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Acute Care Hospital

Kaleida Health

Also listed as: Buffalo General Medical Center/Gates Vascular Institute

Buffalo, New York · Erie County · Emergency services listed

Kaleida Health is an acute care hospital at 100 High Street, Buffalo, NY 14210. Phone: (716) 859-8620. It has an emergency department. Medicare overall rating: 3 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Kaleida Health is an acute care hospital in Buffalo, New York. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 7 services, specialties and programs. Medicare lists 1,688 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(716) 859‑8620 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
1,688Doctors and clinicians
7Services listed

Quick answers

Does Kaleida Health have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Kaleida Health. In a medical emergency, call 911.
Where is Kaleida Health?
100 High Street, Buffalo, NY 14210, in Erie County, New York.
What is the phone number of Kaleida Health?
(716) 859-8620, as listed by Medicare (CMS).
What is the Medicare star rating of Kaleida Health?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Kaleida Health for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Kaleida Health under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.6550; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4]

  • Cardiac
  • Stroke
  • Bariatric (weight loss surgery)
  • Orthopaedics
  • Cancer Care
  • Neurosciences

Programs and centers[4]

  • Stroke Care Center

Visiting and practical information

Patient portalMyChart

Recognition[4]

  • DNV Comprehensive Stroke
  • Commission on Cancer
  • MBSAQIP Accredited Center
  • DNV Accredited Hospital

Doctors and clinicians (1,688)

1,688 doctors and other clinicians list Kaleida Health as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (1,688)

And 1,664 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Buffalo

All hospitals in Buffalo · Hospitals in Erie County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Kaleida Health 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 hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean2 of 5 stars
Restfulness of Environment1 of 5 stars
Care Coordination2 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1064%National average: 72%
Would definitely recommend the hospital67%National average: 71%
Nurses “always” communicated well76%National average: 80%
Doctors “always” communicated well74%National average: 80%
“Always” got help as soon as they wanted58%National average: 64%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home86%National average: 86%
Room and bathroom “always” clean57%National average: 73%
Completed surveys4,739Response rate: 30%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.796No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.592Better than the national benchmark
Surgical site infections after colon surgery0.446Better than the national benchmark
Surgical site infections after abdominal hysterectomy0Better than the national benchmark
MRSA bloodstream infections0.381Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.022No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients9.4%
Deaths within 30 days: heart failure patients9.3%
Deaths within 30 days: pneumonia patients10.8%
Deaths within 30 days: COPD patients7%
Deaths within 30 days: stroke patients13.6%
Deaths within 30 days: coronary bypass surgery (CABG)1.4%
Serious complications (patient safety indicator PSI-90)0.9No different from the national rate
Complications after hip or knee replacement3.6%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)14.6%
Readmitted within 30 days: heart attack12.7%
Readmitted within 30 days: heart failure20.4%
Readmitted within 30 days: pneumonia16.5%
Readmitted within 30 days: COPD16.8%
Readmitted within 30 days: coronary bypass surgery10.4%
Readmitted within 30 days: hip or knee replacement6.1%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)239 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)51%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score0.6550Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack0.9190Fewer readmissions than expected
Heart failure1.1166More readmissions than expected
Pneumonia1.0174More readmissions than expected
COPD (chronic lung disease)0.9601Fewer readmissions than expected
Hip or knee replacement0.9441Fewer readmissions than expected
Coronary bypass surgery (CABG)1.0596More readmissions than expected

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score31.50 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)70.00 out of 100
Person and community engagement (patient survey)16.00 out of 100
Safety (infections and sepsis care)20.00 out of 100
Efficiency and cost reduction (Medicare spending)20.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio0.94Below the national median hospital (1.00): Medicare spent less

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

ER wait times and Medicare ratings nearby

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

ER wait times in BuffaloBest hospitals in Buffalo

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 Kaleida Health 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 →

$ 1 amount is marked with “!”: it is 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. It is shown exactly as listed; ask the hospital before relying on it.

Show the prices of 87 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $51.83 – $255.37
New patient office visit (about 30–44 minutes): 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $95.90
  • Aetna - WCHOB — All Commercial Plans: $95.90
  • GHI/Emblem Health — All Commercial Plans: $115.08
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $115.08
  • Independent Health Association — Article 43 PPO: $154.72
  • Independent Health Association — Article 44 HMO: $162.46
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $51.83
  • Independent Health Association — Medicare Managed Care Plan: $89.74
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $51.83
  • Independent Health Association — Self Funded Other Commercial Plan: $162.46
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $68.56 – $113.57
New patient office visit (about 30–44 minutes): rates for 2 insurance plans
  • Highmark WNY — All Plans: $113.57
  • United Healthcare Medicare Advantage — All Plans: $68.56
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Level 3 New Detail Lowmdm $385 $385 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $84.42 – $362.09
New patient office visit (about 45–59 minutes): 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $156.35
  • Aetna - WCHOB — All Commercial Plans: $156.35
  • GHI/Emblem Health — All Commercial Plans: $187.62
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $187.62
  • Independent Health Association — Article 43 PPO: $252
  • Independent Health Association — Article 44 HMO: $264.60
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $84.42
  • Independent Health Association — Medicare Managed Care Plan: $146.16
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $84.42
  • Independent Health Association — Self Funded Other Commercial Plan: $264.60
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $129.97
New patient office visit (about 45–59 minutes): rates for 1 insurance plan
  • United Healthcare Medicare Advantage — All Plans: $129.97
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Level 4 New Compr Modmdm $649 $649 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $114.77 – $459.42
New patient office visit (about 60–74 minutes): 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $212.59
  • Aetna - WCHOB — All Commercial Plans: $212.59
  • GHI/Emblem Health — All Commercial Plans: $255.11
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $255.11
  • Independent Health Association — Article 43 PPO: $342.60
  • Independent Health Association — Article 44 HMO: $359.73
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $114.77
  • Independent Health Association — Medicare Managed Care Plan: $198.71
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $114.77
  • Independent Health Association — Self Funded Other Commercial Plan: $359.73
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $169.68 – $203.98
New patient office visit (about 60–74 minutes): rates for 1 insurance plan
  • United Healthcare Medicare Advantage — All Plans: $203.98
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Level 5 New Comp High Mdm $675 $675 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $41.79 – $138.75
Established patient office visit (about 20–29 minutes): 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $77.40
  • Aetna - WCHOB — All Commercial Plans: $77.40
  • GHI/Emblem Health — All Commercial Plans: $92.88
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $92.88
  • Independent Health Association — Article 43 PPO: $124.74
  • Independent Health Association — Article 44 HMO: $130.98
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $41.79
  • Independent Health Association — Medicare Managed Care Plan: $72.35
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $41.79
  • Independent Health Association — Self Funded Other Commercial Plan: $130.98
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $59.64 – $84.14
Established patient office visit (about 20–29 minutes): rates for 1 insurance plan
  • United Healthcare Medicare Advantage — All Plans: $84.14
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Lev 3 Est Expfexpf Lowmdm $359 $359 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $61.65 – $217.86
Established patient office visit (about 30–39 minutes): 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $113.93
  • Aetna - WCHOB — All Commercial Plans: $113.93
  • GHI/Emblem Health — All Commercial Plans: $136.71
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $136.71
  • Independent Health Association — Article 43 PPO: $184.04
  • Independent Health Association — Article 44 HMO: $193.24
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $61.65
  • Independent Health Association — Medicare Managed Care Plan: $106.74
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $61.65
  • Independent Health Association — Self Funded Other Commercial Plan: $193.24
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $34.03 – $128.26
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans
  • HUMANA INC. — All Plans: $54.56
  • United Healthcare — All Plans: $34.03
  • United Healthcare Medicare Advantage — All Plans: $128.26
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Level 4 Est Detdet Modmdm $620 $620 Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation Not listed in the file Not listed in the file $200.87 – $322.97
Office consultation with a specialist (moderate): rates for 6 insurance plans
  • Univera — Access Other Commercial Plan: $274.53
  • Univera — Medicare Managed Care Plan: $200.87
  • Univera — Other Commercial Plan: $322.97
  • Univera - WCHOB — Access Other Commercial Plan: $274.53
  • Univera - WCHOB — All Commercial Plans: $322.97
  • Univera - WCHOB — Medicare Managed Care Plan: $200.87
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: Level3 Op Conslt Dtlowmdm $649 $649 Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: Tel Lev3 Op Con Dtlowmdm $649 $649 Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation Not listed in the file Not listed in the file $283.83 – $456.31
Office consultation with a specialist (moderate to high): rates for 6 insurance plans
  • Univera — Access Other Commercial Plan: $387.87
  • Univera — Medicare Managed Care Plan: $283.83
  • Univera — Other Commercial Plan: $456.31
  • Univera - WCHOB — Access Other Commercial Plan: $387.87
  • Univera - WCHOB — All Commercial Plans: $456.31
  • Univera - WCHOB — Medicare Managed Care Plan: $283.83
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: Levl4 Op Conslt Compmdmdm $860 $860 Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: Tel Lev4 Op Con Compmdmdm $860 $860 Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 18-39 Not listed in the file Not listed in the file $195.14 – $313.74
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans
  • Univera — Access Other Commercial Plan: $266.68
  • Univera — Medicare Managed Care Plan: $195.14
  • Univera — Other Commercial Plan: $313.74
  • Univera - WCHOB — Access Other Commercial Plan: $266.68
  • Univera - WCHOB — All Commercial Plans: $313.74
  • Univera - WCHOB — Medicare Managed Care Plan: $195.14
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: New Pt Prevnt Med 18-39Yr $617 $617 Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: Tel New Pt Prevnt 18-39Yr $617 $617 Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 40-64 Not listed in the file Not listed in the file $229.71 – $369.29
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans
  • Univera — Access Other Commercial Plan: $313.89
  • Univera — Medicare Managed Care Plan: $229.71
  • Univera — Other Commercial Plan: $369.29
  • Univera - WCHOB — Access Other Commercial Plan: $313.89
  • Univera - WCHOB — All Commercial Plans: $369.29
  • Univera - WCHOB — Medicare Managed Care Plan: $229.71
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: New Pt Prevnt Med 40-64Yr $617 $617 Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64 $229 $229 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $79.55 – $1,271.56
Emergency room visit (moderate): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $82.86
  • Aetna — Medicare Managed Care Plan: $361.20
  • Aetna - WCHOB — All Commercial Plans: $82.86
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $625.01
  • BCBS — Align - HealthNow Other Commercial Plan: $922.69
  • BCBS — HealthNow PPO/Traditional: $1,166.23
  • BCBS — HealthNow Standard Exchange: $830.45
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $387.88
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $1,007.88
  • BCBS - WCHOB — HealthNow PPO/Traditional: $1,271.56
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $24.41 – $145.32
Emergency room visit (moderate): rates for 4 insurance plans
  • MAGNACARE ADMIN SRV,LLC — All Plans: $85
  • Meritain Health — All Plans: $95.45
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $24.41
  • NOVA HEALTHCARE ADMINISTRATORS — All Plans: $145.32
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Level Iii Visit Hosp $1,332 $1,332 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $135.59 – $1,943.65
Emergency room visit (moderately high): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $141.24
  • Aetna — Medicare Managed Care Plan: $552.11
  • Aetna - WCHOB — All Commercial Plans: $141.24
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $955.36
  • BCBS — Align - HealthNow Other Commercial Plan: $1,410.39
  • BCBS — HealthNow PPO/Traditional: $1,782.65
  • BCBS — HealthNow Standard Exchange: $1,269.39
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $592.90
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $1,540.61
  • BCBS - WCHOB — HealthNow PPO/Traditional: $1,943.65
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Level Iv Visit Hosp $2,162 $2,162 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Level Iv Visit Hosp 25 $2,162 $2,162 Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $196.58 – $2,774.04
Emergency room visit (high): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $204.78
  • Aetna — Medicare Managed Care Plan: $788
  • Aetna - WCHOB — All Commercial Plans: $204.78
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $1,363.53
  • BCBS — Align - HealthNow Other Commercial Plan: $2,012.96
  • BCBS — HealthNow PPO/Traditional: $2,544.26
  • BCBS — HealthNow Standard Exchange: $1,811.72
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $846.20
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $2,198.80
  • BCBS - WCHOB — HealthNow PPO/Traditional: $2,774.04
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Level V Visit Hosp $2,825 $2,825 Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: Er Level V Visit Hosp 25 $2,825 $2,825 Not listed in the file

