $290.89 Highmark — Highmark Connect Blue: $290.89 Highmark — Highmark Indemnity: $290.89 Highmark — Highmark Managed Care: $290.89 Highmark — Highmark My Blue Access: $290.89 Highmark — Highmark My Direct Blue: $290.89 Highmark — Highmark Performance Blue: $290.89 Highmark — Highmark Social Mission Indemnity: $290.89 Highmark — Highmark Social Mission Managed Care: $290.89
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$180	$34.20	$52.80 – $868.34
MRI of a leg joint (such as the knee), without contrast: 10 of 45 insurance plan rates Aetna — Aetna Commercial: $566.47 Aetna — Aetna Medicare: $241.84 American Health Plans — American Health Plans Medicare: $232.54 Amerihealth — Amerihealth Caritas D-SNP Medicare: $244.17 Cigna — Cigna Commercial: $542.14 Cigna — Cigna Medicare: $248.82 Devoted Medicare — Devoted Health Medicare Advantage: $239.52 Highmark — Highmark Blue High Performance: $257.88 Highmark — Highmark Community Blue: $257.88 Highmark — Highmark Community Blue Medicare HMO: $241.84
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HC MRI LE JNT WO CNTRST	$2,756	$2,232.36	$108.55 – $761.74
MRI of a leg joint (such as the knee), without contrast: 10 of 44 insurance plan rates Aetna — Aetna Commercial: $566.47 Aetna — Aetna Medicare: $241.84 American Health Plans — American Health Plans Medicare: $232.54 Amerihealth — Amerihealth Caritas D-SNP Medicare: $244.17 Cigna — Cigna Commercial: $542.14 Cigna — Cigna Medicare: $248.82 Devoted Medicare — Devoted Health Medicare Advantage: $239.52 Highmark — Highmark Blue High Performance: $257.88 Highmark — Highmark Community Blue: $257.88 Highmark — Highmark Community Blue Medicare HMO: $241.84
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) In the file: HC MRI LE JNT WO CNTRST	$2,756	$2,232.36	$169.22 – $420.39
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $257.88 Highmark — Highmark Community Blue: $257.88 Highmark — Highmark Connect Blue: $257.88 Highmark — Highmark Indemnity: $257.88 Highmark — Highmark Managed Care: $257.88 Highmark — Highmark My Blue Access: $257.88 Highmark — Highmark My Direct Blue: $257.88 Highmark — Highmark Performance Blue: $257.88 Highmark — Highmark Social Mission Indemnity: $257.88 Highmark — Highmark Social Mission Managed Care: $257.88
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$243	$46.17	$70.54 – $2,042.42
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $315.79 Aetna — Aetna Commercial: $836.93 Aetna — Aetna Medicare: $357.31 American Health Plans — American Health Plans Medicare: $343.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $360.74 Amerihealth — Amerihealth Medicaid CHC: $434.21 Amerihealth — Amerihealth Medicaid HC: $434.21 Cigna — Cigna Commercial: $800.99 Cigna — Cigna Medicare: $367.62 Devoted Medicare — Devoted Health Medicare Advantage: $353.87
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HC CT ABD&PELVIS W CNTRST	$4,919	$3,984.39	$160.38 – $1,125.43
CT scan of the abdomen and pelvis, with contrast: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $315.79 Aetna — Aetna Commercial: $836.93 Aetna — Aetna Medicare: $357.31 American Health Plans — American Health Plans Medicare: $343.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $360.74 Amerihealth — Amerihealth Medicaid CHC: $434.21 Amerihealth — Amerihealth Medicaid HC: $434.21 Cigna — Cigna Commercial: $800.99 Cigna — Cigna Medicare: $367.62 Devoted Medicare — Devoted Health Medicare Advantage: $353.87
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) In the file: HC CT ABD&PELVIS W CNTRST	$4,919	$3,984.39	$252.74 – $600.72
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $385.37 Highmark — Highmark Community Blue: $385.37 Highmark — Highmark Connect Blue: $385.37 Highmark — Highmark Indemnity: $385.37 Highmark — Highmark Managed Care: $385.37 Highmark — Highmark My Blue Access: $385.37 Highmark — Highmark My Direct Blue: $385.37 Highmark — Highmark Performance Blue: $385.37 Highmark — Highmark Social Mission Indemnity: $385.37 Highmark — Highmark Social Mission Managed Care: $385.37
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$107	$20.33	$31.27 – $335.11
Ultrasound of the abdomen, complete: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $114.32 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $157.20 Amerihealth — Amerihealth Medicaid HC: $157.20 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HC US ABD COMPLT	$758	$613.98	$47.75 – $335.11
Ultrasound of the abdomen, complete: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $114.32 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $157.20 Amerihealth — Amerihealth Medicaid HC: $157.20 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) In the file: HC US ABD COMPLT	$758	$613.98	$94.51 – $226.89
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $144 Highmark — Highmark Community Blue: $144 Highmark — Highmark Connect Blue: $144 Highmark — Highmark Indemnity: $144 Highmark — Highmark Managed Care: $144 Highmark — Highmark My Blue Access: $144 Highmark — Highmark My Direct Blue: $144 Highmark — Highmark Performance Blue: $144 Highmark — Highmark Social Mission Indemnity: $144 Highmark — Highmark Social Mission Managed Care: $144
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$133	$25.27	$32.55 – $335.11
Pregnancy ultrasound (after the first trimester): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $93 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $127.88 Amerihealth — Amerihealth Medicaid HC: $127.88 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HC US OB OVER 14WKS SNGL	$758	$613.98	$47.75 – $335.11
Pregnancy ultrasound (after the first trimester): 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $93 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $127.88 Amerihealth — Amerihealth Medicaid HC: $127.88 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) In the file: HC US OB OVER 14WKS SNGL	$758	$613.98	$110.35 – $258.56
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $164.40 Highmark — Highmark Community Blue: $164.40 Highmark — Highmark Connect Blue: $164.40 Highmark — Highmark Indemnity: $164.40 Highmark — Highmark Managed Care: $164.40 Highmark — Highmark My Blue Access: $164.40 Highmark — Highmark My Direct Blue: $164.40 Highmark — Highmark Performance Blue: $164.40 Highmark — Highmark Social Mission Indemnity: $164.40 Highmark — Highmark Social Mission Managed Care: $164.40
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: CHG US TRANSVAGINAL	$92	$17.48	$26.86 – $335.11
Transvaginal ultrasound: 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $91.80 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $126.23 Amerihealth — Amerihealth Medicaid HC: $126.23 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HC US TV	$758	$613.98	$47.75 – $335.11
Transvaginal ultrasound: 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $91.80 Aetna — Aetna Commercial: $249.21 Aetna — Aetna Medicare: $106.39 American Health Plans — American Health Plans Medicare: $102.30 Amerihealth — Amerihealth Caritas D-SNP Medicare: $107.42 Amerihealth — Amerihealth Medicaid CHC: $126.23 Amerihealth — Amerihealth Medicaid HC: $126.23 Cigna — Cigna Commercial: $238.51 Cigna — Cigna Medicare: $109.46 Devoted Medicare — Devoted Health Medicare Advantage: $105.37
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) In the file: HC US TV	$758	$613.98	$96.82 – $226.34
Transvaginal ultrasound: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $147.72 Highmark — Highmark Community Blue: $147.72 Highmark — Highmark Connect Blue: $147.72 Highmark — Highmark Indemnity: $147.72 Highmark — Highmark Managed Care: $147.72 Highmark — Highmark My Blue Access: $147.72 Highmark — Highmark My Direct Blue: $147.72 Highmark — Highmark Performance Blue: $147.72 Highmark — Highmark Social Mission Indemnity: $147.72 Highmark — Highmark Social Mission Managed Care: $147.72
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$107	$20.33	$31.53 – $246.86
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates Aetna — Aetna Better Health CHIP: $122.89 Amerihealth — Amerihealth Medicaid CHC: $168.98 Amerihealth — Amerihealth Medicaid HC: $168.98 Cigna — Cigna Commercial: $194.59 Geisinger — Geisinger CHIP: $163.86 Geisinger — Geisinger Medicaid HC: $163.86 Highmark — Highmark Blue High Performance: $149.44 Highmark — Highmark Community Blue: $149.44 Highmark — Highmark Connect Blue: $149.44 Highmark — Highmark Indemnity: $149.44
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HC DX MAMMO INCL CAD UNI	$466	$377.46	$101.82 – $246.86
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna — Aetna Better Health CHIP: $122.89 Amerihealth — Amerihealth Medicaid CHC: $168.98 Amerihealth — Amerihealth Medicaid HC: $168.98 Geisinger — Geisinger CHIP: $163.86 Geisinger — Geisinger Medicaid HC: $163.86 Highmark — Highmark Blue High Performance: $149.44 Highmark — Highmark Community Blue: $149.44 Highmark — Highmark Connect Blue: $149.44 Highmark — Highmark Indemnity: $149.44 Highmark — Highmark Managed Care: $149.44
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) In the file: HC DX MAMMO INCL CAD UNI	$466	$377.46	$101.82 – $246.86
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $149.44 Highmark — Highmark Community Blue: $149.44 Highmark — Highmark Connect Blue: $149.44 Highmark — Highmark Indemnity: $149.44 Highmark — Highmark Managed Care: $149.44 Highmark — Highmark My Blue Access: $149.44 Highmark — Highmark My Direct Blue: $149.44 Highmark — Highmark Performance Blue: $149.44 Highmark — Highmark Social Mission Indemnity: $149.44 Highmark — Highmark Social Mission Managed Care: $149.44
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$132	$25.08	$38.73 – $348.82
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates Aetna — Aetna Better Health CHIP: $155.82 Amerihealth — Amerihealth Medicaid CHC: $214.25 Amerihealth — Amerihealth Medicaid HC: $214.25 Cigna — Cigna Commercial: $246.24 Geisinger — Geisinger CHIP: $207.76 Geisinger — Geisinger Medicaid HC: $207.76 Highmark — Highmark Blue High Performance: $189.18 Highmark — Highmark Community Blue: $189.18 Highmark — Highmark Connect Blue: $189.18 Highmark — Highmark Indemnity: $189.18
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HC DX MAMMO INCL CAD BI	$580	$469.80	$128.83 – $310.74
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates Aetna — Aetna Better Health CHIP: $155.82 Amerihealth — Amerihealth Medicaid CHC: $214.25 Amerihealth — Amerihealth Medicaid HC: $214.25 Geisinger — Geisinger CHIP: $207.76 Geisinger — Geisinger Medicaid HC: $207.76 Highmark — Highmark Blue High Performance: $189.18 Highmark — Highmark Community Blue: $189.18 Highmark — Highmark Connect Blue: $189.18 Highmark — Highmark Indemnity: $189.18 Highmark — Highmark Managed Care: $189.18
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) In the file: HC DX MAMMO INCL CAD BI	$580	$469.80	$128.83 – $310.74
Diagnostic mammogram, both breasts: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $189.18 Highmark — Highmark Community Blue: $189.18 Highmark — Highmark Connect Blue: $189.18 Highmark — Highmark Indemnity: $189.18 Highmark — Highmark Managed Care: $189.18 Highmark — Highmark My Blue Access: $189.18 Highmark — Highmark My Direct Blue: $189.18 Highmark — Highmark Performance Blue: $189.18 Highmark — Highmark Social Mission Indemnity: $189.18 Highmark — Highmark Social Mission Managed Care: $189.18
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$102	$19.38	$29.58 – $284.95
Screening mammogram, both breasts: 10 of 31 insurance plan rates Aetna — Aetna Better Health CHIP: $125.64 Amerihealth — Amerihealth Medicaid CHC: $172.76 Amerihealth — Amerihealth Medicaid HC: $172.76 Cigna — Cigna Commercial: $198.46 Geisinger — Geisinger CHIP: $167.52 Geisinger — Geisinger Medicaid HC: $167.52 Highmark — Highmark Blue High Performance: $152.61 Highmark — Highmark Community Blue: $152.61 Highmark — Highmark Connect Blue: $152.61 Highmark — Highmark Indemnity: $152.61
