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Acute Care Hospital

Maimonides Medical Center

Brooklyn, New York · Kings County · Emergency services listed

Maimonides Medical Center is an acute care hospital at 4802 Tenth Avenue, Brooklyn, NY 11219. Phone: (718) 283-6000. It has an emergency department. Medicare overall rating: 2 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

Maimonides Medical Center is an acute care hospital in Brooklyn, New York. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 21 services, specialties and programs. Medicare lists 825 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(718) 283‑6000 Directions Website Medicare profile
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Exterior of Maimonides Medical Center
Photo: Jim.henderson, Public domain, via Wikimedia Commons · source

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
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
825Doctors and clinicians
21Services listed

Quick answers

Does Maimonides Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Maimonides Medical Center. In a medical emergency, call 911.
Where is Maimonides Medical Center?
4802 Tenth Avenue, Brooklyn, NY 11219, in Kings County, New York.
What is the phone number of Maimonides Medical Center?
(718) 283-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Maimonides Medical Center?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Maimonides Medical Center for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Maimonides Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.5454; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[5][6][7]

Conditions treated[6][7]

Treatments[6][7]

  • Trauma care
  • Stroke care
  • Psychiatric emergency care

Procedures[7]

  • CT and X-ray imaging in the emergency department

Programs and centers[5][7]

  • Bone and Joint Center
  • Cancer Center
  • Children's Hospital
  • Heart & Vascular Institute
  • Stroke and Neurosciences Institute
  • Women's Health Institute
  • Fast Track Program

Emergency care (hospital website)[6][7]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel I

Visiting and practical information

VisitingRegular hours: Sun-Fri 9am-9pm, Sat 9am-10pm; up to two visitors at bedside; hours may change[9]
Interpreters and languagesInterpreters provided for non-English speaking patients and those who are hearing impaired (Emergency Department)[7]
Patient portalPatient Portal

Recognition[6]

  • ACS Level 1 Trauma Center (American College of Surgeons)

Doctors and clinicians (825)

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

Main specialties

Doctors with a page on this site (825)

And 801 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 Brooklyn

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Patients got help quickly from staff1 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean2 of 5 stars
Restfulness of Environment1 of 5 stars
Care Coordination1 of 5 stars
Symptoms After Stay2 of 5 stars
Rated the hospital 9 or 10 out of 1055%National average: 72%
Would definitely recommend the hospital63%National average: 71%
Nurses “always” communicated well67%National average: 80%
Doctors “always” communicated well71%National average: 80%
“Always” got help as soon as they wanted46%National average: 64%
Staff “always” explained medicines before giving them51%National average: 62%
Were given information about recovery at home79%National average: 86%
Room and bathroom “always” clean58%National average: 73%
Completed surveys2,371Response rate: 19%

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)1.679Worse than the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.76No different from the national benchmark
Surgical site infections after colon surgery0.676No different from the national benchmark
Surgical site infections after abdominal hysterectomy0No different from the national benchmark
MRSA bloodstream infections1.369No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.196No 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 patients10%
Deaths within 30 days: heart failure patients6.2%
Deaths within 30 days: pneumonia patients11.4%
Deaths within 30 days: COPD patients7.2%
Deaths within 30 days: stroke patients8.2%
Deaths within 30 days: coronary bypass surgery (CABG)1.7%
Serious complications (patient safety indicator PSI-90)1.08No different from the national rate
Complications after hip or knee replacement4%

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)18.6%
Readmitted within 30 days: heart attack15.7%
Readmitted within 30 days: heart failure23.1%
Readmitted within 30 days: pneumonia19.5%
Readmitted within 30 days: COPD20.5%
Readmitted within 30 days: coronary bypass surgery10.4%
Readmitted within 30 days: hip or knee replacement5%

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)206 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)60%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 Maimonides Medical Center, 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 Score0.5454Lower 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 attack1.0368More readmissions than expected
Heart failure1.1235More readmissions than expected
Pneumonia1.3011More readmissions than expected
COPD (chronic lung disease)1.0524More readmissions than expected
Hip or knee replacement0.9715Fewer readmissions than expected
Coronary bypass surgery (CABG)1.0523More 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 Score27.83 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)60.00 out of 100
Person and community engagement (patient survey)28.00 out of 100
Safety (infections and sepsis care)23.33 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio1.07Above the national median hospital (1.00): Medicare spent more

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

ER wait times and Medicare ratings nearby

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

ER wait times in BrooklynBest hospitals in Brooklyn

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 Maimonides Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