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca Not listed in the file Not listed in the file $4.92 – $31.57
Basic metabolic panel (blood test): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $9.73
  • Aetna — Medicare Managed Care Plan: $8.97
  • Aetna - WCHOB — All Commercial Plans: $9.73
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $5.77
  • BCBS — Align - HealthNow Other Commercial Plan: $7.45
  • BCBS — HealthNow PPO/Traditional: $9.40
  • BCBS — HealthNow Standard Exchange: $6.70
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $9.63
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $9.14
  • BCBS - WCHOB — HealthNow PPO/Traditional: $11.53
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Basic Metabolic Panel $84 $84 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel Not listed in the file Not listed in the file $6.14 – $39.41
Comprehensive metabolic panel (blood test): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $12.14
  • Aetna — Medicare Managed Care Plan: $11.19
  • Aetna - WCHOB — All Commercial Plans: $12.14
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $7.20
  • BCBS — Align - HealthNow Other Commercial Plan: $9.30
  • BCBS — HealthNow PPO/Traditional: $11.73
  • BCBS — HealthNow Standard Exchange: $8.37
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $12.02
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $11.41
  • BCBS - WCHOB — HealthNow PPO/Traditional: $14.39
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Compre Metabolic Panel $107 $107 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Ycmp Poc $107 $107 Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel Not listed in the file Not listed in the file $27.82 – $178.41
Obstetric blood test panel: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $54.98
  • Aetna — Medicare Managed Care Plan: $50.68
  • Aetna - WCHOB — All Commercial Plans: $54.98
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $32.60
  • BCBS — Align - HealthNow Other Commercial Plan: $42.09
  • BCBS — HealthNow PPO/Traditional: $53.10
  • BCBS — HealthNow Standard Exchange: $37.88
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $54.42
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $51.64
  • BCBS - WCHOB — HealthNow PPO/Traditional: $65.15
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel Not listed in the file Not listed in the file $7.79 – $49.97
Cholesterol panel (lipid panel): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $15.40
  • Aetna — Medicare Managed Care Plan: $14.19
  • Aetna - WCHOB — All Commercial Plans: $15.40
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $9.13
  • BCBS — Align - HealthNow Other Commercial Plan: $11.79
  • BCBS — HealthNow PPO/Traditional: $14.87
  • BCBS — HealthNow Standard Exchange: $10.61
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $15.24
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $14.46
  • BCBS - WCHOB — HealthNow PPO/Traditional: $18.25
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lipid Panel $140 $140 Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel Not listed in the file Not listed in the file $5.05 – $32.39
Kidney function panel: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $9.98
  • Aetna — Medicare Managed Care Plan: $9.20
  • Aetna - WCHOB — All Commercial Plans: $9.98
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $5.92
  • BCBS — Align - HealthNow Other Commercial Plan: $7.64
  • BCBS — HealthNow PPO/Traditional: $9.64
  • BCBS — HealthNow Standard Exchange: $6.88
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $9.88
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $9.38
  • BCBS - WCHOB — HealthNow PPO/Traditional: $11.83
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Renal Function Panel $104 $104 Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel Not listed in the file Not listed in the file $4.75 – $30.49
Liver function panel: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $9.40
  • Aetna — Medicare Managed Care Plan: $8.66
  • Aetna - WCHOB — All Commercial Plans: $9.40
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $5.57
  • BCBS — Align - HealthNow Other Commercial Plan: $7.19
  • BCBS — HealthNow PPO/Traditional: $9.07
  • BCBS — HealthNow Standard Exchange: $6.47
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $9.30
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $8.82
  • BCBS - WCHOB — HealthNow PPO/Traditional: $11.13
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Hepatic Function Panel $84 $84 Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $1.84 – $11.83
Urine test (automated, with microscope): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $3.65
  • Aetna — Medicare Managed Care Plan: $3.36
  • Aetna - WCHOB — All Commercial Plans: $3.65
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2.16
  • BCBS — Align - HealthNow Other Commercial Plan: $2.79
  • BCBS — HealthNow PPO/Traditional: $3.52
  • BCBS — HealthNow Standard Exchange: $2.51
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $3.61
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3.42
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4.32
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: Urinalysis W Microscopy $33 $33 Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope Not listed in the file Not listed in the file $2.02 – $12.99
Urine test (manual, without microscope): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $4
  • Aetna — Medicare Managed Care Plan: $3.69
  • Aetna - WCHOB — All Commercial Plans: $4
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2.37
  • BCBS — Align - HealthNow Other Commercial Plan: $3.06
  • BCBS — HealthNow PPO/Traditional: $3.86
  • BCBS — HealthNow Standard Exchange: $2.76
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $3.96
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3.76
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4.74
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: Ua Nonauto W/O Micro Poct $26 $26 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope Not listed in the file Not listed in the file $1.31 – $8.40
Urine test (automated, without microscope): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $2.59
  • Aetna — Medicare Managed Care Plan: $2.39
  • Aetna - WCHOB — All Commercial Plans: $2.59
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $1.53
  • BCBS — Align - HealthNow Other Commercial Plan: $1.98
  • BCBS — HealthNow PPO/Traditional: $2.50
  • BCBS — HealthNow Standard Exchange: $1.78
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $2.56
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $2.43
  • BCBS - WCHOB — HealthNow PPO/Traditional: $3.07
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Urinalysis $24 $24 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Specific Gravity Ur $24 $24 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total Not listed in the file Not listed in the file $10.70 – $68.62
PSA (prostate specific antigen) blood test: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $21.15
  • Aetna — Medicare Managed Care Plan: $19.49
  • Aetna - WCHOB — All Commercial Plans: $21.15
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $12.54
  • BCBS — Align - HealthNow Other Commercial Plan: $16.19
  • BCBS — HealthNow PPO/Traditional: $20.42
  • BCBS — HealthNow Standard Exchange: $14.57
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $20.93
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $19.86
  • BCBS - WCHOB — HealthNow PPO/Traditional: $25.06
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Psa - Prostate Specif Ag $189 $189 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Psa Screen $189 $189 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone Not listed in the file Not listed in the file $9.77 – $62.69
Thyroid stimulating hormone (TSH) test: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $19.32
  • Aetna — Medicare Managed Care Plan: $17.81
  • Aetna - WCHOB — All Commercial Plans: $19.32
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $11.46
  • BCBS — Align - HealthNow Other Commercial Plan: $14.79
  • BCBS — HealthNow PPO/Traditional: $18.66
  • BCBS — HealthNow Standard Exchange: $13.31
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $19.12
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $18.15
  • BCBS - WCHOB — HealthNow PPO/Traditional: $22.89
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Thyroid Stimulating Hormo $175 $175 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Esoterix Tsh $175 $175 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc Not listed in the file Not listed in the file $4.52 – $28.99
Complete blood count (CBC) with differential: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $8.94
  • Aetna — Medicare Managed Care Plan: $8.24
  • Aetna - WCHOB — All Commercial Plans: $8.94
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $5.30
  • BCBS — Align - HealthNow Other Commercial Plan: $6.84
  • BCBS — HealthNow PPO/Traditional: $8.63
  • BCBS — HealthNow Standard Exchange: $6.16
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $8.84
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $8.39
  • BCBS - WCHOB — HealthNow PPO/Traditional: $10.59
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Bill Auto Diff $80 $80 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Ycbc Poc $80 $80 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated Not listed in the file Not listed in the file $3.76 – $24.14
Complete blood count (CBC), automated: 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $7.44
  • Aetna — Medicare Managed Care Plan: $6.86
  • Aetna - WCHOB — All Commercial Plans: $7.44
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $4.41
  • BCBS — Align - HealthNow Other Commercial Plan: $5.70
  • BCBS — HealthNow PPO/Traditional: $7.19
  • BCBS — HealthNow Standard Exchange: $5.13
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $7.36
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $6.99
  • BCBS - WCHOB — HealthNow PPO/Traditional: $8.82
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Bill Cbc $67 $67 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Bill Auto + Plt Est $67 $67 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time Not listed in the file Not listed in the file $2.50 – $16.01
Blood clotting time test (prothrombin time, PT): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $4.93
  • Aetna — Medicare Managed Care Plan: $4.55
  • Aetna - WCHOB — All Commercial Plans: $4.93
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2.93
  • BCBS — Align - HealthNow Other Commercial Plan: $3.78
  • BCBS — HealthNow PPO/Traditional: $4.76
  • BCBS — HealthNow Standard Exchange: $3.40
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $4.88
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $4.63
  • BCBS - WCHOB — HealthNow PPO/Traditional: $5.85
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt - Prothrombin Time W $41 $41 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Protime Poc $41 $41 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial Not listed in the file Not listed in the file $3.50 – $22.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 44 insurance plan rates
  • Aetna — All Commercial Plans: $6.91
  • Aetna — Medicare Managed Care Plan: $6.37
  • Aetna - WCHOB — All Commercial Plans: $6.91
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $4.10
  • BCBS — Align - HealthNow Other Commercial Plan: $5.29
  • BCBS — HealthNow PPO/Traditional: $6.67
  • BCBS — HealthNow Standard Exchange: $4.76
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $6.84
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $6.49
  • BCBS - WCHOB — HealthNow PPO/Traditional: $8.19
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Aptt Act.Partial Thrombop $62 $62 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Mixing Study Aptt Basline $62 $62 Not listed in the file