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HC SCR MAMMO BI INCL CAD	$476	$385.56	$103.90 – $251.79
Screening mammogram, both breasts: 10 of 29 insurance plan rates Aetna — Aetna Better Health CHIP: $125.64 Amerihealth — Amerihealth Medicaid CHC: $172.76 Amerihealth — Amerihealth Medicaid HC: $172.76 Geisinger — Geisinger CHIP: $167.52 Geisinger — Geisinger Medicaid HC: $167.52 Highmark — Highmark Blue High Performance: $152.61 Highmark — Highmark Community Blue: $152.61 Highmark — Highmark Connect Blue: $152.61 Highmark — Highmark Indemnity: $152.61 Highmark — Highmark Managed Care: $152.61
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) In the file: HC SCR MAMMO BI INCL CAD	$476	$385.56	$103.90 – $251.79
Screening mammogram, both breasts: 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $152.61 Highmark — Highmark Community Blue: $152.61 Highmark — Highmark Connect Blue: $152.61 Highmark — Highmark Indemnity: $152.61 Highmark — Highmark Managed Care: $152.61 Highmark — Highmark My Blue Access: $152.61 Highmark — Highmark My Direct Blue: $152.61 Highmark — Highmark Performance Blue: $152.61 Highmark — Highmark Social Mission Indemnity: $152.61 Highmark — Highmark Social Mission Managed Care: $152.61

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$40	$7.60	$11.67 – $52.50
Electrocardiogram (ECG/EKG) with reading: 10 of 37 insurance plan rates Aetna — Aetna Better Health CHIP: $23.06 Amerihealth — Amerihealth Caritas CHC Medicaid: $27.87 Amerihealth — Amerihealth Caritas D-SNP Medicare: $20.18 Amerihealth — Amerihealth Caritas HC Medicaid: $27.87 Amerihealth — Amerihealth Caritas Medicare (NY): $20.18 Amerihealth — Amerihealth Medicaid CHC: $31.71 Amerihealth — Amerihealth Medicaid HC: $31.71 Cigna — Cigna Commercial: $22.56 Geisinger — Geisinger CHIP: $27.87 Geisinger — Geisinger Medicaid HC: $27.87
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	Not listed in the file	Not listed in the file	$11.67 – $52.50
Electrocardiogram (ECG/EKG) with reading: 10 of 27 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $27.87 Amerihealth — Amerihealth Caritas D-SNP Medicare: $20.18 Amerihealth — Amerihealth Caritas HC Medicaid: $27.87 Amerihealth — Amerihealth Caritas Medicare (NY): $20.18 Cigna — Cigna Commercial: $22.56 Geisinger — Geisinger CHIP: $27.87 Geisinger — Geisinger Medicaid HC: $27.87 Highmark — Highmark Blue High Performance: $16.69 Highmark — Highmark Community Blue: $16.69 Highmark — Highmark Connect Blue: $16.69
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · modifier 00 In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	Not listed in the file	Not listed in the file	$11.67 – $52.50
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan United Healthcare — United Healthcare Of OH Medicaid: $31.65
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$646	$122.74	$186.28 – $10,135.93
Left heart catheterization (diagnostic): 10 of 45 insurance plan rates Aetna — Aetna Commercial: $7,537.59 Aetna — Aetna Medicare: $3,218.02 American Health Plans — American Health Plans Medicare: $3,094.25 Amerihealth — Amerihealth Caritas D-SNP Medicare: $3,248.96 Cigna — Cigna Commercial: $7,610.96 Cigna — Cigna Medicare: $3,310.85 Devoted Medicare — Devoted Health Medicare Advantage: $3,187.08 Highmark — Highmark Blue High Performance: $1,202.46 Highmark — Highmark Community Blue: $1,202.46 Highmark — Highmark Community Blue Medicare HMO: $3,218.02
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: HC LT HRT CATH S&I	$12,223	$9,900.63	$713.07 – $10,135.93
Left heart catheterization (diagnostic): 10 of 44 insurance plan rates Aetna — Aetna Commercial: $7,537.59 Aetna — Aetna Medicare: $3,218.02 American Health Plans — American Health Plans Medicare: $3,094.25 Amerihealth — Amerihealth Caritas D-SNP Medicare: $3,248.96 Cigna — Cigna Commercial: $7,610.96 Cigna — Cigna Medicare: $3,310.85 Devoted Medicare — Devoted Health Medicare Advantage: $3,187.08 Highmark — Highmark Blue High Performance: $1,202.46 Highmark — Highmark Community Blue: $1,202.46 Highmark — Highmark Community Blue Medicare HMO: $3,218.02
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) In the file: HC LT HRT CATH S&I	$12,223	$9,900.63	$713.07 – $1,688.15
Left heart catheterization (diagnostic): 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $1,202.46 Highmark — Highmark Community Blue: $1,202.46 Highmark — Highmark Connect Blue: $1,202.46 Highmark — Highmark Indemnity: $1,202.46 Highmark — Highmark Managed Care: $1,202.46 Highmark — Highmark My Blue Access: $1,202.46 Highmark — Highmark My Direct Blue: $1,202.46 Highmark — Highmark Performance Blue: $1,202.46 Highmark — Highmark Social Mission Indemnity: $1,202.46 Highmark — Highmark Social Mission Managed Care: $1,202.46
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$1,047	$198.93	$285.67 – $23,912.51
Heart rhythm study (electrophysiology evaluation): 10 of 51 insurance plan rates Aetna — Aetna Commercial: $17,782.57 Aetna — Aetna Medicare: $7,591.90 American Health Plans — American Health Plans Medicare: $7,299.90 Amerihealth — Amerihealth Caritas CHC Medicaid: $985.87 Amerihealth — Amerihealth Caritas D-SNP Medicare: $713.91 Amerihealth — Amerihealth Caritas HC Medicaid: $985.87 Amerihealth — Amerihealth Caritas Medicare (NY): $713.91 Cigna — Cigna Commercial: $17,955.65 Cigna — Cigna Medicare: $7,810.90 Devoted Medicare — Devoted Health Medicare Advantage: $7,518.90
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: HC EPS WO ARRYTH	$28,834	$23,355.54	$588.42 – $23,912.51
Heart rhythm study (electrophysiology evaluation): 10 of 50 insurance plan rates Aetna — Aetna Commercial: $17,782.57 Aetna — Aetna Medicare: $7,591.90 American Health Plans — American Health Plans Medicare: $7,299.90 Amerihealth — Amerihealth Caritas CHC Medicaid: $985.87 Amerihealth — Amerihealth Caritas D-SNP Medicare: $713.91 Amerihealth — Amerihealth Caritas HC Medicaid: $985.87 Amerihealth — Amerihealth Caritas Medicare (NY): $713.91 Cigna — Cigna Commercial: $17,955.65 Cigna — Cigna Medicare: $7,810.90 Devoted Medicare — Devoted Health Medicare Advantage: $7,518.90
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) In the file: HC EPS WO ARRYTH	$28,834	$23,355.54	$588.42 – $1,361.79
Heart rhythm study (electrophysiology evaluation): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $985.87 Amerihealth — Amerihealth Caritas D-SNP Medicare: $713.91 Amerihealth — Amerihealth Caritas HC Medicaid: $985.87 Amerihealth — Amerihealth Caritas Medicare (NY): $713.91 Geisinger — Geisinger CHIP: $985.87 Geisinger — Geisinger Medicaid HC: $985.87 Highmark — Highmark Blue High Performance: $953.40 Highmark — Highmark Community Blue: $953.40 Highmark — Highmark Connect Blue: $953.40 Highmark — Highmark Indemnity: $953.40
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$2,593	$492.67	$744.28 – $77,309.07
Heart rhythm study with ablation for atrial fibrillation: 10 of 51 insurance plan rates Aetna — Aetna Commercial: $57,490.97 Aetna — Aetna Medicare: $24,544.59 American Health Plans — American Health Plans Medicare: $23,600.56 Amerihealth — Amerihealth Caritas CHC Medicaid: $1,268.03 Amerihealth — Amerihealth Caritas D-SNP Medicare: $24,780.59 Amerihealth — Amerihealth Caritas HC Medicaid: $1,268.03 Amerihealth — Amerihealth Caritas Medicare (NY): $918.23 Cigna — Cigna Commercial: $58,050.54 Cigna — Cigna Medicare: $25,252.60 Devoted Medicare — Devoted Health Medicare Advantage: $24,308.58
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$93,223	$75,510.63	$744.28 – $77,309.07
Heart rhythm study with ablation for atrial fibrillation: 10 of 50 insurance plan rates Aetna — Aetna Commercial: $57,490.97 Aetna — Aetna Medicare: $24,544.59 American Health Plans — American Health Plans Medicare: $23,600.56 Amerihealth — Amerihealth Caritas CHC Medicaid: $1,268.03 Amerihealth — Amerihealth Caritas D-SNP Medicare: $24,780.59 Amerihealth — Amerihealth Caritas HC Medicaid: $1,268.03 Amerihealth — Amerihealth Caritas Medicare (NY): $918.23 Cigna — Cigna Commercial: $58,050.54 Cigna — Cigna Medicare: $25,252.60 Devoted Medicare — Devoted Health Medicare Advantage: $24,308.58
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) In the file: HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$93,223	$75,510.63	$744.28 – $2,191.61
Heart rhythm study with ablation for atrial fibrillation: 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $1,268.03 Amerihealth — Amerihealth Caritas D-SNP Medicare: $918.23 Amerihealth — Amerihealth Caritas HC Medicaid: $1,268.03 Amerihealth — Amerihealth Caritas Medicare (NY): $918.23 Geisinger — Geisinger CHIP: $1,268.03 Geisinger — Geisinger Medicaid HC: $1,268.03 Highmark — Highmark Blue High Performance: $1,255.52 Highmark — Highmark Community Blue: $1,255.52 Highmark — Highmark Connect Blue: $1,255.52 Highmark — Highmark Indemnity: $1,255.52
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$327	$62.13	$80.05 – $3,206.12
Sleep study (overnight, in a sleep lab): 10 of 55 insurance plan rates Aetna — Aetna Better Health CHIP: $415.87 Aetna — Aetna Commercial: $2,384.23 Aetna — Aetna Medicare: $1,017.90 American Health Plans — American Health Plans Medicare: $978.75 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,027.69 Amerihealth — Amerihealth Medicaid CHC: $571.82 Amerihealth — Amerihealth Medicaid HC: $571.82 Cigna — Cigna Commercial: $2,407.44 Cigna — Cigna Medicare: $1,047.26 Devoted Medicare — Devoted Health Medicare Advantage: $1,008.11
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HC POLYSOMNOGRAPHY >=4	$4,833	$3,914.73	$398.54 – $3,206.12
Sleep study (overnight, in a sleep lab): 10 of 54 insurance plan rates Aetna — Aetna Better Health CHIP: $415.87 Aetna — Aetna Commercial: $2,384.23 Aetna — Aetna Medicare: $1,017.90 American Health Plans — American Health Plans Medicare: $978.75 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,027.69 Amerihealth — Amerihealth Medicaid CHC: $571.82 Amerihealth — Amerihealth Medicaid HC: $571.82 Cigna — Cigna Commercial: $2,407.44 Cigna — Cigna Medicare: $1,047.26 Devoted Medicare — Devoted Health Medicare Advantage: $1,008.11
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) In the file: HC POLYSOMNOGRAPHY >=4	$4,833	$3,914.73	$504.79 – $1,118.62
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $766.02 Highmark — Highmark Community Blue: $766.02 Highmark — Highmark Connect Blue: $766.02 Highmark — Highmark Indemnity: $766.02 Highmark — Highmark Managed Care: $766.02 Highmark — Highmark My Blue Access: $766.02 Highmark — Highmark My Direct Blue: $766.02 Highmark — Highmark Performance Blue: $766.02 Highmark — Highmark Social Mission Indemnity: $766.02 Highmark — Highmark Social Mission Managed Care: $766.02

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$83	$15.77	$8.80 – $80
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 50 insurance plan rates Aetna — Aetna Commercial: $67.60 Aetna — Aetna Medicare: $28.86 American Health Plans — American Health Plans Medicare: $27.75 Amerihealth — Amerihealth Caritas CHC Medicaid: $12.15 Amerihealth — Amerihealth Caritas D-SNP Medicare: $29.14 Amerihealth — Amerihealth Caritas HC Medicaid: $12.15 Amerihealth — Amerihealth Caritas Medicare (NY): $8.80 Cigna — Cigna Commercial: $46.59 Cigna — Cigna Medicare: $29.69 Devoted Medicare — Devoted Health Medicare Advantage: $28.58
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC THRPY EXERCISE EA 15MIN	$156	$126.36	$8.80 – $80