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

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

$ 5 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

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 · Inpatient or outpatient · Doctor (professional) fee In the file: New patient office or other outpatient visit, 30-44 minutes Not listed in the file Not listed in the file $23.34 – $224.42
New patient office visit (about 30–44 minutes): 10 of 73 insurance plan rates
  • Aetna — Commercial HMO: $145.20
  • Aetna — Commercial PPO: $147.70
  • Aetna — Medicare Advantage HMO: $95.55
  • Aetna — Medicare Advantage PPO: $92.18
  • Anthem — Commercial HMO: $133.91
  • Anthem — Commercial PPO: $133.91
  • Anthem — Medicare Advantage PPO: $102.24
  • Anthem Health Plus — Child Health Plus: $127.50
  • Anthem Health Plus — Commercial PPO: $91.79
  • Anthem Health Plus — Essential Plan 1-2: $105.41
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 $321.86
New patient office visit (about 30–44 minutes): rates for 2 insurance plans
  • Anthem — Commercial HMO: $321.86
  • Anthem — Commercial PPO: $321.86
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: NP LEVEL III $603 $603 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: New patient office or other outpatient visit, 45-59 minutes Not listed in the file Not listed in the file $23.04 – $384.54
New patient office visit (about 45–59 minutes): 10 of 71 insurance plan rates
  • Aetna — Commercial HMO: $210.94
  • Aetna — Commercial PPO: $208.75
  • Aetna — Medicare Advantage HMO: $149.11
  • Aetna — Medicare Advantage PPO: $152.09
  • Anthem — Commercial HMO: $209.98
  • Anthem — Commercial PPO: $227.12
  • Anthem — Medicare Advantage PPO: $152.51
  • Anthem Health Plus — Child Health Plus: $149.04
  • Anthem Health Plus — Commercial PPO: $140.19
  • Anthem Health Plus — Essential Plan 1-2: $165.19
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 $539.50
New patient office visit (about 45–59 minutes): rates for 2 insurance plans
  • Anthem — Commercial HMO: $539.50
  • Anthem — Commercial PPO: $539.50
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: NP LEVEL 4 $528 $528 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: New patient office or other outpatient visit, 60-74 minutes Not listed in the file Not listed in the file $35.29 – $439.81
New patient office visit (about 60–74 minutes): 10 of 66 insurance plan rates
  • Aetna — Commercial HMO: $294.24
  • Aetna — Commercial PPO: $280.80
  • Aetna — Medicare Advantage HMO: $199.24
  • Aetna — Medicare Advantage PPO: $199.24
  • Anthem — Commercial HMO: $288.73
  • Anthem — Commercial PPO: $295.34
  • Anthem — Medicare Advantage PPO: $217.01
  • Anthem Health Plus — Child Health Plus: $203.31
  • Anthem Health Plus — Essential Plan 1-2: $226.44
  • Anthem Health Plus — Medicaid HMO: $203.31
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 $701.45
New patient office visit (about 60–74 minutes): rates for 2 insurance plans
  • Anthem — Commercial HMO: $701.45
  • Anthem — Commercial PPO: $701.45
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: NP LEVEL 5 $812 $812 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: Established patient office or other outpatient visit, 20-29 minutes Not listed in the file Not listed in the file $11.49 – $180.14
Established patient office visit (about 20–29 minutes): 10 of 72 insurance plan rates
  • Aetna — Commercial HMO: $105.81
  • Aetna — Commercial PPO: $101.55
  • Aetna — Medicare Advantage HMO: $71.63
  • Aetna — Medicare Advantage PPO: $71.63
  • Anthem — Commercial HMO: $85.94
  • Anthem — Commercial PPO: $82.33
  • Anthem — Medicare Advantage PPO: $54.46
  • Anthem Health Plus — Child Health Plus: $73.09
  • Anthem Health Plus — Commercial PPO: $75.57
  • Anthem Health Plus — Essential Plan 1-2: $78.37
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 $176 – $206.45
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans
  • Anthem — Commercial HMO: $206.45
  • Anthem — Commercial PPO: $206.45
  • Carelon Behavioral Health — Child Health Plus: $176
  • Carelon Behavioral Health — Commercial: $176
  • Carelon Behavioral Health — Exchange Plan: $176
  • Carelon Behavioral Health — Exchange Plan Silver: $176
  • Carelon Behavioral Health — Medicare Advantage HMO: $176
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: EP LEVEL III $413 $413 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: Established patient office or other outpatient visit, 30-39 minutes Not listed in the file Not listed in the file $14.06 – $201.77
Established patient office visit (about 30–39 minutes): 10 of 76 insurance plan rates
  • Aetna — Commercial HMO: $149.60
  • Aetna — Commercial PPO: $149.60
  • Aetna — Medicare Advantage HMO: $105.48
  • Aetna — Medicare Advantage PPO: $105.48
  • Anthem — Commercial HMO: $135.71
  • Anthem — Commercial PPO: $138.65
  • Anthem — Medicare Advantage PPO: $96.50
  • Anthem Health Plus — Child Health Plus: $107.63
  • Anthem Health Plus — Commercial PPO: $120.28
  • Anthem Health Plus — Essential Plan 1-2: $107.63
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 $198 – $319.98
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans
  • Anthem — Commercial HMO: $319.98
  • Anthem — Commercial PPO: $319.98
  • Carelon Behavioral Health — Child Health Plus: $198
  • Carelon Behavioral Health — Commercial: $198
  • Carelon Behavioral Health — Exchange Plan: $198
  • Carelon Behavioral Health — Exchange Plan Silver: $198
  • Carelon Behavioral Health — Medicare Advantage HMO: $198
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: EP LEVEL IV $468 $468 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 $70
Office consultation with a specialist (moderate): rates for 2 insurance plans
  • United Behavioral — Commercial HMO: $70
  • United Behavioral — Medicare Advantage HMO: $70
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: CONSULTATION PT. LEVEL 3 $495 $495 Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: CONSULT VST - LEVEL 3 $495 $495 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 $96
Office consultation with a specialist (moderate to high): rates for 2 insurance plans
  • United Behavioral — Commercial HMO: $96
  • United Behavioral — Medicare Advantage HMO: $96
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: CONSULTATION PT. LEVEL 4 $660 $660 Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: CONSULT VST - LEVEL 4 $660 $660 Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: Initial new patient preventive medicine evaluation (18-39 years) Not listed in the file Not listed in the file $65.52 – $300