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $75.43 – $486.98
CT scan of the head or brain, without contrast: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $78.58
  • Aetna — Medicare Managed Care Plan: $138.33
  • Aetna - WCHOB — All Commercial Plans: $78.58
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $239.37
  • BCBS — Align - HealthNow Other Commercial Plan: $353.37
  • BCBS — HealthNow PPO/Traditional: $446.65
  • BCBS — HealthNow Standard Exchange: $318.05
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $148.55
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $386
  • BCBS - WCHOB — HealthNow PPO/Traditional: $486.98
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $20 – $79.13
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • AMBETTER FROM FIDELIS CARE — All Plans: $49.35
  • AMERICAN PROGRESSIVE LIFE & HEALTH — All Plans: $38.32
  • EmblemHealth - HIP — All Plans: $55.36
  • Fidelis Care — All Plans: $38.32
  • FIDELIS CARE — All Plans: $79.13
  • Highmark WNY — All Plans: $50.46
  • HUMANA INC. — All Plans: $37.65
  • Meritain Health — All Plans: $60.74
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $79.13
  • MVP Healthplan — All Plans: $52.90
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: Ct Brain/Head W/O C $823 $823 Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $238.08 – $2,502.42
MRI of the brain, before and after contrast: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $248
  • Aetna — Medicare Managed Care Plan: $461.62
  • Aetna - WCHOB — All Commercial Plans: $248
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $798.78
  • BCBS — Align - HealthNow Other Commercial Plan: $1,179.23
  • BCBS — HealthNow PPO/Traditional: $1,490.48
  • BCBS — HealthNow Standard Exchange: $1,061.34
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $495.72
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $1,288.10
  • BCBS - WCHOB — HealthNow PPO/Traditional: $1,625.09
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $56.98 – $275.92
MRI of the brain, before and after contrast: rates for 10 insurance plans
  • AMERICAN PROGRESSIVE LIFE & HEALTH — All Plans: $103.28
  • Fidelis Care — All Plans: $82.62
  • FIDELIS CARE — All Plans: $179
  • Highmark WNY — All Plans: $138.50
  • HUMANA INC. — All Plans: $100.27
  • Meritain Health — All Plans: $164.16
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $214.22
  • OPTUM VA CCN — All Plans: $102.32
  • United Healthcare — All Plans: $114.52
  • Univera Healthcare — All Plans: $275.92
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: Mri Brain Ww C $3,612 $3,612 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views Not listed in the file Not listed in the file $21.12 – $405.37
Chest X-ray, 2 views: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $26.78
  • Aetna — Medicare Managed Care Plan: $115.15
  • Aetna - WCHOB — All Commercial Plans: $26.78
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $199.25
  • BCBS — Align - HealthNow Other Commercial Plan: $294.15
  • BCBS — HealthNow PPO/Traditional: $371.79
  • BCBS — HealthNow Standard Exchange: $264.75
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $123.66
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $321.31
  • BCBS - WCHOB — HealthNow PPO/Traditional: $405.37
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-ray exam chest 2 views Not listed in the file Not listed in the file $8.94 – $26.67
Chest X-ray, 2 views: rates for 5 insurance plans
  • Highmark WNY — All Plans: $9.16
  • HUMANA INC. — All Plans: $9.61
  • Meritain Health — All Plans: $15.70
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $9.16
  • Univera Healthcare — All Plans: $26.67
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: Chest Xray 2 Views $311 $311 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $43.38 – $486.98
X-ray of the lower spine, at least 4 views: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $45.19
  • Aetna — Medicare Managed Care Plan: $138.33
  • Aetna - WCHOB — All Commercial Plans: $45.19
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $239.37
  • BCBS — Align - HealthNow Other Commercial Plan: $353.37
  • BCBS — HealthNow PPO/Traditional: $446.65
  • BCBS — HealthNow Standard Exchange: $318.05
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $148.55
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $386
  • BCBS - WCHOB — HealthNow PPO/Traditional: $486.98
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: Lumbosacral Min 4V $497 $497 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: X-RAY EXAM L-2 SPINE 4/>VWS $35 $35 Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $137.23 – $1,250.15
MRI of the lower back (lumbar spine), without contrast: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $142.95
  • Aetna — Medicare Managed Care Plan: $315.71
  • Aetna - WCHOB — All Commercial Plans: $142.95
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $546.30
  • BCBS — Align - HealthNow Other Commercial Plan: $806.50
  • BCBS — HealthNow PPO/Traditional: $1,019.37
  • BCBS — HealthNow Standard Exchange: $725.87
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $339.03
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $880.96
  • BCBS - WCHOB — HealthNow PPO/Traditional: $1,111.43
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $62.09 – $115
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans
  • FIDELIS CARE — All Plans: $65.36
  • Highmark WNY — All Plans: $85.73
  • OPTUM VA CCN — All Plans: $62.80
  • United Healthcare — All Plans: $65.46
  • Univera Healthcare — All Plans: $115
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: Mri L-Spine W/O C $1,699 $1,699 Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $127.39 – $817.03
CT scan of the pelvis, with contrast: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $202.04
  • Aetna — Medicare Managed Care Plan: $232.09
  • Aetna - WCHOB — All Commercial Plans: $202.04
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $401.60
  • BCBS — Align - HealthNow Other Commercial Plan: $592.87
  • BCBS — HealthNow PPO/Traditional: $749.36
  • BCBS — HealthNow Standard Exchange: $533.60
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $249.23
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $647.61
  • BCBS - WCHOB — HealthNow PPO/Traditional: $817.03
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Doctor (professional) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $28.79 – $90
CT scan of the pelvis, with contrast: rates for 7 insurance plans
  • FIDELIS CARE — All Plans: $50.52
  • Highmark WNY — All Plans: $65.91
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $47.73
  • United Healthcare — All Plans: $63.25
  • United Healthcare Student Resources — All Plans: $57.85
  • Univera Healthcare — All Plans: $90
  • Wellcare — All Plans: $55.73
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: Ct Pelvis W/ C $1,819 $1,819 Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $157.40 – $1,112.42
MRI of a leg joint (such as the knee), without contrast: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $163.96
  • Aetna — Medicare Managed Care Plan: $315.71
  • Aetna - WCHOB — All Commercial Plans: $163.96
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $546.30
  • BCBS — Align - HealthNow Other Commercial Plan: $806.50
  • BCBS — HealthNow PPO/Traditional: $1,019.37
  • BCBS — HealthNow Standard Exchange: $725.87
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $339.03
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $880.96
  • BCBS - WCHOB — HealthNow PPO/Traditional: $1,111.43
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $60.44 – $120
MRI of a leg joint (such as the knee), without contrast: rates for 2 insurance plans
  • Highmark WNY — All Plans: $82.61
  • Univera Healthcare — All Plans: $120
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: Mri Joint Low Ext W/Oc Lt $1,699 $1,699 Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast Not listed in the file Not listed in the file $243.32 – $1,625.09
CT scan of the abdomen and pelvis, with contrast: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $253.46
  • Aetna — Medicare Managed Care Plan: $461.62
  • Aetna - WCHOB — All Commercial Plans: $253.46
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $798.78
  • BCBS — Align - HealthNow Other Commercial Plan: $1,179.23
  • BCBS — HealthNow PPO/Traditional: $1,490.48
  • BCBS — HealthNow Standard Exchange: $1,061.34
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $495.72
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $1,288.10
  • BCBS - WCHOB — HealthNow PPO/Traditional: $1,625.09
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: Ct abd & pelv w/contrast Not listed in the file Not listed in the file $4.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $171.09
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates
  • AMBETTER FROM FIDELIS CARE — All Plans: $106.20
  • AMERICAN PROGRESSIVE LIFE & HEALTH — All Plans: $82.27
  • EmblemHealth - HIP — All Plans: $116.25
  • Fidelis Care — All Plans: $82.27
  • FIDELIS CARE — All Plans: $171.09
  • Highmark WNY — All Plans: $103.62
  • HUMANA INC. — All Plans: $80.06
  • Meritain Health — All Plans: $130.40
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $171.09
  • MVP Healthplan — All Plans: $76.34
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: Ct Abdomen/Pelvis W/Con $1,834 $1,834 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $75.93 – $486.98
Ultrasound of the abdomen, complete: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $88.85
  • Aetna — Medicare Managed Care Plan: $138.33
  • Aetna - WCHOB — All Commercial Plans: $88.85
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $239.37
  • BCBS — Align - HealthNow Other Commercial Plan: $353.37
  • BCBS — HealthNow PPO/Traditional: $446.65
  • BCBS — HealthNow Standard Exchange: $318.05
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $148.55
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $386
  • BCBS - WCHOB — HealthNow PPO/Traditional: $486.98
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $33.10 – $45.26
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • Highmark WNY — All Plans: $33.73
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $33.10
  • Univera Healthcare — All Plans: $45.26
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: Us Abdomen Comp $653 $653 Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus Not listed in the file Not listed in the file $75.93 – $486.98
Pregnancy ultrasound (after the first trimester): 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $99.98
  • Aetna — Medicare Managed Care Plan: $138.33
  • Aetna - WCHOB — All Commercial Plans: $99.98
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $239.37
  • BCBS — Align - HealthNow Other Commercial Plan: $353.37
  • BCBS — HealthNow PPO/Traditional: $446.65
  • BCBS — HealthNow Standard Exchange: $318.05
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $148.55
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $386
  • BCBS - WCHOB — HealthNow PPO/Traditional: $486.98
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: Ob us >/= 14 wks sngl fetus Not listed in the file Not listed in the file $49.64
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan
  • NOVA HEALTHCARE ADMINISTRATORS — All Plans: $49.64
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: Us Preg Uter>14Wks 1 Gst $690 $690 Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $75.93 – $486.98
Transvaginal ultrasound: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $97.68
  • Aetna — Medicare Managed Care Plan: $138.33
  • Aetna - WCHOB — All Commercial Plans: $97.68
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $239.37
  • BCBS — Align - HealthNow Other Commercial Plan: $353.37
  • BCBS — HealthNow PPO/Traditional: $446.65
  • BCBS — HealthNow Standard Exchange: $318.05
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $148.55
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $386
  • BCBS - WCHOB — HealthNow PPO/Traditional: $486.98
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $18.32 – $85.55
Transvaginal ultrasound: rates for 4 insurance plans
  • FIDELIS CARE — All Plans: $39.27
  • Highmark WNY — All Plans: $39.43
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $65.45
  • Univera Healthcare — All Plans: $85.55
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: Us Transvaginal $653 $653 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $54.50 – $170.81
Diagnostic mammogram, one breast: 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $100.74
  • Aetna - WCHOB — All Commercial Plans: $100.74
  • GHI/Emblem Health — All Commercial Plans: $120.89
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $120.89
  • Independent Health Association — Article 43 PPO: $162.68
  • Independent Health Association — Article 44 HMO: $170.81
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $54.50
  • Independent Health Association — Medicare Managed Care Plan: $94.35
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $54.50
  • Independent Health Association — Self Funded Other Commercial Plan: $170.81
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: Scrn To Dx Mam Dig Uni Lt $383 $383 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: Scrn To Dx Mam Dig Uni Rt $383 $383 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $69.86 – $218.97
Diagnostic mammogram, both breasts: 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $128.36
  • Aetna - WCHOB — All Commercial Plans: $128.36
  • GHI/Emblem Health — All Commercial Plans: $154.04
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $154.04
  • Independent Health Association — Article 43 PPO: $208.54
  • Independent Health Association — Article 44 HMO: $218.97
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $69.86
  • Independent Health Association — Medicare Managed Care Plan: $120.95
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $69.86
  • Independent Health Association — Self Funded Other Commercial Plan: $218.97
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Dx Mammogrm Dig Bil $383 $383 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: Scrn To Dx Mammo Dig Bil $383 $383 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $57.62 – $180.60
Screening mammogram, both breasts: 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $106.20
  • Aetna - WCHOB — All Commercial Plans: $106.20
  • GHI/Emblem Health — All Commercial Plans: $127.44
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $127.44
  • Independent Health Association — Article 43 PPO: $172
  • Independent Health Association — Article 44 HMO: $180.60
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $57.62
  • Independent Health Association — Medicare Managed Care Plan: $99.76
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $57.62
  • Independent Health Association — Self Funded Other Commercial Plan: $180.60
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Scrn Mammogrm Dig Bil $329 $329 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: Scrn Mammogr Dig Uni Lt $329 $329 Not listed in the file