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 48 insurance plan rates Aetna — Aetna Commercial: $67.60 Aetna — Aetna Medicare: $28.86 American Health Plans — American Health Plans Medicare: $27.75 Amerihealth — Amerihealth Caritas CHC Medicaid: $12.15 Amerihealth — Amerihealth Caritas D-SNP Medicare: $29.14 Amerihealth — Amerihealth Caritas HC Medicaid: $12.15 Amerihealth — Amerihealth Caritas Medicare (NY): $8.80 Cigna — Cigna Medicare: $29.69 Devoted Medicare — Devoted Health Medicare Advantage: $28.58 Geisinger — Geisinger CHIP: $12.15
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) In the file: HC THRPY EXERCISE EA 15MIN	$156	$126.36	$8.80 – $46.36
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $12.15 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8.80 Amerihealth — Amerihealth Caritas HC Medicaid: $12.15 Amerihealth — Amerihealth Caritas Medicare (NY): $8.80 Geisinger — Geisinger CHIP: $12.15 Geisinger — Geisinger Medicaid HC: $12.15 Highmark — Highmark Blue High Performance: $26.13 Highmark — Highmark Community Blue: $26.13 Highmark — Highmark Connect Blue: $26.13 Highmark — Highmark Indemnity: $26.13
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC PT EVAL LOW COMPLEX 20 MIN	$426	$345.06	$45.77 – $230.18
Physical therapy evaluation (low complexity): 10 of 42 insurance plan rates Aetna — Aetna Commercial: $230.18 Aetna — Aetna Medicare: $98.27 American Health Plans — American Health Plans Medicare: $94.49 Amerihealth — Amerihealth Caritas D-SNP Medicare: $99.21 Cigna — Cigna Medicare: $101.10 Devoted Medicare — Devoted Health Medicare Advantage: $97.32 Highmark — Highmark Blue High Performance: $130.72 Highmark — Highmark Community Blue: $161.07 Highmark — Highmark Community Blue Medicare HMO: $98.27 Highmark — Highmark Community Blue Medicare PPO: $86.93
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) In the file: HC PT EVAL LOW COMPLEX 20 MIN	$426	$345.06	$82.80 – $129.28
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $89.36 Highmark — Highmark Community Blue: $89.36 Highmark — Highmark Connect Blue: $89.36 Highmark — Highmark Indemnity: $89.36 Highmark — Highmark Managed Care: $89.36 Highmark — Highmark My Blue Access: $89.36 Highmark — Highmark My Direct Blue: $89.36 Highmark — Highmark Performance Blue: $89.36 Highmark — Highmark Social Mission Indemnity: $89.36 Highmark — Highmark Social Mission Managed Care: $89.36
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PR PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	Not listed in the file	Not listed in the file	$73.15 – $159.35
Physical therapy evaluation (low complexity): rates for 2 insurance plans Cigna — Cigna Commercial: $159.35 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center Commercial: $99.08
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PR PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$282	$53.58	$40.53 – $913.34
Physical therapy evaluation (moderate complexity): 10 of 44 insurance plan rates Aetna — Aetna Commercial: $230.18 Aetna — Aetna Medicare: $98.27 American Health Plans — American Health Plans Medicare: $94.49 Amerihealth — Amerihealth Caritas D-SNP Medicare: $99.21 Cigna — Cigna Commercial: $159.35 Cigna — Cigna Medicare: $101.10 Devoted Medicare — Devoted Health Medicare Advantage: $97.32 Highmark — Highmark Blue High Performance: $130.72 Highmark — Highmark Community Blue: $161.07 Highmark — Highmark Community Blue Medicare HMO: $98.27
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC PT EVAL MOD COMPLEX 30 MIN	$665	$538.65	$40.53 – $913.34
Physical therapy evaluation (moderate complexity): 10 of 42 insurance plan rates Aetna — Aetna Commercial: $230.18 Aetna — Aetna Medicare: $98.27 American Health Plans — American Health Plans Medicare: $94.49 Amerihealth — Amerihealth Caritas D-SNP Medicare: $99.21 Cigna — Cigna Medicare: $101.10 Devoted Medicare — Devoted Health Medicare Advantage: $97.32 Highmark — Highmark Blue High Performance: $130.72 Highmark — Highmark Community Blue: $161.07 Highmark — Highmark Community Blue Medicare HMO: $98.27 Highmark — Highmark Community Blue Medicare PPO: $86.93
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) In the file: HC PT EVAL MOD COMPLEX 30 MIN	$665	$538.65	$82.80 – $129.28
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $89.36 Highmark — Highmark Community Blue: $89.36 Highmark — Highmark Connect Blue: $89.36 Highmark — Highmark Indemnity: $89.36 Highmark — Highmark Managed Care: $89.36 Highmark — Highmark My Blue Access: $89.36 Highmark — Highmark My Direct Blue: $89.36 Highmark — Highmark Performance Blue: $89.36 Highmark — Highmark Social Mission Indemnity: $89.36 Highmark — Highmark Social Mission Managed Care: $89.36
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC PT EVAL HIGH COMPLEX 45 MIN	$832	$673.92	$45.77 – $230.18
Physical therapy evaluation (high complexity): 10 of 42 insurance plan rates Aetna — Aetna Commercial: $230.18 Aetna — Aetna Medicare: $98.27 American Health Plans — American Health Plans Medicare: $94.49 Amerihealth — Amerihealth Caritas D-SNP Medicare: $99.21 Cigna — Cigna Medicare: $101.10 Devoted Medicare — Devoted Health Medicare Advantage: $97.32 Highmark — Highmark Blue High Performance: $130.72 Highmark — Highmark Community Blue: $161.07 Highmark — Highmark Community Blue Medicare HMO: $98.27 Highmark — Highmark Community Blue Medicare PPO: $86.93
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) In the file: HC PT EVAL HIGH COMPLEX 45 MIN	$832	$673.92	$82.80 – $129.28
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates Highmark — Highmark Blue High Performance: $89.36 Highmark — Highmark Community Blue: $89.36 Highmark — Highmark Connect Blue: $89.36 Highmark — Highmark Indemnity: $89.36 Highmark — Highmark Managed Care: $89.36 Highmark — Highmark My Blue Access: $89.36 Highmark — Highmark My Direct Blue: $89.36 Highmark — Highmark Performance Blue: $89.36 Highmark — Highmark Social Mission Indemnity: $89.36 Highmark — Highmark Social Mission Managed Care: $89.36
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PR PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	Not listed in the file	Not listed in the file	$73.15 – $159.35
Physical therapy evaluation (high complexity): rates for 2 insurance plans Cigna — Cigna Commercial: $159.35 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center Commercial: $115
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$203	$38.57	$32.32 – $506.32
Psychotherapy, 30 minutes: 10 of 57 insurance plan rates Aetna — Aetna Commercial: $376.53 Aetna — Aetna Medicare: $160.75 American Health Plans — American Health Plans Medicare: $154.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $162.30 Carelon — Carelon Armstrong County: $32.32 Carelon — Carelon Beaver County: $32.32 Carelon — Carelon Butler County: $32.32 Carelon — Carelon Indiana County: $32.32 Carelon — Carelon Lawrence County: $32.32 Carelon — Carelon Washington County: $32.32
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	Not listed in the file	Not listed in the file	$32.32 – $120.48
Psychotherapy, 30 minutes: 10 of 35 insurance plan rates American Health Plans — American Health Plans Medicare: $74.29 Carelon — Carelon Armstrong County: $32.32 Carelon — Carelon Beaver County: $32.32 Carelon — Carelon Butler County: $32.32 Carelon — Carelon Indiana County: $32.32 Carelon — Carelon Lawrence County: $32.32 Carelon — Carelon Washington County: $32.32 Carelon — Carelon Westmoreland County: $32.32 Cigna — Cigna Commercial: $111.45 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $42.50
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · modifier HE In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	Not listed in the file	Not listed in the file	$32.32 – $120.48
Psychotherapy, 30 minutes: rates for 4 insurance plans Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $51.98 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $51.98 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $51.98 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $51.98
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$267	$50.73	$62.40 – $506.32
Psychotherapy, 45 minutes: 10 of 57 insurance plan rates Aetna — Aetna Commercial: $376.53 Aetna — Aetna Medicare: $160.75 American Health Plans — American Health Plans Medicare: $154.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $162.30 Carelon — Carelon Armstrong County: $126.14 Carelon — Carelon Beaver County: $126.14 Carelon — Carelon Butler County: $126.14 Carelon — Carelon Indiana County: $126.14 Carelon — Carelon Lawrence County: $126.14 Carelon — Carelon Washington County: $126.14
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	Not listed in the file	Not listed in the file	$64.64 – $160.65
Psychotherapy, 45 minutes: 10 of 35 insurance plan rates American Health Plans — American Health Plans Medicare: $98 Carelon — Carelon Armstrong County: $126.14 Carelon — Carelon Beaver County: $126.14 Carelon — Carelon Butler County: $126.14 Carelon — Carelon Indiana County: $126.14 Carelon — Carelon Lawrence County: $126.14 Carelon — Carelon Washington County: $126.14 Carelon — Carelon Westmoreland County: $126.14 Cigna — Cigna Commercial: $147.32 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $105
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · modifier HE In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	Not listed in the file	Not listed in the file	$64.64 – $160.65
Psychotherapy, 45 minutes: rates for 4 insurance plans Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $82.50 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $82.50 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $82.50 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $82.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$396	$75.24	$72.15 – $506.32
Psychotherapy, 60 minutes: 10 of 58 insurance plan rates Aetna — Aetna Commercial: $376.53 Aetna — Aetna Medicare: $160.75 American Health Plans — American Health Plans Medicare: $154.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $162.30 Carelon — Carelon Armstrong County: $156.88 Carelon — Carelon Beaver County: $156.88 Carelon — Carelon Butler County: $156.88 Carelon — Carelon Indiana County: $156.88 Carelon — Carelon Lawrence County: $156.88 Carelon — Carelon Washington County: $156.88
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	Not listed in the file	Not listed in the file	$80.81 – $240.31
Psychotherapy, 60 minutes: 10 of 35 insurance plan rates American Health Plans — American Health Plans Medicare: $145.09 Carelon — Carelon Armstrong County: $156.88 Carelon — Carelon Beaver County: $156.88 Carelon — Carelon Butler County: $156.88 Carelon — Carelon Indiana County: $156.88 Carelon — Carelon Lawrence County: $156.88 Carelon — Carelon Washington County: $156.88 Carelon — Carelon Westmoreland County: $156.88 Cigna — Cigna Commercial: $217.46 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $130.50
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · modifier HE In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	Not listed in the file	Not listed in the file	$80.81 – $240.31
Psychotherapy, 60 minutes: rates for 4 insurance plans Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $106.15 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $106.15 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $106.15 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $106.15
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$289	$54.91	$16.16 – $506.32
Family psychotherapy, without the patient: 10 of 58 insurance plan rates Aetna — Aetna Commercial: $376.53 Aetna — Aetna Medicare: $160.75 American Health Plans — American Health Plans Medicare: $154.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $162.30 Carelon — Carelon Armstrong County: $16.16 Carelon — Carelon Beaver County: $16.16 Carelon — Carelon Butler County: $16.16 Carelon — Carelon Indiana County: $16.16 Carelon — Carelon Lawrence County: $16.16 Carelon — Carelon Washington County: $16.16