Preventive checkup, new patient, age 18–39: 10 of 43 insurance plan rates
  • Aetna — Commercial HMO: $200.13
  • Aetna — Commercial PPO: $200.13
  • Aetna — Medicare Advantage HMO: $143.07
  • Anthem — Commercial HMO: $200.28
  • Anthem — Commercial PPO: $222.54
  • Anthem Health Plus — Commercial PPO: $145.99
  • Anthem Health Plus — Essential Plan 1-2: $145.99
  • Anthem Health Plus — Medicaid HMO: $145.99
  • Centivo — Commercial HMO: $255.48
  • Cigna — Commercial PPO: $202.68
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 $134
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • Local 1199 — Commercial PPO: $134
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: PREV EXAM NP AGE 18-39 $392 $392 Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: Initial new patient preventive medicine evaluation (40-64 years) Not listed in the file Not listed in the file $76.49 – $300
Preventive checkup, new patient, age 40–64: 10 of 44 insurance plan rates
  • Aetna — Commercial HMO: $229.68
  • Aetna — Commercial PPO: $229.68
  • Aetna — Medicare Advantage HMO: $139.58
  • Aetna — Medicare Advantage PPO: $167.58
  • Anthem — Commercial HMO: $231.34
  • Anthem — Commercial PPO: $267.14
  • Anthem Health Plus — Commercial PPO: $167.56
  • Anthem Health Plus — Essential Plan 1-2: $167.56
  • Anthem Health Plus — Medicaid HMO: $167.56
  • Anthem Health Plus — Medicare Advantage HMO: $167.56
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 $157
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • Local 1199 — Commercial PPO: $157
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: PREV EXAM NP AGE 40-64 $392 $392 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency department visit with low level of medical decision making Not listed in the file Not listed in the file $0.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $200
Emergency room visit (moderate): 10 of 68 insurance plan rates
  • Aetna — Commercial HMO: $183.40
  • Aetna — Commercial PPO: $199
  • Aetna — Medicare Advantage HMO: $77.02
  • Aetna — Medicare Advantage PPO: $77.02
  • Anthem — Commercial HMO: $200
  • Anthem — Commercial PPO: $200
  • Anthem — Medicare Advantage PPO: $77.02
  • Anthem Health Plus — Child Health Plus: $78.59
  • Anthem Health Plus — Commercial PPO: $78.59
  • Anthem Health Plus — Essential Plan 1-2: $78.59
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 $66 – $1,035.89
Emergency room visit (moderate): rates for 8 insurance plans
  • Aetna — Medicare Advantage HMO: $340.75
  • Anthem — Commercial HMO: $255.41
  • Anthem — Commercial PPO: $255.41
  • Emblem Health - GHI — Commercial: $1,035.89
  • Healthfirst — Medicare Advantage HMO: $333.94
  • Local 1199 — Commercial PPO: $66
  • Metroplus — Exchange Plan: $408.90
  • United Community Plan — Medicare Advantage HMO: $374.83
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: ER LEVEL III $1,020 $1,020 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency department visit with moderate level of medical decision making Not listed in the file Not listed in the file $11.89 – $400.64
Emergency room visit (moderately high): 10 of 71 insurance plan rates
  • Aetna — Commercial HMO: $305.10
  • Aetna — Commercial PPO: $337.89
  • Aetna — Medicare Advantage HMO: $131.75
  • Aetna — Medicare Advantage PPO: $131.75
  • Anthem — Commercial HMO: $339
  • Anthem — Commercial PPO: $340
  • Anthem — Medicare Advantage PPO: $108.15
  • Anthem Health Plus — Child Health Plus: $134.44
  • Anthem Health Plus — Commercial PPO: $134.44
  • Anthem Health Plus — Essential Plan 1-2: $134.44
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 $104 – $1,583.42
Emergency room visit (moderately high): rates for 8 insurance plans
  • Aetna — Medicare Advantage HMO: $520.86
  • Anthem — Commercial HMO: $487.32
  • Anthem — Commercial PPO: $487.32
  • Emblem Health - GHI — Commercial: $1,583.42
  • Healthfirst — Medicare Advantage HMO: $510.44
  • Local 1199 — Commercial PPO: $104
  • Metroplus — Exchange Plan: $625.03
  • United Community Plan — Medicare Advantage HMO: $572.95
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: ER LEVEL IV $1,700 $1,700 Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency department visit with high level of medical decision making Not listed in the file Not listed in the file $24.01 – $729.90
Emergency room visit (high): 10 of 73 insurance plan rates
  • Aetna — Commercial HMO: $446.02
  • Aetna — Commercial PPO: $490
  • Aetna — Medicare Advantage HMO: $191.14
  • Aetna — Medicare Advantage PPO: $191.14
  • Anthem — Commercial HMO: $490
  • Anthem — Commercial PPO: $490
  • Anthem — Exchange Plan Silver: $214.68
  • Anthem — Medicare Advantage PPO: $39.01
  • Anthem Health Plus — Child Health Plus: $195.04
  • Anthem Health Plus — Commercial PPO: $195.04
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 $161 – $2,259.91
Emergency room visit (high): rates for 8 insurance plans
  • Aetna — Medicare Advantage HMO: $743.39
  • Anthem — Commercial HMO: $724.39
  • Anthem — Commercial PPO: $724.39
  • Emblem Health - GHI — Commercial: $2,259.91
  • Healthfirst — Medicare Advantage HMO: $728.52
  • Local 1199 — Commercial PPO: $161
  • Metroplus — Exchange Plan: $892.07
  • United Community Plan — Medicare Advantage HMO: $817.73
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: ER LEVEL V $3,000 $3,000 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 $8.29 – $25.72
Basic metabolic panel (blood test): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $8.46
  • Cigna — Commercial: $19.65
  • Cigna — Commercial HMO: $19.65
  • Cigna — Commercial PPO: $19.65
  • Emblem Health - GHI — Commercial: $25.72
  • Healthfirst — Medicare Advantage HMO: $8.29
  • Local 1199 — Commercial PPO: $9
  • Magnacare — Commercial: $23.26
  • Metroplus — Exchange Plan: $10.15
  • Oxford Health Plan — Commercial: $10.44
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $42 $42 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 $10.35 – $32.10
Comprehensive metabolic panel (blood test): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $10.56
  • Cigna — Commercial: $24.56
  • Cigna — Commercial HMO: $24.56
  • Cigna — Commercial PPO: $24.56
  • Emblem Health - GHI — Commercial: $32.10
  • Healthfirst — Medicare Advantage HMO: $10.35
  • Local 1199 — Commercial PPO: $12
  • Magnacare — Commercial: $29.04
  • Metroplus — Exchange Plan: $12.67