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $16.01 – $154.51
Electrocardiogram (ECG/EKG) with reading: 10 of 26 insurance plan rates
  • Aetna — All Commercial Plans: $16.68
  • Aetna - WCHOB — All Commercial Plans: $16.68
  • GHI/Emblem Health — All Commercial Plans: $20.01
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $20.01
  • Independent Health Association — Article 43 PPO: $147.15
  • Independent Health Association — Article 44 HMO: $154.51
  • Independent Health Association — Essential Plan Medicaid Managed Care Plan: $49.30
  • Independent Health Association — Medicare Managed Care Plan: $85.35
  • Independent Health Association — Medisource Medicaid Managed Care Plan: $49.30
  • Independent Health Association — Self Funded Other Commercial Plan: $154.51
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee In the file: Md Ekg 12+ Lead W/Int&Rpt $79 $79 Not listed in the file
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROCARDIOGRAM COMPLETE $44 $44 Not listed in the file
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy Not listed in the file Not listed in the file $691.08 – $15,101.23
Left heart catheterization (diagnostic): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $719.88
  • Aetna — Medicare Managed Care Plan: $4,289.66
  • Aetna - WCHOB — All Commercial Plans: $719.88
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $7,422.73
  • BCBS — Align - HealthNow Other Commercial Plan: $10,958.06
  • BCBS — HealthNow PPO/Traditional: $13,850.35
  • BCBS — HealthNow Standard Exchange: $9,862.58
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $4,606.53
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $11,969.78
  • BCBS - WCHOB — HealthNow PPO/Traditional: $15,101.23
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: LEFT HRT CATH W/VENTRCLGRPHY $648 $648 Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrophysiology evaluation Not listed in the file Not listed in the file $414.94 – $36,331.58
Heart rhythm study (electrophysiology evaluation): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $432.23
  • Aetna — Medicare Managed Care Plan: $10,320.37
  • Aetna - WCHOB — All Commercial Plans: $432.23
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $17,858.13
  • BCBS — Align - HealthNow Other Commercial Plan: $26,363.67
  • BCBS — HealthNow PPO/Traditional: $33,322.13
  • BCBS — HealthNow Standard Exchange: $23,728.08
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $11,082.71
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $28,797.72
  • BCBS - WCHOB — HealthNow PPO/Traditional: $36,331.58
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol Not listed in the file Not listed in the file $1,022.66 – $121,752.66
Heart rhythm study with ablation for atrial fibrillation: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $1,065.28
  • Aetna — Medicare Managed Care Plan: $34,585.12
  • Aetna - WCHOB — All Commercial Plans: $1,065.28
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $59,845.30
  • BCBS — Align - HealthNow Other Commercial Plan: $88,348.66
  • BCBS — HealthNow PPO/Traditional: $111,667.51
  • BCBS — HealthNow Standard Exchange: $79,516.40
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $37,139.85
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $96,505.53
  • BCBS - WCHOB — HealthNow PPO/Traditional: $121,752.66
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $563.72 – $4,000.09
Sleep study (overnight, in a sleep lab): 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $587.21
  • Aetna — Medicare Managed Care Plan: $1,136.27
  • Aetna - WCHOB — All Commercial Plans: $587.21
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $1,966.17
  • BCBS — Align - HealthNow Other Commercial Plan: $2,902.63
  • BCBS — HealthNow PPO/Traditional: $3,668.75
  • BCBS — HealthNow Standard Exchange: $2,612.45
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,220.20
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3,170.62
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4,000.09
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Polysm4+Par/6Yrs+Pfsonly $1,347 $1,347 Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Polysom 4+Parm/Stg 6Yrs+ $1,347 $1,347 Not listed in the file