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	Not listed in the file	Not listed in the file	$16.16 – $256
Family psychotherapy, without the patient: 10 of 36 insurance plan rates American Health Plans — American Health Plans Medicare: $105.97 Carelon — Carelon Armstrong County: $16.16 Carelon — Carelon Beaver County: $16.16 Carelon — Carelon Butler County: $16.16 Carelon — Carelon Indiana County: $16.16 Carelon — Carelon Lawrence County: $16.16 Carelon — Carelon Washington County: $16.16 Carelon — Carelon Westmoreland County: $16.16 Cigna — Cigna Commercial: $158.65 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $103
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · modifier HE In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	Not listed in the file	Not listed in the file	$16.16 – $256
Family psychotherapy, without the patient: rates for 4 insurance plans Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $24 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $24 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $24 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $24
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$301	$57.19	$16.16 – $506.32
Family psychotherapy, with the patient: 10 of 58 insurance plan rates Aetna — Aetna Commercial: $376.53 Aetna — Aetna Medicare: $160.75 American Health Plans — American Health Plans Medicare: $154.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $162.30 Carelon — Carelon Armstrong County: $16.16 Carelon — Carelon Beaver County: $16.16 Carelon — Carelon Butler County: $16.16 Carelon — Carelon Indiana County: $16.16 Carelon — Carelon Lawrence County: $16.16 Carelon — Carelon Washington County: $16.16
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	Not listed in the file	Not listed in the file	$16.16 – $201.43
Family psychotherapy, with the patient: 10 of 35 insurance plan rates American Health Plans — American Health Plans Medicare: $110.51 Carelon — Carelon Armstrong County: $16.16 Carelon — Carelon Beaver County: $16.16 Carelon — Carelon Butler County: $16.16 Carelon — Carelon Indiana County: $16.16 Carelon — Carelon Lawrence County: $16.16 Carelon — Carelon Washington County: $16.16 Carelon — Carelon Westmoreland County: $16.16 Cigna — Cigna Commercial: $165.71 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $110
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · modifier HE In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	Not listed in the file	Not listed in the file	$16.16 – $201.43
Family psychotherapy, with the patient: rates for 4 insurance plans Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $24 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $24 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $24 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $24
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: PR GROUP PSYCHOTHERAPY	$71	$13.49	$5.39 – $291.50
Group psychotherapy: 10 of 58 insurance plan rates Aetna — Aetna Commercial: $216.77 Aetna — Aetna Medicare: $92.55 American Health Plans — American Health Plans Medicare: $88.99 Amerihealth — Amerihealth Caritas D-SNP Medicare: $93.44 Carelon — Carelon Armstrong County: $10.44 Carelon — Carelon Beaver County: $10.44 Carelon — Carelon Butler County: $10.44 Carelon — Carelon Indiana County: $10.44 Carelon — Carelon Lawrence County: $10.44 Carelon — Carelon Washington County: $10.44
Group psychotherapy CPT 90853 · Inpatient (hospital stay) In the file: PR GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$5.39 – $47.63
Group psychotherapy: 10 of 35 insurance plan rates American Health Plans — American Health Plans Medicare: $26.15 Carelon — Carelon Armstrong County: $10.44 Carelon — Carelon Beaver County: $10.44 Carelon — Carelon Butler County: $10.44 Carelon — Carelon Indiana County: $10.44 Carelon — Carelon Lawrence County: $10.44 Carelon — Carelon Washington County: $10.44 Carelon — Carelon Westmoreland County: $10.44 Cigna — Cigna Commercial: $39.12 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $40
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · modifier HE In the file: PR GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$5.39 – $47.63
Group psychotherapy: rates for 4 insurance plans Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Allegheny (HC: $11.55 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Erie (HCER): $11.55 Community Care Behavorial Health HealthChoices — Community Care Behavorial Health HealthChoices Northcentral : $11.55 Community Care Behavorial Health University of Pittsburgh Me — Community Care Behavorial Health University of Pittsburgh Me: $11.55

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,183	$224.77	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,067.28
Removal of breast growth (open surgery): 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $207.60 Aetna — Aetna Commercial: $8,973.84 Aetna — Aetna Medicare: $3,831.20 American Health Plans — American Health Plans Medicare: $3,683.84 Amerihealth — Amerihealth Caritas CHC Medicaid: $250.85 Amerihealth — Amerihealth Caritas D-SNP Medicare: $181.65 Amerihealth — Amerihealth Caritas HC Medicaid: $250.85 Amerihealth — Amerihealth Caritas Medicare (NY): $181.65 Amerihealth — Amerihealth Medicaid CHC: $11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Amerihealth — Amerihealth Medicaid HC: $11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	Not listed in the file	Not listed in the file	$33.95 – $1,222
Removal of breast growth (open surgery): 10 of 33 insurance plan rates American Health Plans — American Health Plans Medicare: $433.62 Amerihealth — Amerihealth Caritas CHC Medicaid: $250.85 Amerihealth — Amerihealth Caritas D-SNP Medicare: $181.65 Amerihealth — Amerihealth Caritas HC Medicaid: $250.85 Amerihealth — Amerihealth Caritas Medicare (NY): $181.65 Cigna — Cigna Commercial: $667.83 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $417.85 Devoted Medicare — Devoted Health Medicare Advantage: $417.85 Geisinger — Geisinger CHIP: $250.85 Geisinger — Geisinger Medicaid HC: $250.85
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier SG In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	Not listed in the file	Not listed in the file	$11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,067.28
Removal of breast growth (open surgery): rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $999.60 Amerihealth — Amerihealth Medicaid CHC: $1,374.45 Amerihealth — Amerihealth Medicaid HC: $1,374.45 Geisinger — Geisinger CHIP: $1,332.80 Geisinger — Geisinger Medicaid HC: $1,332.80 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,149.54 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,249.50 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $957.95 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $957.95 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $957.95
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$3,617	$687.23	$104.08 – $40,547.44
Total hip replacement: 10 of 44 insurance plan rates Aetna — Aetna Commercial: $30,153.14 Aetna — Aetna Medicare: $12,873.26 American Health Plans — American Health Plans Medicare: $12,378.14 Amerihealth — Amerihealth Caritas D-SNP Medicare: $12,997.05 Cigna — Cigna Commercial: $30,446.63 Cigna — Cigna Medicare: $13,244.61 Devoted Medicare — Devoted Health Medicare Advantage: $12,749.48 Highmark — Highmark Blue High Performance: $16,497.58 Highmark — Highmark Community Blue: $1,673.38 Highmark — Highmark Community Blue Medicare HMO: $12,873.26
Total hip replacement CPT 27130 · Inpatient (hospital stay) In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	Not listed in the file	Not listed in the file	$104.08 – $3,380
Total hip replacement: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $2,043.99 Highmark — Highmark Blue High Performance: $1,673.38 Highmark — Highmark Community Blue: $1,673.38 Highmark — Highmark Connect Blue: $1,673.38 Highmark — Highmark Indemnity: $1,673.38 Highmark — Highmark Managed Care: $1,673.38 Highmark — Highmark My Blue Access: $1,673.38 Highmark — Highmark My Direct Blue: $1,673.38 Highmark — Highmark Performance Blue: $1,673.38 Highmark — Highmark Social Mission Indemnity: $1,673.38
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier SG In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	Not listed in the file	Not listed in the file	$104.08 – $40,547.44
Total hip replacement: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$3,613	$686.47	$103.93 – $40,547.44
Total knee replacement: 10 of 45 insurance plan rates Aetna — Aetna Commercial: $30,153.14 Aetna — Aetna Medicare: $12,873.26 American Health Plans — American Health Plans Medicare: $12,378.14 Amerihealth — Amerihealth Caritas D-SNP Medicare: $12,997.05 Cigna — Cigna Commercial: $30,446.63 Cigna — Cigna Medicare: $13,244.61 Devoted Medicare — Devoted Health Medicare Advantage: $12,749.48 Highmark — Highmark Blue High Performance: $16,497.58 Highmark — Highmark Community Blue: $1,670.78 Highmark — Highmark Community Blue Medicare HMO: $12,873.26
Total knee replacement CPT 27447 · Inpatient (hospital stay) In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	Not listed in the file	Not listed in the file	$103.93 – $3,379
Total knee replacement: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $2,040.94 Highmark — Highmark Blue High Performance: $1,670.78 Highmark — Highmark Community Blue: $1,670.78 Highmark — Highmark Connect Blue: $1,670.78 Highmark — Highmark Indemnity: $1,670.78 Highmark — Highmark Managed Care: $1,670.78 Highmark — Highmark My Blue Access: $1,670.78 Highmark — Highmark My Direct Blue: $1,670.78 Highmark — Highmark Performance Blue: $1,670.78 Highmark — Highmark Social Mission Indemnity: $1,670.78
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier SG In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	Not listed in the file	Not listed in the file	$103.93 – $40,547.44
Total knee replacement: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$481	$91.39	$114.14 – $1,372.27
Shoulder arthroscopy: shaving of shoulder bone: 10 of 21 insurance plan rates Cigna — Cigna Commercial: $271.50 Highmark — Highmark Blue High Performance: $220.92 Highmark — Highmark Community Blue: $220.92 Highmark — Highmark Connect Blue: $220.92 Highmark — Highmark Indemnity: $220.92 Highmark — Highmark Managed Care: $220.92 Highmark — Highmark My Blue Access: $220.92 Highmark — Highmark My Direct Blue: $220.92 Highmark — Highmark Performance Blue: $220.92 Highmark — Highmark Social Mission Indemnity: $220.92
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	Not listed in the file	Not listed in the file	$114.14 – $788.08
Shoulder arthroscopy: shaving of shoulder bone: 10 of 18 insurance plan rates Cigna — Cigna Commercial: $271.50 Highmark — Highmark Blue High Performance: $220.92 Highmark — Highmark Community Blue: $220.92 Highmark — Highmark Connect Blue: $220.92 Highmark — Highmark Indemnity: $220.92 Highmark — Highmark Managed Care: $220.92 Highmark — Highmark My Blue Access: $220.92 Highmark — Highmark My Direct Blue: $220.92 Highmark — Highmark Performance Blue: $220.92 Highmark — Highmark Social Mission Indemnity: $220.92
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · modifier 80 In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	Not listed in the file	Not listed in the file	$114.14 – $788.08
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans Amerihealth — Amerihealth Caritas CHC Medicaid: $157.62 Amerihealth — Amerihealth Caritas D-SNP Medicare: $114.14 Amerihealth — Amerihealth Caritas HC Medicaid: $157.62 Amerihealth — Amerihealth Caritas Medicare (NY): $114.14 Geisinger — Geisinger CHIP: $157.62 Geisinger — Geisinger Medicaid HC: $157.62 Pennsylvania Health and Wellness — PA Health and Wellness Medicaid CHC: $143.48 United Healthcare — United Healthcare Medicaid: $157.62