  • Oxford Health Plan — Commercial: $13.04
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: COMPREHENSIVE MP 1AGR CC $55 $55 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANE $55 $55 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 $43 – $145.34
Obstetric blood test panel: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $47.81
  • Cigna — Commercial: $112.17
  • Cigna — Commercial HMO: $112.17
  • Cigna — Commercial PPO: $112.17
  • Emblem Health - GHI — Commercial: $145.34
  • Healthfirst — Medicare Advantage HMO: $46.85
  • Local 1199 — Commercial PPO: $43
  • Magnacare — Commercial: $131.48
  • Metroplus — Exchange Plan: $57.37
  • Oxford Health Plan — Commercial: $59.02
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: OBSTETRIC PANEL (PNTL) $146 $146 Not listed in the file
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 $13.12 – $40.71
Cholesterol panel (lipid panel): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $13.39
  • Cigna — Commercial: $31.11
  • Cigna — Commercial HMO: $31.11
  • Cigna — Commercial PPO: $31.11
  • Emblem Health - GHI — Commercial: $40.71
  • Healthfirst — Medicare Advantage HMO: $13.12
  • Local 1199 — Commercial PPO: $19
  • Magnacare — Commercial: $36.82
  • Metroplus — Exchange Plan: $16.07
  • Oxford Health Plan — Commercial: $16.53
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: LIPID PANEL $68 $68 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 $8.51 – $26.39
Kidney function panel: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $8.68
  • Cigna — Commercial: $20.46
  • Cigna — Commercial HMO: $20.46
  • Cigna — Commercial PPO: $20.46
  • Emblem Health - GHI — Commercial: $26.39
  • Healthfirst — Medicare Advantage HMO: $8.51
  • Local 1199 — Commercial PPO: $12
  • Magnacare — Commercial: $23.87
  • Metroplus — Exchange Plan: $10.42
  • Oxford Health Plan — Commercial: $10.72
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: RFP $44 $44 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 $8.01 – $24.84
Liver function panel: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $8.17
  • Cigna — Commercial: $18.83
  • Cigna — Commercial HMO: $18.83
  • Cigna — Commercial PPO: $18.83
  • Emblem Health - GHI — Commercial: $24.84
  • Healthfirst — Medicare Advantage HMO: $8.01
  • Local 1199 — Commercial PPO: $11
  • Magnacare — Commercial: $22.47
  • Metroplus — Exchange Plan: $9.80
  • Oxford Health Plan — Commercial: $10.09
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HEPATIC FUNCTION $42 $42 Not listed in the file
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HEPATIC PANEL $42 $42 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 $3.11 – $9.64
Urine test (automated, with microscope): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $3.17
  • Cigna — Commercial: $7.37
  • Cigna — Commercial HMO: $7.37
  • Cigna — Commercial PPO: $7.37
  • Emblem Health - GHI — Commercial: $9.64
  • Healthfirst — Medicare Advantage HMO: $3.11
  • Local 1199 — Commercial PPO: $5
  • Magnacare — Commercial: $8.72
  • Metroplus — Exchange Plan: $3.80
  • Oxford Health Plan — Commercial: $3.92
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALY AUTO W/ MICRO $17 $17 Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALYSIS AUTO W/MICRO $17 $17 Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: Urinalysis, manual test Not listed in the file Not listed in the file $1.43 – $6.89
Urine test (manual, without microscope): 10 of 53 insurance plan rates
  • Aetna — Commercial HMO: $6.52
  • Aetna — Commercial PPO: $6.89
  • Aetna — Medicare Advantage HMO: $3.41
  • Aetna — Medicare Advantage PPO: $3.41
  • Anthem — Commercial HMO: $4.29
  • Anthem — Commercial PPO: $4.95
  • Anthem — Medicare Advantage PPO: $3.41
  • Anthem Health Plus — Child Health Plus: $1.57
  • Anthem Health Plus — Essential Plan 1-2: $1.57
  • Anthem Health Plus — Medicaid HMO: $1.57
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 $3.41 – $10.58
Urine test (manual, without microscope): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $3.48
  • Cigna — Commercial: $8.19
  • Cigna — Commercial HMO: $8.19
  • Cigna — Commercial PPO: $8.19
  • Emblem Health - GHI — Commercial: $10.58
  • Healthfirst — Medicare Advantage HMO: $3.41
  • Local 1199 — Commercial PPO: $4
  • Magnacare — Commercial: $9.57
  • Metroplus — Exchange Plan: $4.18
  • Oxford Health Plan — Commercial: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: URINE DIPSTICK,WO/MICROSCOPY $13 $13 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 $2.20 – $6.84
Urine test (automated, without microscope): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $2.25
  • Cigna — Commercial: $4.91
  • Cigna — Commercial HMO: $4.91
  • Cigna — Commercial PPO: $4.91
  • Emblem Health - GHI — Commercial: $6.84
  • Healthfirst — Medicare Advantage HMO: $2.20
  • Local 1199 — Commercial PPO: $4
  • Magnacare — Commercial: $6.19
  • Metroplus — Exchange Plan: $2.70
  • Oxford Health Plan — Commercial: $2.77
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALYSIS AUTO W/O MICRO $12 $12 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS-AUTOMATED W/O MICROSCOPY $8 $8 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 $18.02 – $55.91
PSA (prostate specific antigen) blood test: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $18.39
  • Cigna — Commercial: $43.40
  • Cigna — Commercial HMO: $43.40
  • Cigna — Commercial PPO: $43.40
  • Emblem Health - GHI — Commercial: $55.91
  • Healthfirst — Medicare Advantage HMO: $18.02
  • Local 1199 — Commercial PPO: $26
  • Magnacare — Commercial: $50.57
  • Metroplus — Exchange Plan: $22.07
  • Oxford Health Plan — Commercial: $22.71
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA, TOTAL $91 $91 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA/TOTAL $91 $91 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 $16.46 – $51.07
Thyroid stimulating hormone (TSH) test: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $16.80
  • Cigna — Commercial: $39.30
  • Cigna — Commercial HMO: $39.30
  • Cigna — Commercial PPO: $39.30
  • Emblem Health - GHI — Commercial: $51.07
  • Healthfirst — Medicare Advantage HMO: $16.46
  • Local 1199 — Commercial PPO: $24
  • Magnacare — Commercial: $46.20
  • Metroplus — Exchange Plan: $20.16
  • Oxford Health Plan — Commercial: $20.75
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE $88 $88 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: THYROID STIM HORMONE (TSH) $88 $88 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 $7.61 – $23.62