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises Not listed in the file Not listed in the file $16.45 – $105.49
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $34.99
  • Aetna — Medicare Managed Care Plan: $29.97
  • Aetna - WCHOB — All Commercial Plans: $34.99
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $51.85
  • BCBS — Align - HealthNow Other Commercial Plan: $76.55
  • BCBS — HealthNow PPO/Traditional: $96.75
  • BCBS — HealthNow Standard Exchange: $68.90
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $32.18
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $83.62
  • BCBS - WCHOB — HealthNow PPO/Traditional: $105.49
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Theraptc Exer Ea 15Min $163 $163 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: Ot Theraptc Exer Ea 15Min $163 $163 Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $55.54 – $356.22
Physical therapy evaluation (low complexity): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $119.09
  • Aetna — Medicare Managed Care Plan: $101.19
  • Aetna - WCHOB — All Commercial Plans: $119.09
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $175.09
  • BCBS — Align - HealthNow Other Commercial Plan: $258.49
  • BCBS — HealthNow PPO/Traditional: $326.71
  • BCBS — HealthNow Standard Exchange: $232.65
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $108.66
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $282.35
  • BCBS - WCHOB — HealthNow PPO/Traditional: $356.22
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $19.05
Physical therapy evaluation (low complexity): rates for 1 insurance plan
  • APWU Health Plan — All Plans: $19.05
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval Low Complex 20Min $222 $222 Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $55.54 – $356.22
Physical therapy evaluation (moderate complexity): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $119.09
  • Aetna — Medicare Managed Care Plan: $101.19
  • Aetna - WCHOB — All Commercial Plans: $119.09
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $175.09
  • BCBS — Align - HealthNow Other Commercial Plan: $258.49
  • BCBS — HealthNow PPO/Traditional: $326.71
  • BCBS — HealthNow Standard Exchange: $232.65
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $108.66
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $282.35
  • BCBS - WCHOB — HealthNow PPO/Traditional: $356.22
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval Mod Complex 30Min $333 $333 Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $55.54 – $356.22
Physical therapy evaluation (high complexity): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $119.09
  • Aetna — Medicare Managed Care Plan: $101.19
  • Aetna - WCHOB — All Commercial Plans: $119.09
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $175.09
  • BCBS — Align - HealthNow Other Commercial Plan: $258.49
  • BCBS — HealthNow PPO/Traditional: $326.71
  • BCBS — HealthNow Standard Exchange: $232.65
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $108.66
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $282.35
  • BCBS - WCHOB — HealthNow PPO/Traditional: $356.22
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: Pt Eval High Complx 45Min $500 $500 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes Not listed in the file Not listed in the file $56.16 – $826.79
Psychotherapy, 30 minutes: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $85.21
  • Aetna — Medicare Managed Care Plan: $234.86
  • Aetna - WCHOB — All Commercial Plans: $85.21
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $406.39
  • BCBS — Align - HealthNow Other Commercial Plan: $599.95
  • BCBS — HealthNow PPO/Traditional: $758.31
  • BCBS — HealthNow Standard Exchange: $539.98
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $252.21
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $655.34
  • BCBS - WCHOB — HealthNow PPO/Traditional: $826.79
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Psy Tx 30Min Minim $355 $355 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: Offsite Psy Tx (30 Min) $355 $355 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes Not listed in the file Not listed in the file $85.94 – $826.79
Psychotherapy, 45 minutes: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $112.44
  • Aetna — Medicare Managed Care Plan: $234.86
  • Aetna - WCHOB — All Commercial Plans: $112.44
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $406.39
  • BCBS — Align - HealthNow Other Commercial Plan: $599.95
  • BCBS — HealthNow PPO/Traditional: $758.31
  • BCBS — HealthNow Standard Exchange: $539.98
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $252.21
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $655.34
  • BCBS - WCHOB — HealthNow PPO/Traditional: $826.79
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Psych Tx 45Min Minim $515 $515 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: Offsite Psy Tx 45Min $515 $515 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes Not listed in the file Not listed in the file $115.10 – $826.79
Psychotherapy, 60 minutes: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $166.41
  • Aetna — Medicare Managed Care Plan: $234.86
  • Aetna - WCHOB — All Commercial Plans: $166.41
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $406.39
  • BCBS — Align - HealthNow Other Commercial Plan: $599.95
  • BCBS — HealthNow PPO/Traditional: $758.31
  • BCBS — HealthNow Standard Exchange: $539.98
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $252.21
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $655.34
  • BCBS - WCHOB — HealthNow PPO/Traditional: $826.79
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: Psych Tx 60Min Minimum $515 $515 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES $498 $498 Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $115.10 – $826.79
Family psychotherapy, without the patient: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $121.55
  • Aetna — Medicare Managed Care Plan: $234.86
  • Aetna - WCHOB — All Commercial Plans: $121.55
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $406.39
  • BCBS — Align - HealthNow Other Commercial Plan: $599.95
  • BCBS — HealthNow PPO/Traditional: $758.31
  • BCBS — HealthNow Standard Exchange: $539.98
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $252.21
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $655.34
  • BCBS - WCHOB — HealthNow PPO/Traditional: $826.79
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Family Psy Tx W/O Pt $613 $613 Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Offsite Fam Psy Tx W/O Pt $613 $613 Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min Not listed in the file Not listed in the file $115.10 – $826.79
Family psychotherapy, with the patient: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $126.76
  • Aetna — Medicare Managed Care Plan: $234.86
  • Aetna - WCHOB — All Commercial Plans: $126.76
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $406.39
  • BCBS — Align - HealthNow Other Commercial Plan: $599.95
  • BCBS — HealthNow PPO/Traditional: $758.31
  • BCBS — HealthNow Standard Exchange: $539.98
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $252.21
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $655.34
  • BCBS - WCHOB — HealthNow PPO/Traditional: $826.79
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Family Psy Tx W/Pt $660 $660 Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Offsite Family Psytx W/Pt $660 $660 Not listed in the file
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $28.74 – $473.21
Group psychotherapy: 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $29.94
  • Aetna — Medicare Managed Care Plan: $134.42
  • Aetna - WCHOB — All Commercial Plans: $29.94
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $232.60
  • BCBS — Align - HealthNow Other Commercial Plan: $343.38
  • BCBS — HealthNow PPO/Traditional: $434.02
  • BCBS — HealthNow Standard Exchange: $309.06
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $144.35
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $375.09
  • BCBS - WCHOB — HealthNow PPO/Traditional: $473.21
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: Group Psychotherapy $295 $295 Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: Group Counseling 1-2 Hrs $258 $258 Not listed in the file