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$1,538	$292.22	$19 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $10,224.80
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 59 insurance plan rates Aetna — Aetna Better Health CHIP: $652.20 Aetna — Aetna Commercial: $7,603.68 Aetna — Aetna Medicare: $3,246.23 American Health Plans — American Health Plans Medicare: $3,121.38 Amerihealth — Amerihealth Caritas CHC Medicaid: $788.08 Amerihealth — Amerihealth Caritas D-SNP Medicare: $3,277.45 Amerihealth — Amerihealth Caritas HC Medicaid: $788.08 Amerihealth — Amerihealth Caritas Medicare (NY): $570.67 Amerihealth — Amerihealth Medicaid CHC: $19 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Amerihealth — Amerihealth Medicaid HC: $19 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	Not listed in the file	Not listed in the file	$44.46 – $1,036.45
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $788.08 Amerihealth — Amerihealth Caritas D-SNP Medicare: $570.67 Amerihealth — Amerihealth Caritas HC Medicaid: $788.08 Amerihealth — Amerihealth Caritas Medicare (NY): $570.67 Cigna — Cigna Commercial: $867.71 Geisinger — Geisinger CHIP: $788.08 Geisinger — Geisinger Medicaid HC: $788.08 Highmark — Highmark Blue High Performance: $714.75 Highmark — Highmark Community Blue: $714.75 Highmark — Highmark Connect Blue: $714.75
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier SG In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	Not listed in the file	Not listed in the file	$19 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $10,224.80
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $1,118.40 Amerihealth — Amerihealth Medicaid CHC: $1,537.80 Amerihealth — Amerihealth Medicaid HC: $1,537.80 Geisinger — Geisinger CHIP: $1,491.20 Geisinger — Geisinger Medicaid HC: $1,491.20 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,286.16 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,398 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $1,071.80 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $1,071.80 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $1,071.80
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$825	$156.75	$21.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $18,642.12
Removal of tonsils and adenoids (under age 12): 10 of 51 insurance plan rates Aetna — Aetna Commercial: $13,863.24 Aetna — Aetna Medicare: $5,918.62 American Health Plans — American Health Plans Medicare: $5,690.98 Amerihealth — Amerihealth Caritas CHC Medicaid: $266.80 Amerihealth — Amerihealth Caritas D-SNP Medicare: $193.20 Amerihealth — Amerihealth Caritas HC Medicaid: $266.80 Amerihealth — Amerihealth Caritas Medicare (NY): $193.20 Cigna — Cigna Commercial: $13,998.17 Cigna — Cigna Medicare: $6,089.35 Devoted Medicare — Devoted Health Medicare Advantage: $5,861.71
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	Not listed in the file	Not listed in the file	$21.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $550.71
Removal of tonsils and adenoids (under age 12): 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $266.80 Amerihealth — Amerihealth Caritas D-SNP Medicare: $193.20 Amerihealth — Amerihealth Caritas HC Medicaid: $266.80 Amerihealth — Amerihealth Caritas Medicare (NY): $193.20 Cigna — Cigna Commercial: $467.22 Geisinger — Geisinger CHIP: $266.80 Geisinger — Geisinger Medicaid HC: $266.80 Highmark — Highmark Blue High Performance: $332.55 Highmark — Highmark Community Blue: $332.55 Highmark — Highmark Connect Blue: $332.55
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier SG In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	Not listed in the file	Not listed in the file	$21.60 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $18,642.12
Removal of tonsils and adenoids (under age 12): rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $832.80 Amerihealth — Amerihealth Medicaid CHC: $1,145.10 Amerihealth — Amerihealth Medicaid HC: $1,145.10 Geisinger — Geisinger CHIP: $1,110.40 Geisinger — Geisinger Medicaid HC: $1,110.40 Highmark Wholecare — Highmark Wholecare Medicaid HC: $957.72 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,041 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $798.10 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $798.10 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $798.10
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$341	$64.79	$98.89 – $2,954.55
Upper GI endoscopy (diagnostic): 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $150.26 Aetna — Aetna Commercial: $2,197.15 Aetna — Aetna Medicare: $938.03 American Health Plans — American Health Plans Medicare: $901.95 Amerihealth — Amerihealth Caritas CHC Medicaid: $181.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $131.48 Amerihealth — Amerihealth Caritas HC Medicaid: $181.57 Amerihealth — Amerihealth Caritas Medicare (NY): $131.48 Amerihealth — Amerihealth Medicaid CHC: $206.61 Amerihealth — Amerihealth Medicaid HC: $206.61
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	Not listed in the file	Not listed in the file	$98.89 – $237.27
Upper GI endoscopy (diagnostic): 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $124.91 Amerihealth — Amerihealth Caritas CHC Medicaid: $181.57 Amerihealth — Amerihealth Caritas D-SNP Medicare: $131.48 Amerihealth — Amerihealth Caritas HC Medicaid: $181.57 Amerihealth — Amerihealth Caritas Medicare (NY): $131.48 Cigna — Cigna Commercial: $193.08 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $120.36 Devoted Medicare — Devoted Health Medicare Advantage: $120.36 Geisinger — Geisinger CHIP: $181.57 Geisinger — Geisinger Medicaid HC: $181.57
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier SG In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	Not listed in the file	Not listed in the file	$98.89 – $2,954.55
Upper GI endoscopy (diagnostic): rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $343.20 Amerihealth — Amerihealth Medicaid CHC: $471.90 Amerihealth — Amerihealth Medicaid HC: $471.90 Geisinger — Geisinger CHIP: $457.60 Geisinger — Geisinger Medicaid HC: $457.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $394.68 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $429 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $328.90 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $328.90 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $328.90
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$383	$72.77	$111.70 – $2,954.55
Upper GI endoscopy with biopsy: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $178.30 Aetna — Aetna Commercial: $2,197.15 Aetna — Aetna Medicare: $938.03 American Health Plans — American Health Plans Medicare: $901.95 Amerihealth — Amerihealth Caritas CHC Medicaid: $215.44 Amerihealth — Amerihealth Caritas D-SNP Medicare: $156.01 Amerihealth — Amerihealth Caritas HC Medicaid: $215.44 Amerihealth — Amerihealth Caritas Medicare (NY): $156.01 Amerihealth — Amerihealth Medicaid CHC: $245.16 Amerihealth — Amerihealth Medicaid HC: $245.16
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$111.70 – $267.54
Upper GI endoscopy with biopsy: 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $140.40 Amerihealth — Amerihealth Caritas CHC Medicaid: $215.44 Amerihealth — Amerihealth Caritas D-SNP Medicare: $156.01 Amerihealth — Amerihealth Caritas HC Medicaid: $215.44 Amerihealth — Amerihealth Caritas Medicare (NY): $156.01 Cigna — Cigna Commercial: $218.19 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $135.30 Devoted Medicare — Devoted Health Medicare Advantage: $135.30 Geisinger — Geisinger CHIP: $215.44 Geisinger — Geisinger Medicaid HC: $215.44
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier SG In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$111.70 – $2,954.55
Upper GI endoscopy with biopsy: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $337.20 Amerihealth — Amerihealth Medicaid CHC: $463.65 Amerihealth — Amerihealth Medicaid HC: $463.65 Geisinger — Geisinger CHIP: $449.60 Geisinger — Geisinger Medicaid HC: $449.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $387.78 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $421.50 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $323.15 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $323.15 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $323.15
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$512	$97.28	$74.37 – $2,873.09
Colonoscopy (diagnostic): 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $216.60 Aetna — Aetna Commercial: $2,136.57 Aetna — Aetna Medicare: $912.17 American Health Plans — American Health Plans Medicare: $877.08 Amerihealth — Amerihealth Caritas CHC Medicaid: $261.73 Amerihealth — Amerihealth Caritas D-SNP Medicare: $189.53 Amerihealth — Amerihealth Caritas HC Medicaid: $261.73 Amerihealth — Amerihealth Caritas Medicare (NY): $189.53 Amerihealth — Amerihealth Medicaid CHC: $297.83 Amerihealth — Amerihealth Medicaid HC: $297.83
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	Not listed in the file	Not listed in the file	$74.37 – $359.04
Colonoscopy (diagnostic): 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $187.79 Amerihealth — Amerihealth Caritas CHC Medicaid: $261.73 Amerihealth — Amerihealth Caritas D-SNP Medicare: $189.53 Amerihealth — Amerihealth Caritas HC Medicaid: $261.73 Amerihealth — Amerihealth Caritas Medicare (NY): $189.53 Cigna — Cigna Commercial: $290.37 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $180.96 Devoted Medicare — Devoted Health Medicare Advantage: $180.96 Geisinger — Geisinger CHIP: $261.73 Geisinger — Geisinger Medicaid HC: $261.73
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · modifier 53 In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	Not listed in the file	Not listed in the file	$74.37 – $359.04
Colonoscopy (diagnostic): rates for 10 insurance plans American Health Plans — American Health Plans Medicare: $94.23 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $90.80 Devoted Medicare — Devoted Health Medicare Advantage: $90.80 Highmark — Highmark Community Blue Medicare: $79.66 Highmark — Highmark Security Blue: $88.23 Life Pittsburgh — Life Pittsburgh Medicare: $85.66 Univera — Univera Commercial: $132.99 Univera — Univera Essential Plan: $74.37 Univera — Univera Healthy New York: $74.37 Univera — Univera Medicare: $102.10
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$557	$105.83	$161.40 – $3,715.66
Colonoscopy with biopsy: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $270.50 Aetna — Aetna Commercial: $2,763.15 Aetna — Aetna Medicare: $1,179.67 American Health Plans — American Health Plans Medicare: $1,134.30 Amerihealth — Amerihealth Caritas CHC Medicaid: $326.86 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,191.01 Amerihealth — Amerihealth Caritas HC Medicaid: $326.86 Amerihealth — Amerihealth Caritas Medicare (NY): $236.69 Amerihealth — Amerihealth Medicaid CHC: $371.94 Amerihealth — Amerihealth Medicaid HC: $371.94
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$161.40 – $388.65
Colonoscopy with biopsy: 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $204.28 Amerihealth — Amerihealth Caritas CHC Medicaid: $326.86 Amerihealth — Amerihealth Caritas D-SNP Medicare: $236.69 Amerihealth — Amerihealth Caritas HC Medicaid: $326.86 Amerihealth — Amerihealth Caritas Medicare (NY): $236.69 Cigna — Cigna Commercial: $315.49 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $196.85 Devoted Medicare — Devoted Health Medicare Advantage: $196.85 Geisinger — Geisinger CHIP: $326.86 Geisinger — Geisinger Medicaid HC: $326.86
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier SG In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$161.40 – $3,715.66