Complete blood count (CBC) with differential: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $7.77
  • Cigna — Commercial: $18.01
  • Cigna — Commercial HMO: $18.01
  • Cigna — Commercial PPO: $18.01
  • Emblem Health - GHI — Commercial: $23.62
  • Healthfirst — Medicare Advantage HMO: $7.61
  • Local 1199 — Commercial PPO: $11
  • Magnacare — Commercial: $21.37
  • Metroplus — Exchange Plan: $9.32
  • Oxford Health Plan — Commercial: $9.59
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: BLD CNT COMP W/AUTO DIFF $41 $41 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: AUTOMATED COMPLETE CBC W/DIFF $41 $41 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 $6.34 – $19.67
Complete blood count (CBC), automated: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $6.47
  • Cigna — Commercial: $15.56
  • Cigna — Commercial HMO: $15.56
  • Cigna — Commercial PPO: $15.56
  • Emblem Health - GHI — Commercial: $19.67
  • Healthfirst — Medicare Advantage HMO: $6.34
  • Local 1199 — Commercial PPO: $9
  • Magnacare — Commercial: $17.79
  • Metroplus — Exchange Plan: $7.76
  • Oxford Health Plan — Commercial: $7.98
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC WITHOUT DIFF $34 $34 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 $4.20 – $13.04
Blood clotting time test (prothrombin time, PT): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $4.29
  • Cigna — Commercial: $9.83
  • Cigna — Commercial HMO: $9.83
  • Cigna — Commercial PPO: $9.83
  • Emblem Health - GHI — Commercial: $13.04
  • Healthfirst — Medicare Advantage HMO: $4.20
  • Local 1199 — Commercial PPO: $6
  • Magnacare — Commercial: $11.80
  • Metroplus — Exchange Plan: $5.15
  • Oxford Health Plan — Commercial: $4.85
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PT/INR POC $21 $21 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PROTHROMIN TIME (LUPPNL/MIXPT) $21 $21 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 $5.89 – $18.27
Blood clotting test (partial thromboplastin time, PTT): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $6.01
  • Cigna — Commercial: $13.92
  • Cigna — Commercial HMO: $13.92
  • Cigna — Commercial PPO: $13.92
  • Emblem Health - GHI — Commercial: $18.27
  • Healthfirst — Medicare Advantage HMO: $5.89
  • Local 1199 — Commercial PPO: $9
  • Magnacare — Commercial: $16.53
  • Metroplus — Exchange Plan: $7.21
  • Oxford Health Plan — Commercial: $7.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: TO PTT (LUPPNL) $32 $32 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: THROMBOPLASTIN TIME, PARTIAL $32 $32 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 $127.89 – $396.73
CT scan of the head or brain, without contrast: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $130.50
  • Anthem — Commercial HMO: $313.43
  • Anthem — Commercial PPO: $313.43
  • Cigna — Commercial: $174.08
  • Cigna — Commercial HMO: $174.08
  • Cigna — Commercial PPO: $174.08
  • Emblem Health - GHI — Commercial: $396.73
  • Healthfirst — Medicare Advantage HMO: $127.89
  • Local 1199 — Commercial PPO: $241
  • Metroplus — Exchange Plan: $156.60
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT HEAD W/O CONTRAST $1,700 $1,700 Not listed in the file
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST $1,700 $1,700 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 $426.78 – $1,323.90
MRI of the brain, before and after contrast: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $435.49
  • Anthem — Commercial HMO: $1,122.68
  • Anthem — Commercial PPO: $1,122.68
  • Cigna — Commercial: $585.58
  • Cigna — Commercial HMO: $585.58
  • Cigna — Commercial PPO: $585.58
  • Emblem Health - GHI — Commercial: $1,323.90
  • Healthfirst — Medicare Advantage HMO: $426.78
  • Local 1199 — Commercial PPO: $1,268
  • Metroplus — Exchange Plan: $522.59
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI BRAIN W/W/O CONTRAST $6,564 $6,564 Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: IMAGING OF BRAIN W AND WO CONTRAST $300 $300 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 $24 – $330.24
Chest X-ray, 2 views: 10 of 19 insurance plan rates
  • Aetna — Medicare Advantage HMO: $108.63
  • Cigna — Commercial: $54.53
  • Cigna — Commercial HMO: $54.53
  • Cigna — Commercial PPO: $54.53
  • Emblem Health - GHI — Commercial: $330.24
  • Healthfirst — Medicare Advantage HMO: $106.46
  • Local 1199 — Commercial PPO: $24
  • Metroplus — Exchange Plan: $130.36
  • Oxford Health Plan — Commercial: $93.18
  • Oxford Health Plan — Commercial HMO: $93.18
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: CHEST XRAY TWO VIEWS AP & LAT $355 $355 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: CHEST PA & LAT., $100 $100 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 $47 – $396.73
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $130.50
  • Anthem — Commercial HMO: $140.54
  • Anthem — Commercial PPO: $140.54
  • Cigna — Commercial: $90.56
  • Cigna — Commercial HMO: $90.56
  • Cigna — Commercial PPO: $90.56
  • Emblem Health - GHI — Commercial: $396.73
  • Healthfirst — Medicare Advantage HMO: $127.89
  • Local 1199 — Commercial PPO: $47
  • Metroplus — Exchange Plan: $156.60
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: LUMBAR SPINE AP/LATE PELV. $660 $660 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: LUMBOSACRAL SPINE - 2 VIEWS $150 $150 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 $291.89 – $905.44
MRI of the lower back (lumbar spine), without contrast: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $297.84
  • Anthem — Commercial HMO: $630.19
  • Anthem — Commercial PPO: $630.19
  • Cigna — Commercial: $336.18
  • Cigna — Commercial HMO: $336.18
  • Cigna — Commercial PPO: $336.18
  • Emblem Health - GHI — Commercial: $905.44
  • Healthfirst — Medicare Advantage HMO: $291.89
  • Local 1199 — Commercial PPO: $634
  • Metroplus — Exchange Plan: $357.41
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 CONTRAST $3,512 $3,512 Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MAGNETIC IMAGE, LUMBAR SPINE $195 $195 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 $214.57 – $715.89
CT scan of the pelvis, with contrast: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $218.95
  • Anthem — Commercial HMO: $715.89
  • Anthem — Commercial PPO: $715.89
  • Cigna — Commercial: $461.46
  • Cigna — Commercial HMO: $461.46
  • Cigna — Commercial PPO: $461.46
  • Emblem Health - GHI — Commercial: $665.61