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion Not listed in the file Not listed in the file $469.45 – $18,238.47
Removal of breast growth (open surgery): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $489.01
  • Aetna — Medicare Managed Care Plan: $5,180.83
  • Aetna - WCHOB — All Commercial Plans: $489.01
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $8,964.79
  • BCBS — Align - HealthNow Other Commercial Plan: $13,234.57
  • BCBS — HealthNow PPO/Traditional: $16,727.72
  • BCBS — HealthNow Standard Exchange: $11,911.50
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $5,563.52
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $14,456.46
  • BCBS - WCHOB — HealthNow PPO/Traditional: $18,238.47
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: EXCISE BREAST LESION $1,586 $1,586 Not listed in the file
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $1,439.22 – $59,803.81
Total hip replacement: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $1,499.19
  • Aetna — Medicare Managed Care Plan: $16,987.90
  • Aetna - WCHOB — All Commercial Plans: $1,499.19
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $29,395.48
  • BCBS — Align - HealthNow Other Commercial Plan: $43,396.07
  • BCBS — HealthNow PPO/Traditional: $54,850.08
  • BCBS — HealthNow Standard Exchange: $39,057.74
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $18,242.76
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $47,402.65
  • BCBS - WCHOB — HealthNow PPO/Traditional: $59,803.81
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $95.91 – $1,000.61
Total hip replacement: rates for 2 insurance plans
  • AMERICAN PROGRESSIVE LIFE & HEALTH — All Plans: $1,000.61
  • United Healthcare — All Plans: $159.85
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROPLASTY HIP TOTAL $3,931 $3,931 Not listed in the file
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $1,437.47 – $59,803.81
Total knee replacement: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $1,497.36
  • Aetna — Medicare Managed Care Plan: $16,987.90
  • Aetna - WCHOB — All Commercial Plans: $1,497.36
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $29,395.48
  • BCBS — Align - HealthNow Other Commercial Plan: $43,396.07
  • BCBS — HealthNow PPO/Traditional: $54,850.08
  • BCBS — HealthNow Standard Exchange: $39,057.74
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $18,242.76
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $47,402.65
  • BCBS - WCHOB — HealthNow PPO/Traditional: $59,803.81
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROPLASTY KNEE TOTAL $3,926 $3,926 Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery Not listed in the file Not listed in the file $190.68 – $3,659
Shoulder arthroscopy: shaving of shoulder bone: 10 of 12 insurance plan rates
  • Aetna — All Commercial Plans: $198.63
  • Aetna - WCHOB — All Commercial Plans: $198.63
  • GHI/Emblem Health — All Commercial Plans: $238.35
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $238.35
  • MagnaCare — Brighton Health Network Other Commercial Plan: $198.63
  • MagnaCare - WCHOB — Brighton Health Network Other Commercial Plan: $198.63
  • Univera — Access Other Commercial Plan: $1,507.34
  • Univera — Medicare Managed Care Plan: $1,103.01
  • Univera — Other Commercial Plan: $1,773.34
  • Univera - WCHOB — Access Other Commercial Plan: $1,507.34
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: SHO ARTHRS SRG DECOMPRESSION $521 $521 Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $615.17 – $15,241.29
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $640.80
  • Aetna — Medicare Managed Care Plan: $4,329.45
  • Aetna - WCHOB — All Commercial Plans: $640.80
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $7,491.58
  • BCBS — Align - HealthNow Other Commercial Plan: $11,059.70
  • BCBS — HealthNow PPO/Traditional: $13,978.81
  • BCBS — HealthNow Standard Exchange: $9,954.06
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $4,649.26
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $12,080.80
  • BCBS - WCHOB — HealthNow PPO/Traditional: $15,241.29
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: ARTHROSCOPY KNEE W/MENISCECTOMY $1,680 $1,680 Not listed in the file
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $330.68 – $27,575.14
Removal of tonsils and adenoids (under age 12): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $344.46
  • Aetna — Medicare Managed Care Plan: $7,833.01
  • Aetna - WCHOB — All Commercial Plans: $344.46
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $13,554.06
  • BCBS — Align - HealthNow Other Commercial Plan: $20,009.64
  • BCBS — HealthNow PPO/Traditional: $25,291
  • BCBS — HealthNow Standard Exchange: $18,009.26
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $8,411.61
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $21,857.04
  • BCBS - WCHOB — HealthNow PPO/Traditional: $27,575.14
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $440.91
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan
  • Meritain Health — All Plans: $440.91
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: TONSILLECT ADNOIDECT 12 YR $903 $903 Not listed in the file
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $136.32 – $4,224.82
Upper GI endoscopy (diagnostic): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $142
  • Aetna — Medicare Managed Care Plan: $1,200.11
  • Aetna - WCHOB — All Commercial Plans: $142
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,076.64
  • BCBS — Align - HealthNow Other Commercial Plan: $3,065.70
  • BCBS — HealthNow PPO/Traditional: $3,874.87
  • BCBS — HealthNow Standard Exchange: $2,759.22
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,288.75
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3,348.75
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4,224.82
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: ENDOSCOPY UPPER GI COMPLEX DI $864 $864 Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $153.31 – $4,224.82
Upper GI endoscopy with biopsy: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $159.70
  • Aetna — Medicare Managed Care Plan: $1,200.11
  • Aetna - WCHOB — All Commercial Plans: $159.70
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,076.64
  • BCBS — Align - HealthNow Other Commercial Plan: $3,065.70
  • BCBS — HealthNow PPO/Traditional: $3,874.87
  • BCBS — HealthNow Standard Exchange: $2,759.22
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,288.75
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3,348.75
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4,224.82
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: ENDOSCOPY UPPER GI BIOPSY $1,117 $1,117 Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $102.67 – $4,331.83
Colonoscopy (diagnostic): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $213.23
  • Aetna — Medicare Managed Care Plan: $1,230.50
  • Aetna - WCHOB — All Commercial Plans: $213.23
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,129.23
  • BCBS — Align - HealthNow Other Commercial Plan: $3,143.35
  • BCBS — HealthNow PPO/Traditional: $3,973.01
  • BCBS — HealthNow Standard Exchange: $2,829.11
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,321.40
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3,433.57
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4,331.83
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: DIAGNOSTIC COLONOSCOPY $1,027 $1,027 Not listed in the file
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $222.64 – $5,574.07
Colonoscopy with biopsy: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $231.91
  • Aetna — Medicare Managed Care Plan: $1,583.37
  • Aetna - WCHOB — All Commercial Plans: $231.91
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,739.83
  • BCBS — Align - HealthNow Other Commercial Plan: $4,044.77
  • BCBS — HealthNow PPO/Traditional: $5,112.35
  • BCBS — HealthNow Standard Exchange: $3,640.41
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,700.33
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $4,418.21
  • BCBS - WCHOB — HealthNow PPO/Traditional: $5,574.07
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY $1,298 $1,298 Not listed in the file
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $280.97 – $5,574.07
Colonoscopy with removal of polyps (snare): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $292.68
  • Aetna — Medicare Managed Care Plan: $1,583.37
  • Aetna - WCHOB — All Commercial Plans: $292.68
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,739.83
  • BCBS — Align - HealthNow Other Commercial Plan: $4,044.77
  • BCBS — HealthNow PPO/Traditional: $5,112.35
  • BCBS — HealthNow Standard Exchange: $3,640.41
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,700.33
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $4,418.21
  • BCBS - WCHOB — HealthNow PPO/Traditional: $5,574.07
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/LESION REMOVAL $1,366 $1,366 Not listed in the file
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $284.96 – $5,574.07
Ultrasound of the lower bowel by endoscope: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $296.84
  • Aetna — Medicare Managed Care Plan: $1,583.37
  • Aetna - WCHOB — All Commercial Plans: $296.84
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,739.83
  • BCBS — Align - HealthNow Other Commercial Plan: $4,044.77
  • BCBS — HealthNow PPO/Traditional: $5,112.35
  • BCBS — HealthNow Standard Exchange: $3,640.41
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,700.33
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $4,418.21
  • BCBS - WCHOB — HealthNow PPO/Traditional: $5,574.07
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY W/ENDOSCOPE US $778 $778 Not listed in the file
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $102.67 – $4,331.83
Screening colonoscopy (not high risk): 10 of 41 insurance plan rates
  • Aetna — All Commercial Plans: $213.53
  • Aetna — Medicare Managed Care Plan: $1,230.50
  • Aetna - WCHOB — All Commercial Plans: $213.53
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,129.23
  • BCBS — Align - HealthNow Other Commercial Plan: $3,143.35
  • BCBS — HealthNow PPO/Traditional: $3,973.01
  • BCBS — HealthNow Standard Exchange: $2,829.11
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,321.40
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3,433.57
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4,331.83
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: COLON CA SCRN NOT HI RSK IND $1,028 $1,028 Not listed in the file
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $737.59 – $28,160.65
Gallbladder removal by laparoscope: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $768.33
  • Aetna — Medicare Managed Care Plan: $7,999.33
  • Aetna - WCHOB — All Commercial Plans: $768.33
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $13,841.85
  • BCBS — Align - HealthNow Other Commercial Plan: $20,434.51
  • BCBS — HealthNow PPO/Traditional: $25,828.01
  • BCBS — HealthNow Standard Exchange: $18,391.66
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $8,590.22
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $22,321.14
  • BCBS - WCHOB — HealthNow PPO/Traditional: $28,160.65
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $277.46
Gallbladder removal by laparoscope: rates for 1 insurance plan
  • FIDELIS CARE — All Plans: $277.46
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY $2,015 $2,015 Not listed in the file
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $586.16 – $16,677.85
Groin (inguinal) hernia repair, age 5 or older: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $610.59
  • Aetna — Medicare Managed Care Plan: $4,737.52
  • Aetna - WCHOB — All Commercial Plans: $610.59
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $8,197.69
  • BCBS — Align - HealthNow Other Commercial Plan: $12,102.12
  • BCBS — HealthNow PPO/Traditional: $15,296.37
  • BCBS — HealthNow Standard Exchange: $10,892.27
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $5,087.47
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $13,219.46
  • BCBS - WCHOB — HealthNow PPO/Traditional: $16,677.85
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: PRP I/HERN INIT REDUC >5 YR $1,601 $1,601 Not listed in the file
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $144.70 – $3,205
Prostate biopsy: 10 of 12 insurance plan rates
  • Aetna — All Commercial Plans: $150.73
  • Aetna - WCHOB — All Commercial Plans: $150.73
  • GHI/Emblem Health — All Commercial Plans: $180.87
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $180.87
  • MagnaCare — Brighton Health Network Other Commercial Plan: $150.73
  • MagnaCare - WCHOB — Brighton Health Network Other Commercial Plan: $150.73
  • Univera — Access Other Commercial Plan: $490.61
  • Univera — Medicare Managed Care Plan: $359.01
  • Univera — Other Commercial Plan: $577.19
  • Univera - WCHOB — Access Other Commercial Plan: $490.61
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $1,256.86
Prostate biopsy: rates for 1 insurance plan
  • MOLINA HEALTHCARE OF NEW YORK, INC. — All Plans: $1,256.86
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy Not listed in the file Not listed in the file $1,338.65 – $49,514.79
Prostate removal by laparoscope (radical prostatectomy): 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $1,394.43
  • Aetna — Medicare Managed Care Plan: $14,065.19
  • Aetna - WCHOB — All Commercial Plans: $1,394.43
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $24,338.09
  • BCBS — Align - HealthNow Other Commercial Plan: $35,929.94
  • BCBS — HealthNow PPO/Traditional: $45,413.33
  • BCBS — HealthNow Standard Exchange: $32,338
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $15,104.16
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $39,247.20
  • BCBS - WCHOB — HealthNow PPO/Traditional: $49,514.79
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $257.92 – $15,078.84
Hysteroscopy with biopsy of the uterus lining: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $268.66
  • Aetna — Medicare Managed Care Plan: $4,283.30
  • Aetna - WCHOB — All Commercial Plans: $268.66
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $7,411.73
  • BCBS — Align - HealthNow Other Commercial Plan: $10,941.82
  • BCBS — HealthNow PPO/Traditional: $13,829.82
  • BCBS — HealthNow Standard Exchange: $9,847.96
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $4,599.70
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $11,952.03
  • BCBS - WCHOB — HealthNow PPO/Traditional: $15,078.84
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: HYSTEROSCOPY BIOPSY $3,761 $3,761 Not listed in the file
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: Tc Hystersc W/Bx/Plypctmy $6,232 $6,232 Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $111.54 – $3,288.06
Spinal injection, lower back (epidural), with imaging guidance: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $116.19
  • Aetna — Medicare Managed Care Plan: $934.01
  • Aetna - WCHOB — All Commercial Plans: $116.19
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $1,616.19
  • BCBS — Align - HealthNow Other Commercial Plan: $2,385.95
  • BCBS — HealthNow PPO/Traditional: $3,015.70
  • BCBS — HealthNow Standard Exchange: $2,147.43
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,003
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $2,606.24
  • BCBS - WCHOB — HealthNow PPO/Traditional: $3,288.06
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s Not listed in the file Not listed in the file $125.08 – $4,119.96
Nerve root injection, lower back, with imaging guidance: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $130.29
  • Aetna — Medicare Managed Care Plan: $1,170.32
  • Aetna - WCHOB — All Commercial Plans: $130.29
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $2,025.09
  • BCBS — Align - HealthNow Other Commercial Plan: $2,989.61
  • BCBS — HealthNow PPO/Traditional: $3,778.69
  • BCBS — HealthNow Standard Exchange: $2,690.74
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $1,256.77
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $3,265.63
  • BCBS - WCHOB — HealthNow PPO/Traditional: $4,119.96
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $498.42 – $9,095.98
Carpal tunnel release: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $519.19
  • Aetna — Medicare Managed Care Plan: $2,583.81
  • Aetna - WCHOB — All Commercial Plans: $519.19
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $4,470.96
  • BCBS — Align - HealthNow Other Commercial Plan: $6,600.41
  • BCBS — HealthNow PPO/Traditional: $8,342.53
  • BCBS — HealthNow Standard Exchange: $5,940.57
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $2,774.67
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $7,209.80
  • BCBS - WCHOB — HealthNow PPO/Traditional: $9,095.98
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: CARPAL TUNNEL SURGERY $1,384 $1,384 Not listed in the file
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $345.04 – $3,205
Laser treatment of clouding after cataract surgery: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $359.41
  • Aetna — Medicare Managed Care Plan: $727.75
  • Aetna - WCHOB — All Commercial Plans: $359.41
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $1,259.28
  • BCBS — Align - HealthNow Other Commercial Plan: $1,859.05
  • BCBS — HealthNow PPO/Traditional: $2,349.73
  • BCBS — HealthNow Standard Exchange: $1,673.20
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $781.50
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $2,030.69
  • BCBS - WCHOB — HealthNow PPO/Traditional: $2,561.94
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: Tc Aftr Cataract Lsr Surg $1,598 $1,598 Not listed in the file
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: Md Aftr Cataract Lsr Surg $650 $650 Not listed in the file
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage Not listed in the file Not listed in the file $604.08 – $10,750.07
Cataract removal with lens implant: 10 of 37 insurance plan rates
  • Aetna — All Commercial Plans: $629.25
  • Aetna — Medicare Managed Care Plan: $3,053.67
  • Aetna - WCHOB — All Commercial Plans: $629.25
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $5,284
  • BCBS — Align - HealthNow Other Commercial Plan: $7,800.68
  • BCBS — HealthNow PPO/Traditional: $9,859.60
  • BCBS — HealthNow Standard Exchange: $7,020.84
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $3,279.24
  • BCBS - WCHOB — Align - HealthNow Other Commercial Plan: $8,520.89
  • BCBS - WCHOB — HealthNow PPO/Traditional: $10,750.07
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: XCAPSL CTRC RMVL W/O ECP $1,650 $1,650 Not listed in the file