Colonoscopy with biopsy: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $384 Amerihealth — Amerihealth Medicaid CHC: $528 Amerihealth — Amerihealth Medicaid HC: $528 Geisinger — Geisinger CHIP: $512 Geisinger — Geisinger Medicaid HC: $512 Highmark Wholecare — Highmark Wholecare Medicaid HC: $441.60 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $480 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $368 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $368 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $368
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$703	$133.57	$204.27 – $3,715.66
Colonoscopy with removal of polyps (snare): 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $321.70 Aetna — Aetna Commercial: $2,763.15 Aetna — Aetna Medicare: $1,179.67 American Health Plans — American Health Plans Medicare: $1,134.30 Amerihealth — Amerihealth Caritas CHC Medicaid: $388.72 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,191.01 Amerihealth — Amerihealth Caritas HC Medicaid: $388.72 Amerihealth — Amerihealth Caritas Medicare (NY): $281.48 Amerihealth — Amerihealth Medicaid CHC: $442.33 Amerihealth — Amerihealth Medicaid HC: $442.33
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	Not listed in the file	Not listed in the file	$204.27 – $493.58
Colonoscopy with removal of polyps (snare): 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $257.59 Amerihealth — Amerihealth Caritas CHC Medicaid: $388.72 Amerihealth — Amerihealth Caritas D-SNP Medicare: $281.48 Amerihealth — Amerihealth Caritas HC Medicaid: $388.72 Amerihealth — Amerihealth Caritas Medicare (NY): $281.48 Cigna — Cigna Commercial: $399.42 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $248.22 Devoted Medicare — Devoted Health Medicare Advantage: $248.22 Geisinger — Geisinger CHIP: $388.72 Geisinger — Geisinger Medicaid HC: $388.72
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier SG In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	Not listed in the file	Not listed in the file	$204.27 – $3,715.66
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $456 Amerihealth — Amerihealth Medicaid CHC: $627 Amerihealth — Amerihealth Medicaid HC: $627 Geisinger — Geisinger CHIP: $608 Geisinger — Geisinger Medicaid HC: $608 Highmark Wholecare — Highmark Wholecare Medicaid HC: $524.40 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $570 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $437 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $437 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $437
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$712	$135.28	$207.18 – $3,715.66
Ultrasound of the lower bowel by endoscope: 10 of 59 insurance plan rates Aetna — Aetna Better Health CHIP: $263.15 Aetna — Aetna Commercial: $2,763.15 Aetna — Aetna Medicare: $1,179.67 American Health Plans — American Health Plans Medicare: $1,134.30 Amerihealth — Amerihealth Caritas CHC Medicaid: $317.97 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,191.01 Amerihealth — Amerihealth Caritas HC Medicaid: $317.97 Amerihealth — Amerihealth Caritas Medicare (NY): $230.25 Amerihealth — Amerihealth Medicaid CHC: $361.83 Amerihealth — Amerihealth Medicaid HC: $361.83
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	Not listed in the file	Not listed in the file	$207.18 – $498.99
Ultrasound of the lower bowel by endoscope: 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $317.97 Amerihealth — Amerihealth Caritas D-SNP Medicare: $230.25 Amerihealth — Amerihealth Caritas HC Medicaid: $317.97 Amerihealth — Amerihealth Caritas Medicare (NY): $230.25 Cigna — Cigna Commercial: $404.79 Geisinger — Geisinger CHIP: $317.97 Geisinger — Geisinger Medicaid HC: $317.97 Highmark — Highmark Blue High Performance: $324.70 Highmark — Highmark Community Blue: $324.70 Highmark — Highmark Connect Blue: $324.70
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · modifier SG In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	Not listed in the file	Not listed in the file	$207.18 – $3,715.66
Ultrasound of the lower bowel by endoscope: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: PR COLON CA SCRN NOT HI RSK IND	$513	$97.47	$74.57 – $2,873.09
Screening colonoscopy (not high risk): 10 of 47 insurance plan rates Aetna — Aetna Commercial: $2,136.57 Aetna — Aetna Medicare: $912.17 American Health Plans — American Health Plans Medicare: $877.08 Amerihealth — Amerihealth Caritas D-SNP Medicare: $920.94 Cigna — Cigna Commercial: $2,157.37 Cigna — Cigna Medicare: $938.48 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $181.28 Devoted Medicare — Devoted Health Medicare Advantage: $903.40 Highmark — Highmark Blue High Performance: $1,168.98 Highmark — Highmark Community Blue: $1,440.52
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) In the file: PR COLON CA SCRN NOT HI RSK IND	Not listed in the file	Not listed in the file	$74.57 – $903
Screening colonoscopy (not high risk): 10 of 24 insurance plan rates American Health Plans — American Health Plans Medicare: $188.12 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $181.28 Devoted Medicare — Devoted Health Medicare Advantage: $181.28 Highmark — Highmark Blue High Performance: $233.57 Highmark — Highmark Community Blue: $233.57 Highmark — Highmark Community Blue Medicare: $159.05 Highmark — Highmark Connect Blue: $233.57 Highmark — Highmark Indemnity: $233.57 Highmark — Highmark Managed Care: $233.57 Highmark — Highmark My Blue Access: $233.57
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · modifier 53 In the file: PR COLON CA SCRN NOT HI RSK IND	Not listed in the file	Not listed in the file	$74.57 – $903
Screening colonoscopy (not high risk): rates for 10 insurance plans American Health Plans — American Health Plans Medicare: $94.23 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $90.80 Devoted Medicare — Devoted Health Medicare Advantage: $90.80 Highmark — Highmark Community Blue Medicare: $79.66 Highmark — Highmark Security Blue: $88.23 Life Pittsburgh — Life Pittsburgh Medicare: $85.66 Univera — Univera Commercial: $98.44 Univera — Univera Essential Plan: $74.57 Univera — Univera Healthy New York: $74.57 Univera — Univera Medicare: $80.72
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$1,866	$354.54	$48.04 – $18,385.92
Gallbladder removal by laparoscope: 10 of 51 insurance plan rates Aetna — Aetna Commercial: $13,672.71 Aetna — Aetna Medicare: $5,837.28 American Health Plans — American Health Plans Medicare: $5,612.77 Amerihealth — Amerihealth Caritas CHC Medicaid: $854.56 Amerihealth — Amerihealth Caritas D-SNP Medicare: $5,893.41 Amerihealth — Amerihealth Caritas HC Medicaid: $854.56 Amerihealth — Amerihealth Caritas Medicare (NY): $618.82 Cigna — Cigna Commercial: $13,805.79 Cigna — Cigna Medicare: $6,005.66 Devoted Medicare — Devoted Health Medicare Advantage: $5,781.15
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$48.04 – $1,284.16
Gallbladder removal by laparoscope: 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $854.56 Amerihealth — Amerihealth Caritas D-SNP Medicare: $618.82 Amerihealth — Amerihealth Caritas HC Medicaid: $854.56 Amerihealth — Amerihealth Caritas Medicare (NY): $618.82 Cigna — Cigna Commercial: $1,055.40 Geisinger — Geisinger CHIP: $854.56 Geisinger — Geisinger Medicaid HC: $854.56 Highmark — Highmark Blue High Performance: $750.93 Highmark — Highmark Community Blue: $750.93 Highmark — Highmark Connect Blue: $750.93
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier SG In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$48.04 – $18,385.92
Gallbladder removal by laparoscope: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,481	$281.39	$38.15 – $11,121.19
Groin (inguinal) hernia repair, age 5 or older: 10 of 59 insurance plan rates Aetna — Aetna Better Health CHIP: $381 Aetna — Aetna Commercial: $8,270.28 Aetna — Aetna Medicare: $3,530.83 American Health Plans — American Health Plans Medicare: $3,395.03 Amerihealth — Amerihealth Caritas CHC Medicaid: $460.38 Amerihealth — Amerihealth Caritas D-SNP Medicare: $333.38 Amerihealth — Amerihealth Caritas HC Medicaid: $460.38 Amerihealth — Amerihealth Caritas Medicare (NY): $333.38 Amerihealth — Amerihealth Medicaid CHC: $523.88 Amerihealth — Amerihealth Medicaid HC: $523.88
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	Not listed in the file	Not listed in the file	$38.15 – $1,013.65
Groin (inguinal) hernia repair, age 5 or older: 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $460.38 Amerihealth — Amerihealth Caritas D-SNP Medicare: $333.38 Amerihealth — Amerihealth Caritas HC Medicaid: $460.38 Amerihealth — Amerihealth Caritas Medicare (NY): $333.38 Cigna — Cigna Commercial: $836.76 Geisinger — Geisinger CHIP: $460.38 Geisinger — Geisinger Medicaid HC: $460.38 Highmark — Highmark Blue High Performance: $596.37 Highmark — Highmark Community Blue: $596.37 Highmark — Highmark Connect Blue: $596.37
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 80 In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	Not listed in the file	Not listed in the file	$38.15 – $11,121.19
Groin (inguinal) hernia repair, age 5 or older: 10 of 16 insurance plan rates Aetna — Aetna Better Health CHIP: $76.20 Amerihealth — Amerihealth Caritas CHC Medicaid: $92.08 Amerihealth — Amerihealth Caritas D-SNP Medicare: $66.68 Amerihealth — Amerihealth Caritas HC Medicaid: $92.08 Amerihealth — Amerihealth Caritas Medicare (NY): $66.68 Amerihealth — Amerihealth Medicaid CHC: $104.77 Amerihealth — Amerihealth Medicaid HC: $104.77 Geisinger — Geisinger CHIP: $101.60 Geisinger — Geisinger Medicaid HC: $101.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $87.63
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$362	$68.78	$93.98 – $6,455.51
Prostate biopsy: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $107.40 Aetna — Aetna Commercial: $4,800.64 Aetna — Aetna Medicare: $2,049.54 American Health Plans — American Health Plans Medicare: $1,970.71 Amerihealth — Amerihealth Caritas CHC Medicaid: $129.78 Amerihealth — Amerihealth Caritas D-SNP Medicare: $2,069.24 Amerihealth — Amerihealth Caritas HC Medicaid: $129.78 Amerihealth — Amerihealth Caritas Medicare (NY): $93.98 Amerihealth — Amerihealth Medicaid CHC: $147.67 Amerihealth — Amerihealth Medicaid HC: $147.67
Prostate biopsy CPT 55700 · Inpatient (hospital stay) In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	Not listed in the file	Not listed in the file	$93.98 – $547
Prostate biopsy: 10 of 33 insurance plan rates American Health Plans — American Health Plans Medicare: $132.73 Amerihealth — Amerihealth Caritas CHC Medicaid: $129.78 Amerihealth — Amerihealth Caritas D-SNP Medicare: $93.98 Amerihealth — Amerihealth Caritas HC Medicaid: $129.78 Amerihealth — Amerihealth Caritas Medicare (NY): $93.98 Cigna — Cigna Commercial: $206.42 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $127.90 Devoted Medicare — Devoted Health Medicare Advantage: $127.90 Geisinger — Geisinger CHIP: $129.78 Geisinger — Geisinger Medicaid HC: $129.78
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier SG In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	Not listed in the file	Not listed in the file	$93.98 – $6,455.51
Prostate biopsy: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$3,349	$636.31	$77.57 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $32,809.06
Prostate removal by laparoscope (radical prostatectomy): 10 of 51 insurance plan rates Aetna — Aetna Commercial: $24,398.49 Aetna — Aetna Medicare: $10,416.43 American Health Plans — American Health Plans Medicare: $10,015.80 Amerihealth — Amerihealth Caritas CHC Medicaid: $1,450 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,050 Amerihealth — Amerihealth Caritas HC Medicaid: $1,450 Amerihealth — Amerihealth Caritas Medicare (NY): $1,050 Cigna — Cigna Commercial: $24,635.97 Cigna — Cigna Medicare: $10,716.91 Devoted Medicare — Devoted Health Medicare Advantage: $10,316.28