  • Healthfirst — Medicare Advantage HMO: $214.57
  • Local 1199 — Commercial PPO: $349
  • Metroplus — Exchange Plan: $262.74
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST $2,400 $2,400 Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT PELVIS W/ CONTRAST $2,400 $2,400 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 $291.89 – $905.44
MRI of a leg joint (such as the knee), without contrast: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $297.84
  • Anthem — Commercial HMO: $714.37
  • Anthem — Commercial PPO: $714.37
  • Cigna — Commercial: $378.44
  • Cigna — Commercial HMO: $378.44
  • Cigna — Commercial PPO: $378.44
  • Emblem Health - GHI — Commercial: $905.44
  • Healthfirst — Medicare Advantage HMO: $291.89
  • Local 1199 — Commercial PPO: $571
  • Metroplus — Exchange Plan: $357.41
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI JOINT OF LOW EXT WO/CONTR $2,640 $2,640 Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: MAGNETIC IMAGE JOINT OF LEG $175 $175 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 $318 – $1,323.90
CT scan of the abdomen and pelvis, with contrast: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $435.49
  • Anthem — Commercial HMO: $939.30
  • Anthem — Commercial PPO: $939.30
  • Cigna — Commercial: $584.77
  • Cigna — Commercial HMO: $584.77
  • Cigna — Commercial PPO: $584.77
  • Emblem Health - GHI — Commercial: $1,323.90
  • Healthfirst — Medicare Advantage HMO: $426.78
  • Local 1199 — Commercial PPO: $318
  • Metroplus — Exchange Plan: $522.59
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: CT ABD/PELV W/CONTRAST $2,800 $2,800 Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABD & PELV W/CONT $880 $880 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 $101 – $396.73
Ultrasound of the abdomen, complete: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $130.50
  • Anthem — Commercial HMO: $356.30
  • Anthem — Commercial PPO: $356.30
  • Cigna — Commercial: $198.63
  • Cigna — Commercial HMO: $198.63
  • Cigna — Commercial PPO: $198.63
  • Emblem Health - GHI — Commercial: $396.73
  • Healthfirst — Medicare Advantage HMO: $127.89
  • Local 1199 — Commercial PPO: $101
  • Metroplus — Exchange Plan: $156.60
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: ABD US,B SCAN W/IMAGE DOC,COMP $640 $640 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: ECHO EXAM OF ABDOMEN $335 $335 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 $108 – $396.73
Pregnancy ultrasound (after the first trimester): 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $130.50
  • Anthem — Commercial HMO: $396.09
  • Anthem — Commercial PPO: $396.09
  • Cigna — Commercial: $220.75
  • Cigna — Commercial HMO: $220.75
  • Cigna — Commercial PPO: $220.75
  • Emblem Health - GHI — Commercial: $396.73
  • Healthfirst — Medicare Advantage HMO: $127.89
  • Local 1199 — Commercial PPO: $108
  • Metroplus — Exchange Plan: $156.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: US PRG UTR,/M 14WKS<SG/1ST GST $549 $549 Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: US PREG UTERUS>OR=14WKS,SGL $549 $549 Not listed in the file
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina Not listed in the file Not listed in the file $53.12 – $246.83
Transvaginal ultrasound: 10 of 39 insurance plan rates
  • Aetna — Commercial HMO: $163.35
  • Aetna — Commercial PPO: $174.31
  • Aetna — Medicare Advantage HMO: $110.61
  • Anthem — Commercial HMO: $154.37
  • Anthem — Commercial PPO: $189.37
  • Anthem Health Plus — Essential Plan 1-2: $74.34
  • Anthem Health Plus — Medicaid HMO: $74.34
  • Cigna — Commercial PPO: $205.91
  • Elderplan — Medicare Advantage HMO: $108.13
  • Emblem Health - GHI — Commercial PPO: $214.24
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 $78 – $396.73
Transvaginal ultrasound: 10 of 21 insurance plan rates
  • Aetna — Medicare Advantage HMO: $130.50
  • Anthem — Commercial HMO: $377.72
  • Anthem — Commercial PPO: $377.72
  • Cigna — Commercial: $217.47
  • Cigna — Commercial HMO: $217.47
  • Cigna — Commercial PPO: $217.47
  • Emblem Health - GHI — Commercial: $396.73
  • Healthfirst — Medicare Advantage HMO: $127.89
  • Local 1199 — Commercial PPO: $78
  • Metroplus — Exchange Plan: $156.60
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: TRANSVAG US, NON OB $765 $765 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 $112 – $214.20
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates
  • Cigna — Commercial: $214.20
  • Cigna — Commercial HMO: $214.20
  • Cigna — Commercial PPO: $214.20
  • Local 1199 — Commercial PPO: $112
  • Oxford Health Plan — Commercial: $144.18
  • Oxford Health Plan — Commercial HMO: $144.18
  • Oxford Health Plan — Commercial PPO: $144.18
  • Oxford Liberty — Commercial: $144.18
  • United Healthcare — Commercial: $144.18
  • United Healthcare — Commercial HMO: $144.18
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: DX MAMMO,INCL CAD, UNILAT $638 $638 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: DX MAMMO INCL CAD UNI $105 $105 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 $143 – $273.96
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates
  • Cigna — Commercial: $273.96
  • Cigna — Commercial HMO: $273.96
  • Cigna — Commercial PPO: $273.96
  • Local 1199 — Commercial PPO: $143
  • Oxford Health Plan — Commercial: $184.14
  • Oxford Health Plan — Commercial HMO: $184.14
  • Oxford Health Plan — Commercial PPO: $184.14
  • Oxford Liberty — Commercial: $184.14
  • United Healthcare — Commercial: $184.14
  • United Healthcare — Commercial HMO: $184.14
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: DX MAMMO,INCL CAD, BILAT $787 $787 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: SCREEN TO DX MAMMO,BILAT $787 $787 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 $118 – $226.47
Screening mammogram, both breasts: 10 of 14 insurance plan rates
  • Cigna — Commercial: $226.47
  • Cigna — Commercial HMO: $226.47
  • Cigna — Commercial PPO: $226.47
  • Local 1199 — Commercial PPO: $118
  • Oxford Health Plan — Commercial: $152.28
  • Oxford Health Plan — Commercial HMO: $152.28
  • Oxford Health Plan — Commercial PPO: $152.28
  • Oxford Liberty — Commercial: $152.28
  • United Healthcare — Commercial: $152.28
  • United Healthcare — Commercial HMO: $152.28
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: SCREEN MAMMO,BILAT, INCL CAD $633 $633 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: SCR MAMMO BI INCL CAD $100 $100 Not listed in the file