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $2,653.21 – $4,265.61
Vaginal delivery, with care before and after: 10 of 12 insurance plan rates
  • Aetna — All Commercial Plans: $2,782.21
  • Aetna - WCHOB — All Commercial Plans: $2,782.21
  • GHI/Emblem Health — All Commercial Plans: $3,338.66
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $3,338.66
  • MagnaCare — Brighton Health Network Other Commercial Plan: $2,782.21
  • MagnaCare - WCHOB — Brighton Health Network Other Commercial Plan: $2,782.21
  • Univera — Access Other Commercial Plan: $3,625.76
  • Univera — Medicare Managed Care Plan: $2,653.21
  • Univera — Other Commercial Plan: $4,265.61
  • Univera - WCHOB — Access Other Commercial Plan: $3,625.76
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Hospital (facility) fee In the file: Vag Del W/Antepart & Post $6,177 $6,177 Not listed in the file
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $2,957.34 – $4,834.55
Cesarean delivery (C-section), with care before and after: 10 of 12 insurance plan rates
  • Aetna — All Commercial Plans: $3,080.56
  • Aetna - WCHOB — All Commercial Plans: $3,080.56
  • GHI/Emblem Health — All Commercial Plans: $3,696.68
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $3,696.68
  • MagnaCare — Brighton Health Network Other Commercial Plan: $3,080.56
  • MagnaCare - WCHOB — Brighton Health Network Other Commercial Plan: $3,080.56
  • Univera — Access Other Commercial Plan: $4,109.37
  • Univera — Medicare Managed Care Plan: $3,007.09
  • Univera — Other Commercial Plan: $4,834.55
  • Univera - WCHOB — Access Other Commercial Plan: $4,109.37
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Hospital (facility) fee In the file: C-Section W/Antepar&Post $6,994 $6,994 Not listed in the file
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $2,787.61 – $4,505.47
Vaginal delivery after a previous C-section, with care before and after: 10 of 12 insurance plan rates
  • Aetna — All Commercial Plans: $2,903.76
  • Aetna - WCHOB — All Commercial Plans: $2,903.76
  • GHI/Emblem Health — All Commercial Plans: $3,484.52
  • GHI/Emblem Health - WCHOB — All Commercial Plans: $3,484.52
  • MagnaCare — Brighton Health Network Other Commercial Plan: $2,903.76
  • MagnaCare - WCHOB — Brighton Health Network Other Commercial Plan: $2,903.76
  • Univera — Access Other Commercial Plan: $3,829.64
  • Univera — Medicare Managed Care Plan: $2,802.41
  • Univera — Other Commercial Plan: $4,505.47
  • Univera - WCHOB — Access Other Commercial Plan: $3,829.64
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Hospital (facility) fee In the file: Vag Del W/Ant&Pst Prev Cs $6,503 $6,503 Not listed in the file
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: VBAC DELIVERY $7,614 $7,614 Not listed in the file