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	Not listed in the file	Not listed in the file	$77.57 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,803.67
Prostate removal by laparoscope (radical prostatectomy): 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $1,450 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,050 Amerihealth — Amerihealth Caritas HC Medicaid: $1,450 Amerihealth — Amerihealth Caritas Medicare (NY): $1,050 Cigna — Cigna Commercial: $1,897.84 Geisinger — Geisinger CHIP: $1,450 Geisinger — Geisinger Medicaid HC: $1,450 Highmark — Highmark Blue High Performance: $1,613.35 Highmark — Highmark Community Blue: $1,613.35 Highmark — Highmark Connect Blue: $1,613.35
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · modifier 80 In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	Not listed in the file	Not listed in the file	$77.57 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,803.67
Prostate removal by laparoscope (radical prostatectomy): rates for 8 insurance plans Amerihealth — Amerihealth Caritas CHC Medicaid: $290 Amerihealth — Amerihealth Caritas D-SNP Medicare: $210 Amerihealth — Amerihealth Caritas HC Medicaid: $290 Amerihealth — Amerihealth Caritas Medicare (NY): $210 Geisinger — Geisinger CHIP: $290 Geisinger — Geisinger Medicaid HC: $290 Pennsylvania Health and Wellness — PA Health and Wellness Medicaid CHC: $264 United Healthcare — United Healthcare Medicaid: $290
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$649	$123.31	$187.47 – $10,019.71
Hysteroscopy with biopsy of the uterus lining: 10 of 53 insurance plan rates Aetna — Aetna Commercial: $7,451.17 Aetna — Aetna Medicare: $3,181.12 American Health Plans — American Health Plans Medicare: $3,058.77 Amerihealth — Amerihealth Caritas CHC Medicaid: $346.22 Amerihealth — Amerihealth Caritas D-SNP Medicare: $250.71 Amerihealth — Amerihealth Caritas HC Medicaid: $346.22 Amerihealth — Amerihealth Caritas Medicare (NY): $250.71 Cigna — Cigna Commercial: $7,523.69 Cigna — Cigna Medicare: $3,272.89 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $229.26
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	Not listed in the file	Not listed in the file	$187.47 – $452.78
Hysteroscopy with biopsy of the uterus lining: 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $237.91 Amerihealth — Amerihealth Caritas CHC Medicaid: $346.22 Amerihealth — Amerihealth Caritas D-SNP Medicare: $250.71 Amerihealth — Amerihealth Caritas HC Medicaid: $346.22 Amerihealth — Amerihealth Caritas Medicare (NY): $250.71 Cigna — Cigna Commercial: $368.79 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $229.26 Devoted Medicare — Devoted Health Medicare Advantage: $229.26 Geisinger — Geisinger CHIP: $346.22 Geisinger — Geisinger Medicaid HC: $346.22
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier SG In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	Not listed in the file	Not listed in the file	$187.47 – $10,019.71
Hysteroscopy with biopsy of the uterus lining: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$278	$52.82	$80.97 – $2,182.35
Spinal injection, lower back (epidural), with imaging guidance: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $97.58 Aetna — Aetna Commercial: $1,622.91 Aetna — Aetna Medicare: $692.87 American Health Plans — American Health Plans Medicare: $666.22 Amerihealth — Amerihealth Caritas CHC Medicaid: $117.91 Amerihealth — Amerihealth Caritas D-SNP Medicare: $699.53 Amerihealth — Amerihealth Caritas HC Medicaid: $117.91 Amerihealth — Amerihealth Caritas Medicare (NY): $85.39 Amerihealth — Amerihealth Medicaid CHC: $134.18 Amerihealth — Amerihealth Medicaid HC: $134.18
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HC NJX INTERLAMINAR LMBR/SAC W/IMAG	$3,290	$2,664.90	$80.97 – $2,182.35
Spinal injection, lower back (epidural), with imaging guidance: 10 of 58 insurance plan rates Aetna — Aetna Better Health CHIP: $97.58 Aetna — Aetna Commercial: $1,622.91 Aetna — Aetna Medicare: $692.87 American Health Plans — American Health Plans Medicare: $666.22 Amerihealth — Amerihealth Caritas CHC Medicaid: $117.91 Amerihealth — Amerihealth Caritas D-SNP Medicare: $699.53 Amerihealth — Amerihealth Caritas HC Medicaid: $117.91 Amerihealth — Amerihealth Caritas Medicare (NY): $85.39 Amerihealth — Amerihealth Medicaid CHC: $134.18 Amerihealth — Amerihealth Medicaid HC: $134.18
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) In the file: HC NJX INTERLAMINAR LMBR/SAC W/IMAG	$3,290	$2,664.90	$80.97 – $192.13
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $117.91 Amerihealth — Amerihealth Caritas D-SNP Medicare: $85.39 Amerihealth — Amerihealth Caritas HC Medicaid: $117.91 Amerihealth — Amerihealth Caritas Medicare (NY): $85.39 Geisinger — Geisinger CHIP: $117.91 Geisinger — Geisinger Medicaid HC: $117.91 Highmark — Highmark Blue High Performance: $108.78 Highmark — Highmark Community Blue: $108.78 Highmark — Highmark Connect Blue: $108.78 Highmark — Highmark Indemnity: $108.78
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$311	$59.09	$90.78 – $2,805.59
Nerve root injection, lower back, with imaging guidance: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $114.05 Aetna — Aetna Commercial: $2,086.38 Aetna — Aetna Medicare: $890.74 American Health Plans — American Health Plans Medicare: $856.48 Amerihealth — Amerihealth Caritas CHC Medicaid: $137.81 Amerihealth — Amerihealth Caritas D-SNP Medicare: $899.30 Amerihealth — Amerihealth Caritas HC Medicaid: $137.81 Amerihealth — Amerihealth Caritas Medicare (NY): $99.79 Amerihealth — Amerihealth Medicaid CHC: $156.82 Amerihealth — Amerihealth Medicaid HC: $156.82
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HC INJ ANES FORAMEN EPI LUMB 1ST LVL	$3,383	$2,740.23	$90.78 – $2,805.59
Nerve root injection, lower back, with imaging guidance: 10 of 58 insurance plan rates Aetna — Aetna Better Health CHIP: $114.05 Aetna — Aetna Commercial: $2,086.38 Aetna — Aetna Medicare: $890.74 American Health Plans — American Health Plans Medicare: $856.48 Amerihealth — Amerihealth Caritas CHC Medicaid: $137.81 Amerihealth — Amerihealth Caritas D-SNP Medicare: $899.30 Amerihealth — Amerihealth Caritas HC Medicaid: $137.81 Amerihealth — Amerihealth Caritas Medicare (NY): $99.79 Amerihealth — Amerihealth Medicaid CHC: $156.82 Amerihealth — Amerihealth Medicaid HC: $156.82
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) In the file: HC INJ ANES FORAMEN EPI LUMB 1ST LVL	$3,383	$2,740.23	$90.78 – $215.08
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $137.81 Amerihealth — Amerihealth Caritas D-SNP Medicare: $99.79 Amerihealth — Amerihealth Caritas HC Medicaid: $137.81 Amerihealth — Amerihealth Caritas Medicare (NY): $99.79 Geisinger — Geisinger CHIP: $137.81 Geisinger — Geisinger Medicaid HC: $137.81 Highmark — Highmark Blue High Performance: $122.01 Highmark — Highmark Community Blue: $122.01 Highmark — Highmark Connect Blue: $122.01 Highmark — Highmark Indemnity: $122.01
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$1,243	$236.17	$39.60 – $6,153.80
Carpal tunnel release: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $360 Aetna — Aetna Commercial: $4,576.28 Aetna — Aetna Medicare: $1,953.75 American Health Plans — American Health Plans Medicare: $1,878.60 Amerihealth — Amerihealth Caritas CHC Medicaid: $435 Amerihealth — Amerihealth Caritas D-SNP Medicare: $1,972.53 Amerihealth — Amerihealth Caritas HC Medicaid: $435 Amerihealth — Amerihealth Caritas Medicare (NY): $315 Amerihealth — Amerihealth Medicaid CHC: $495 Amerihealth — Amerihealth Medicaid HC: $495
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	Not listed in the file	Not listed in the file	$39.60 – $1,073
Carpal tunnel release: 10 of 33 insurance plan rates American Health Plans — American Health Plans Medicare: $455.66 Amerihealth — Amerihealth Caritas CHC Medicaid: $435 Amerihealth — Amerihealth Caritas D-SNP Medicare: $315 Amerihealth — Amerihealth Caritas HC Medicaid: $435 Amerihealth — Amerihealth Caritas Medicare (NY): $315 Cigna — Cigna Commercial: $700.21 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $439.09 Devoted Medicare — Devoted Health Medicare Advantage: $439.09 Geisinger — Geisinger CHIP: $435 Geisinger — Geisinger Medicaid HC: $435
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier SG In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	Not listed in the file	Not listed in the file	$39.60 – $6,153.80
Carpal tunnel release: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $796.80 Amerihealth — Amerihealth Medicaid CHC: $1,095.60 Amerihealth — Amerihealth Medicaid HC: $1,095.60 Geisinger — Geisinger CHIP: $1,062.40 Geisinger — Geisinger Medicaid HC: $1,062.40 Highmark Wholecare — Highmark Wholecare Medicaid HC: $916.32 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $996 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $763.60 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $763.60 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $763.60
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: PR POST-CATARACT LASER SURGERY	$851	$161.69	$25.29 – $1,728.81
Laser treatment of clouding after cataract surgery: 10 of 61 insurance plan rates Aetna — Aetna Better Health CHIP: $259.81 Aetna — Aetna Commercial: $1,285.63 Aetna — Aetna Medicare: $548.87 American Health Plans — American Health Plans Medicare: $527.76 Amerihealth — Amerihealth Caritas CHC Medicaid: $313.94 Amerihealth — Amerihealth Caritas D-SNP Medicare: $227.34 Amerihealth — Amerihealth Caritas HC Medicaid: $313.94 Amerihealth — Amerihealth Caritas Medicare (NY): $227.34 Amerihealth — Amerihealth Medicaid CHC: $357.24 Amerihealth — Amerihealth Medicaid HC: $357.24
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) In the file: PR POST-CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$25.29 – $582.15
Laser treatment of clouding after cataract surgery: 10 of 32 insurance plan rates American Health Plans — American Health Plans Medicare: $312.18 Amerihealth — Amerihealth Caritas CHC Medicaid: $313.94 Amerihealth — Amerihealth Caritas D-SNP Medicare: $227.34 Amerihealth — Amerihealth Caritas HC Medicaid: $313.94 Amerihealth — Amerihealth Caritas Medicare (NY): $227.34 Cigna — Cigna Commercial: $486.45 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $300.83 Devoted Medicare — Devoted Health Medicare Advantage: $300.83 Geisinger — Geisinger CHIP: $313.94 Geisinger — Geisinger Medicaid HC: $313.94
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · modifier SG In the file: PR POST-CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$25.29 – $1,728.81
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $931.20 Amerihealth — Amerihealth Medicaid CHC: $1,280.40 Amerihealth — Amerihealth Medicaid HC: $1,280.40 Geisinger — Geisinger CHIP: $1,241.60 Geisinger — Geisinger Medicaid HC: $1,241.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $1,070.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $1,164 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $892.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $892.40
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$1,494	$283.86	$44.06 – $7,187.30
Cataract removal with lens implant: 10 of 59 insurance plan rates Aetna — Aetna Better Health CHIP: $723.04 Aetna — Aetna Commercial: $5,344.85 Aetna — Aetna Medicare: $2,281.87 American Health Plans — American Health Plans Medicare: $2,194.11 Amerihealth — Amerihealth Caritas CHC Medicaid: $873.67 Amerihealth — Amerihealth Caritas D-SNP Medicare: $2,303.81 Amerihealth — Amerihealth Caritas HC Medicaid: $873.67 Amerihealth — Amerihealth Caritas Medicare (NY): $632.66 Amerihealth — Amerihealth Medicaid CHC: $994.17 Amerihealth — Amerihealth Medicaid HC: $994.17