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report Not listed in the file Not listed in the file $3.28 – $34.09
Electrocardiogram (ECG/EKG) with reading: 10 of 62 insurance plan rates
  • Aetna — Commercial HMO: $23.63
  • Aetna — Commercial PPO: $23.63
  • Aetna — Medicare Advantage HMO: $16.08
  • Aetna — Medicare Advantage PPO: $16.08
  • Anthem — Commercial HMO: $23.63
  • Anthem — Commercial PPO: $25.25
  • Anthem — Medicare Advantage PPO: $3.28
  • Anthem Health Plus — Child Health Plus: $16.41
  • Anthem Health Plus — Essential Plan 1-2: $16.41
  • Anthem Health Plus — Medicaid HMO: $16.41
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 $32 – $72.50
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans
  • Anthem — Commercial HMO: $72.50
  • Anthem — Commercial PPO: $72.50
  • Local 1199 — Commercial PPO: $32
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROCARDIOGRAM, ROUTINE ECG COMPLETE $45 $45 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 $3,965.91 – $12,302.43
Left heart catheterization (diagnostic): 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $4,046.85
  • Anthem — Commercial HMO: $6,997
  • Anthem — Commercial PPO: $7,047
  • Centivo — Commercial HMO: $10,600
  • Emblem Health - GHI — Commercial: $12,302.43
  • Healthfirst — Medicare Advantage HMO: $3,965.91
  • Local 1199 — Commercial PPO: $5,102
  • Magnacare — Commercial: $8,056
  • Metroplus — Exchange Plan: $4,856.22
  • Oxford Health Plan — Commercial: $7,007
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: LHC INCL.VENT INJ & IMAG $15,950 $15,950 Not listed in the file
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY $670 $670 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 $381 – $29,598.03
Heart rhythm study (electrophysiology evaluation): 10 of 23 insurance plan rates
  • Aetna — Commercial: $8,057
  • Aetna — Commercial HMO: $8,057
  • Aetna — Commercial PPO: $8,057
  • Aetna — Medicare Advantage HMO: $9,736.19
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $10,600
  • Emblem Health - GHI — Commercial: $29,598.03
  • Healthfirst — Medicare Advantage HMO: $9,541.47
  • Local 1199 — Commercial PPO: $381
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: EP EVAL W/O INDUCT ARRHYTHMIA $26,455 $26,455 Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: ELECTROPHYSIOLOGY EVALUATION $1,085 $1,085 Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction Not listed in the file Not listed in the file $217.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,144
Heart rhythm study with ablation for atrial fibrillation: 10 of 37 insurance plan rates
  • Aetna — Commercial HMO: $1,801.20
  • Aetna — Commercial PPO: $1,801.20
  • Aetna — Medicare Advantage HMO: $1,067.57
  • Aetna — Medicare Advantage PPO: $1,067.57
  • Anthem — Commercial HMO: $1,862.34
  • Anthem — Commercial PPO: $1,862.33
  • Anthem — Medicare Advantage PPO: $217.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Anthem Health Plus — Essential Plan 1-2: $1,089.36
  • Anthem Health Plus — Medicaid HMO: $1,089.36
  • Centers Plan for Healthy Living — Medicare Advantage HMO: $1,089.36
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 $1,224 – $99,187.51
Heart rhythm study with ablation for atrial fibrillation: 10 of 20 insurance plan rates
  • Aetna — Medicare Advantage HMO: $32,627.47
  • Anthem — Commercial HMO: $12,297
  • Anthem — Commercial PPO: $12,523
  • Centivo — Commercial HMO: $10,600
  • Emblem Health - GHI — Commercial: $99,187.51
  • Healthfirst — Medicare Advantage HMO: $31,974.92
  • Local 1199 — Commercial PPO: $1,224
  • Magnacare — Commercial: $9,911
  • Metroplus — Exchange Plan: $39,152.96
  • Oxford Health Plan — Commercial: $37,965
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: COMP EP EVAL,TRANSSEP,W ABL AF $97,011 $97,011 Not listed in the file
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 $1,050.51 – $3,258.73
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates
  • Aetna — Commercial: $2,317.70
  • Aetna — Commercial HMO: $2,317.70
  • Aetna — Commercial PPO: $2,317.70
  • Aetna — Medicare Advantage HMO: $1,071.95
  • Anthem — Commercial HMO: $2,162.98
  • Anthem — Commercial PPO: $2,162.98
  • Emblem Health - GHI — Commercial: $3,258.73
  • Healthfirst — Medicare Advantage HMO: $1,050.51
  • Local 1199 — Commercial PPO: $2,800
  • Metroplus — Exchange Plan: $1,286.34
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: POLYSOM AGE 6<;,4 OR<PARAM,ATT $7,858 $7,858 Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: POLYSOMNOGRAPHY,SLEEP STAGING, 4 OR MORE PARAMETERS $1,815 $1,815 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 $28 – $132.50
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans
  • Aetna — Medicare Advantage HMO: $31.11
  • Anthem — Commercial HMO: $132.50
  • Anthem — Commercial PPO: $132.50
  • Centivo — Commercial HMO: $52.31
  • Emblem Health - GHI — Commercial: $94.57
  • Healthfirst — Child Health Plus: $28
  • Healthfirst — Medicare Advantage HMO: $30.49
  • Local 1199 — Commercial PPO: $50
  • Metroplus — Exchange Plan: $37.33
  • United Community Plan — Medicare Advantage HMO: $34.22