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc Not listed in the file Not listed in the file $105,976.38 – $208,381.09
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 31 insurance plan rates
  • Aetna — All Commercial Plans: $208,381.09
  • Aetna — Medicare Managed Care Plan: $118,247.32
  • Aetna - WCHOB — All Commercial Plans: $203,218.12
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $111,554.08
  • BCBS — HMO Select - HealthNow Medicare Managed Care - HMO: $111,554.08
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $111,554.08
  • BCBS - WCHOB — HMO Select - HealthNow Medicare Managed Care - HMO: $111,554.08
  • Centers Plan for Healthy Living — Medicare Managed Care Plan: $118,247.32
  • Cigna — MVP Medicare Managed Care Plan: $111,554.08
  • Fallon Health — Medicare Managed Care Plan: $111,554.08
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc Not listed in the file Not listed in the file $78,985.03
Spinal fusion (not neck), without major complications: rates for 5 insurance plans
  • Aetna — All Commercial Plans: $78,985.03
  • UnitedHealthCare — Eaton Corporation Other Commercial Plan: 59.4% (a percentage in the contract, not a dollar amount)
  • UnitedHealthCare — Key Bank Other Commercial Plan: 56.7% (a percentage in the contract, not a dollar amount)
  • UnitedHealthCare - WCHOB — Eaton Corporation Other Commercial Plan: 55.7% (a percentage in the contract, not a dollar amount)
  • UnitedHealthCare - WCHOB — Key Bank Other Commercial Plan: 52.8% (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) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc Not listed in the file Not listed in the file $21,308.45 – $40,713.60
Hip or knee replacement (major joint of the leg), without major complications: 10 of 31 insurance plan rates
  • Aetna — All Commercial Plans: $40,713.60
  • Aetna — Medicare Managed Care Plan: $23,775.75
  • Aetna - WCHOB — All Commercial Plans: $39,704.86
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $22,429.95
  • BCBS — HMO Select - HealthNow Medicare Managed Care - HMO: $22,429.95
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $22,429.95
  • BCBS - WCHOB — HMO Select - HealthNow Medicare Managed Care - HMO: $22,429.95
  • Centers Plan for Healthy Living — Medicare Managed Care Plan: $23,775.75
  • Cigna — MVP Medicare Managed Care Plan: $22,429.95
  • Fallon Health — Medicare Managed Care Plan: $22,429.95
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc Not listed in the file Not listed in the file $26,832.31 – $51,114.95
Neck (cervical) spinal fusion, without complications: 10 of 31 insurance plan rates
  • Aetna — All Commercial Plans: $51,114.95
  • Aetna — Medicare Managed Care Plan: $29,939.21
  • Aetna - WCHOB — All Commercial Plans: $49,848.50
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $28,244.54
  • BCBS — HMO Select - HealthNow Medicare Managed Care - HMO: $28,244.54
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $28,244.54
  • BCBS - WCHOB — HMO Select - HealthNow Medicare Managed Care - HMO: $28,244.54
  • Centers Plan for Healthy Living — Medicare Managed Care Plan: $29,939.21
  • Cigna — MVP Medicare Managed Care Plan: $28,244.54
  • Fallon Health — Medicare Managed Care Plan: $28,244.54
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc Not listed in the file Not listed in the file $13,889.40 – $25,881.37
Uterus and ovary surgery (not for cancer), without complications: 10 of 31 insurance plan rates
  • Aetna — All Commercial Plans: $25,881.37
  • Aetna — Medicare Managed Care Plan: $15,497.65
  • Aetna - WCHOB — All Commercial Plans: $25,240.12
  • BCBS — Advantage - HealthNow Medicare Managed Care Plan: $14,620.42
  • BCBS — HMO Select - HealthNow Medicare Managed Care - HMO: $14,620.42
  • BCBS - WCHOB — Advantage - HealthNow Medicare Managed Care Plan: $14,620.42
  • BCBS - WCHOB — HMO Select - HealthNow Medicare Managed Care - HMO: $14,620.42
  • Centers Plan for Healthy Living — Medicare Managed Care Plan: $15,497.65
  • Cigna — MVP Medicare Managed Care Plan: $14,620.42
  • Fallon Health — Medicare Managed Care Plan: $14,620.42

Source: Kaleida Health’s standard charges file (hospitalpricedisclosure.com, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address100 High Street, Buffalo, NY 14210
CountyErie County
StateNew York
Phone(716) 859‑8620
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number330005
Name in Medicare recordsKALEIDA HEALTH
Profile levelMedicare data + hospital website
Name on the hospital’s websiteBuffalo General Medical Center/Gates Vascular Institute
Official websitebuffalogeneral.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

  1. Buffalo General Medical Center/Gates Vascular Institute — buffalogeneral.org