Cataract removal with lens implant CPT 66984 · Inpatient (hospital stay) In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	Not listed in the file	Not listed in the file	$44.06 – $1,026.88
Cataract removal with lens implant: 10 of 26 insurance plan rates Amerihealth — Amerihealth Caritas CHC Medicaid: $873.67 Amerihealth — Amerihealth Caritas D-SNP Medicare: $632.66 Amerihealth — Amerihealth Caritas HC Medicaid: $873.67 Amerihealth — Amerihealth Caritas Medicare (NY): $632.66 Cigna — Cigna Commercial: $850.76 Geisinger — Geisinger CHIP: $873.67 Geisinger — Geisinger Medicaid HC: $873.67 Highmark — Highmark Blue High Performance: $718.51 Highmark — Highmark Community Blue: $718.51 Highmark — Highmark Connect Blue: $718.51
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 50 In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	Not listed in the file	Not listed in the file	$44.06 – $7,187.30
Cataract removal with lens implant: 10 of 16 insurance plan rates Aetna — Aetna Better Health CHIP: $723.04 Amerihealth — Amerihealth Caritas CHC Medicaid: $873.67 Amerihealth — Amerihealth Caritas D-SNP Medicare: $632.66 Amerihealth — Amerihealth Caritas HC Medicaid: $873.67 Amerihealth — Amerihealth Caritas Medicare (NY): $632.66 Amerihealth — Amerihealth Medicaid CHC: $994.17 Amerihealth — Amerihealth Medicaid HC: $994.17 Geisinger — Geisinger CHIP: $873.67 Geisinger — Geisinger Medicaid HC: $873.67 Highmark Wholecare — Highmark Wholecare Medicaid HC: $831.49

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$6,768	$1,285.92	$1,384.19 – $4,966.50
Vaginal delivery, with care before and after: 10 of 22 insurance plan rates Cigna — Cigna Commercial: $3,862.14 Highmark — Highmark Blue High Performance: $3,100.76 Highmark — Highmark Community Blue: $3,100.76 Highmark — Highmark Connect Blue: $3,100.76 Highmark — Highmark Indemnity: $3,100.76 Highmark — Highmark Managed Care: $3,100.76 Highmark — Highmark My Blue Access: $3,100.76 Highmark — Highmark My Direct Blue: $3,100.76 Highmark — Highmark Performance Blue: $3,100.76 Highmark — Highmark Social Mission Indemnity: $3,100.76
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	Not listed in the file	Not listed in the file	$1,950.92 – $4,966.50
Vaginal delivery, with care before and after: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $3,862.14 Highmark — Highmark Blue High Performance: $3,100.76 Highmark — Highmark Community Blue: $3,100.76 Highmark — Highmark Connect Blue: $3,100.76 Highmark — Highmark Indemnity: $3,100.76 Highmark — Highmark Managed Care: $3,100.76 Highmark — Highmark My Blue Access: $3,100.76 Highmark — Highmark My Direct Blue: $3,100.76 Highmark — Highmark Performance Blue: $3,100.76 Highmark — Highmark Social Mission Indemnity: $3,100.76
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · modifier HD In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	Not listed in the file	Not listed in the file	$1,384.19 – $4,966.50
Vaginal delivery, with care before and after: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $2,143.20 Amerihealth — Amerihealth Medicaid CHC: $2,946.90 Amerihealth — Amerihealth Medicaid HC: $2,946.90 Geisinger — Geisinger CHIP: $2,857.60 Geisinger — Geisinger Medicaid HC: $2,857.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $2,464.68 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $2,679 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $2,053.90 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $2,053.90 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $2,053.90
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$7,517	$1,428.23	$2,053.90 – $5,700
Cesarean delivery (C-section), with care before and after: 10 of 22 insurance plan rates Cigna — Cigna Commercial: $4,293.90 Highmark — Highmark Blue High Performance: $3,100.76 Highmark — Highmark Community Blue: $3,100.76 Highmark — Highmark Connect Blue: $3,100.76 Highmark — Highmark Indemnity: $3,100.76 Highmark — Highmark Managed Care: $3,100.76 Highmark — Highmark My Blue Access: $3,100.76 Highmark — Highmark My Direct Blue: $3,100.76 Highmark — Highmark Performance Blue: $3,100.76 Highmark — Highmark Social Mission Indemnity: $3,100.76
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	Not listed in the file	Not listed in the file	$2,162.08 – $5,700
Cesarean delivery (C-section), with care before and after: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $4,293.90 Highmark — Highmark Blue High Performance: $3,100.76 Highmark — Highmark Community Blue: $3,100.76 Highmark — Highmark Connect Blue: $3,100.76 Highmark — Highmark Indemnity: $3,100.76 Highmark — Highmark Managed Care: $3,100.76 Highmark — Highmark My Blue Access: $3,100.76 Highmark — Highmark My Direct Blue: $3,100.76 Highmark — Highmark Performance Blue: $3,100.76 Highmark — Highmark Social Mission Indemnity: $3,100.76
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · modifier HD In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	Not listed in the file	Not listed in the file	$2,053.90 – $5,700
Cesarean delivery (C-section), with care before and after: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $2,143.20 Amerihealth — Amerihealth Medicaid CHC: $2,946.90 Amerihealth — Amerihealth Medicaid HC: $2,946.90 Geisinger — Geisinger CHIP: $2,857.60 Geisinger — Geisinger Medicaid HC: $2,857.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $2,464.68 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $2,679 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $2,053.90 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $2,053.90 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $2,053.90
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$7,089	$1,346.91	$1,575 – $5,400
Vaginal delivery after a previous C-section, with care before and after: 10 of 21 insurance plan rates Cigna — Cigna Commercial: $4,048.45 Highmark — Highmark Blue High Performance: $3,100.76 Highmark — Highmark Community Blue: $3,100.76 Highmark — Highmark Connect Blue: $3,100.76 Highmark — Highmark Indemnity: $3,100.76 Highmark — Highmark Managed Care: $3,100.76 Highmark — Highmark My Blue Access: $3,100.76 Highmark — Highmark My Direct Blue: $3,100.76 Highmark — Highmark Performance Blue: $3,100.76 Highmark — Highmark Social Mission Indemnity: $3,100.76
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	Not listed in the file	Not listed in the file	$1,575 – $5,400
Vaginal delivery after a previous C-section, with care before and after: 10 of 19 insurance plan rates Cigna — Cigna Commercial: $4,048.45 Highmark — Highmark Blue High Performance: $3,100.76 Highmark — Highmark Community Blue: $3,100.76 Highmark — Highmark Connect Blue: $3,100.76 Highmark — Highmark Indemnity: $3,100.76 Highmark — Highmark Managed Care: $3,100.76 Highmark — Highmark My Blue Access: $3,100.76 Highmark — Highmark My Direct Blue: $3,100.76 Highmark — Highmark Performance Blue: $3,100.76 Highmark — Highmark Social Mission Indemnity: $3,100.76
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · modifier TG In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	Not listed in the file	Not listed in the file	$1,575 – $5,400
Vaginal delivery after a previous C-section, with care before and after: rates for 10 insurance plans Aetna — Aetna Better Health CHIP: $2,491.20 Amerihealth — Amerihealth Medicaid CHC: $3,425.40 Amerihealth — Amerihealth Medicaid HC: $3,425.40 Geisinger — Geisinger CHIP: $3,321.60 Geisinger — Geisinger Medicaid HC: $3,321.60 Highmark Wholecare — Highmark Wholecare Medicaid HC: $2,864.88 Pennsylvania Health and Wellness — Pennsylvania Health and Wellness Medicaid CHC: $3,114 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for Kids: $2,387.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid CHC: $2,387.40 University of Pittsburgh Medical Center — University of Pittsburgh Medical Center for You Medicaid HC: $2,387.40

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) 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	$48,126.22 – $159,998.51
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 46 insurance plan rates Aetna — Aetna Commercial: $159,101.22 Aetna — Aetna Medicare: $71,270.60 American Health Plans — American Health Plans Medicare: $75,382.36 Amerihealth — Amerihealth Caritas D-SNP Medicare: $71,955.89 Cigna — Cigna Commercial: $129,189.90 Cigna — Cigna Medicare: $73,326.48 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $79,494.13 Devoted Medicare — Devoted Health Medicare Advantage: $72,641.19 Highmark — Highmark Blue High Performance: $137,413.75 Highmark — Highmark Community Blue: $159,998.51
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	Not listed in the file
Spinal fusion (not neck), without major complications: rates for 4 insurance plans Claritev — Multiplan Complementary Network: 75% (a percentage in the contract, not a dollar amount) Claritev — PHCS Primary Network: 70% (a percentage in the contract, not a dollar amount) First Health — First Health PPO: 50% (a percentage in the contract, not a dollar amount) Intergroup — Intergroup: 70% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$8,463.14 – $31,085.28
Hip or knee replacement (major joint of the leg), without major complications: 10 of 46 insurance plan rates Aetna — Aetna Commercial: $31,085.28 Aetna — Aetna Medicare: $13,924.89 American Health Plans — American Health Plans Medicare: $14,728.24 Amerihealth — Amerihealth Caritas D-SNP Medicare: $14,058.78 Cigna — Cigna Commercial: $25,241.19 Cigna — Cigna Medicare: $14,326.56 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $15,531.60 Devoted Medicare — Devoted Health Medicare Advantage: $14,192.67 Highmark — Highmark Blue High Performance: $24,164.62 Highmark — Highmark Community Blue: $28,136.22
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$10,891.21 – $39,026.82
Neck (cervical) spinal fusion, without complications: 10 of 46 insurance plan rates Aetna — Aetna Commercial: $39,026.82 Aetna — Aetna Medicare: $17,482.36 American Health Plans — American Health Plans Medicare: $18,490.96 Amerihealth — Amerihealth Caritas D-SNP Medicare: $17,650.46 Cigna — Cigna Commercial: $31,689.71 Cigna — Cigna Medicare: $17,986.66 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $19,499.55 Devoted Medicare — Devoted Health Medicare Advantage: $17,818.56 Highmark — Highmark Blue High Performance: $31,097.42 Highmark — Highmark Community Blue: $36,208.47
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$6,126.30 – $20,367.26
Uterus and ovary surgery (not for cancer), without complications: 10 of 46 insurance plan rates Aetna — Aetna Commercial: $19,760.71 Aetna — Aetna Medicare: $8,851.96 American Health Plans — American Health Plans Medicare: $9,362.65 Amerihealth — Amerihealth Caritas D-SNP Medicare: $8,937.07 Cigna — Cigna Commercial: $16,045.66 Cigna — Cigna Medicare: $9,107.30 Devoted Medicare — Devoted Duel Plus PA HMO D-SNP: $9,873.34 Devoted Medicare — Devoted Health Medicare Advantage: $9,022.19 Highmark — Highmark Blue High Performance: $17,492.30 Highmark — Highmark Community Blue: $20,367.26

Source: Jefferson Hospital’s standard charges file (ahn.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 14, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	565 Coal Valley Road, Jefferson Hills, PA 15025
County	Allegheny County
State	Pennsylvania
Phone	(412) 469‑5000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	390265
Name in Medicare records	JEFFERSON HOSPITAL
Profile level	Medicare data + hospital website
Official website	ahn.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Jefferson Hospital — ahn.org
Specialty Services at AHN Jefferson Hospital — ahn.org
Jefferson Hospital Awards and Recognitions | AHN — ahn.org
Emergency Care (ER) | Jefferson Hospital — ahn.org
Visiting Hours | Allegheny Health Network — ahn.org

Jefferson Hospital

Summary

Profile from official sources

At a glance