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES EA 15MIN $193 $193 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Doctor (professional) fee In the file: THERAPEUTIC EXERCISES $85 $85 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 $93 – $318.08
Physical therapy evaluation (low complexity): rates for 8 insurance plans
  • Aetna — Medicare Advantage HMO: $104.63
  • Centivo — Commercial HMO: $175.14
  • Emblem Health - GHI — Commercial: $318.08
  • Healthfirst — Child Health Plus: $94.17
  • Healthfirst — Medicare Advantage HMO: $102.54
  • Local 1199 — Commercial PPO: $93
  • Metroplus — Exchange Plan: $125.56
  • United Community Plan — Medicare Advantage HMO: $115.09
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL; LOW COMPLEXITY $494 $494 Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PHYS THERAPY EVAL LOW COMPLEXITY 20 MIN $280 $280 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 $93 – $334.86
Physical therapy evaluation (moderate complexity): rates for 8 insurance plans
  • Aetna — Medicare Advantage HMO: $110.15
  • Centivo — Commercial HMO: $175.14
  • Emblem Health - GHI — Commercial: $334.86
  • Healthfirst — Child Health Plus: $99.14
  • Healthfirst — Medicare Advantage HMO: $107.95
  • Local 1199 — Commercial PPO: $93
  • Metroplus — Exchange Plan: $132.18
  • United Community Plan — Medicare Advantage HMO: $121.16
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL; MODERATE COMPLEXITY $743 $743 Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PHYS THERAPY EVAL MOD COMPLEXITY 30 MIN $280 $280 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 $93 – $318.08
Physical therapy evaluation (high complexity): rates for 8 insurance plans
  • Aetna — Medicare Advantage HMO: $104.63
  • Centivo — Commercial HMO: $175.14
  • Emblem Health - GHI — Commercial: $318.08
  • Healthfirst — Child Health Plus: $94.17
  • Healthfirst — Medicare Advantage HMO: $102.54
  • Local 1199 — Commercial PPO: $93
  • Metroplus — Exchange Plan: $125.56
  • United Community Plan — Medicare Advantage HMO: $115.09
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL; HIGH COMPLEXITY $1,110 $1,110 Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PHYS THERAPY EVAL HIGH COMPLEXITY 45 MIN $280 $280 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy, 30 minutes Not listed in the file Not listed in the file $16.04 – $126.14
Psychotherapy, 30 minutes: 10 of 21 insurance plan rates
  • Aetna — Commercial HMO: $126.14
  • Aetna — Commercial PPO: $109.50
  • Anthem — Commercial PPO: $73.08
  • Anthem Health Plus — Essential Plan 1-2: $75.48
  • Anthem Health Plus — Medicaid HMO: $75.48
  • Carelon Behavioral Health — Commercial: $45
  • Emblem Health - HIP — Essential Plan 1-2: $25.21
  • Fidelis — Essential Plan 1-2: $56.71
  • Fidelis — Essential Plan 3-4: $71.71
  • Fidelis — Medicaid HMO: $67.93
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 $71 – $673.56
Psychotherapy, 30 minutes: 10 of 13 insurance plan rates
  • Aetna — Medicare Advantage HMO: $221.56
  • Anthem — Commercial HMO: $246.28
  • Anthem — Commercial PPO: $246.28
  • Carelon Behavioral Health — Child Health Plus: $181.60
  • Carelon Behavioral Health — Commercial: $181.60
  • Carelon Behavioral Health — Exchange Plan: $181.60
  • Carelon Behavioral Health — Exchange Plan Silver: $181.60
  • Carelon Behavioral Health — Medicare Advantage HMO: $181.60
  • Emblem Health - GHI — Commercial: $673.56
  • Healthfirst — Medicare Advantage HMO: $217.13
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: PSYCHOTX 30MIN W/PT $617 $617 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy, 45 minutes Not listed in the file Not listed in the file $37.79 – $145.76
Psychotherapy, 45 minutes: 10 of 18 insurance plan rates
  • Aetna — Commercial HMO: $145.76
  • Aetna — Commercial PPO: $142.33
  • Anthem — Commercial HMO: $105.21
  • Anthem Health Plus — Essential Plan 1-2: $99.52
  • Anthem Health Plus — Medicaid HMO: $115.44
  • Fidelis — Essential Plan 1-2: $94.15
  • Fidelis — Essential Plan 3-4: $94.15
  • Fidelis — Medicaid HMO: $89.57
  • Healthfirst — Essential Plan: $92.35
  • Healthfirst — Medicaid HMO: $92.35
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 $100 – $673.56
Psychotherapy, 45 minutes: 10 of 13 insurance plan rates
  • Aetna — Medicare Advantage HMO: $221.56
  • Anthem — Commercial HMO: $326
  • Anthem — Commercial PPO: $326
  • Carelon Behavioral Health — Child Health Plus: $199.64
  • Carelon Behavioral Health — Commercial: $199.64
  • Carelon Behavioral Health — Exchange Plan: $199.64
  • Carelon Behavioral Health — Exchange Plan Silver: $199.64
  • Carelon Behavioral Health — Medicare Advantage HMO: $199.64
  • Emblem Health - GHI — Commercial: $673.56
  • Healthfirst — Medicare Advantage HMO: $217.13
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: PSYCHOTX 45MIN W/PT $675 $675 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 $127 – $673.56
Psychotherapy, 60 minutes: 10 of 13 insurance plan rates
  • Aetna — Medicare Advantage HMO: $221.56
  • Anthem — Commercial HMO: $492.56
  • Anthem — Commercial PPO: $492.56
  • Carelon Behavioral Health — Child Health Plus: $199.64
  • Carelon Behavioral Health — Commercial: $199.64
  • Carelon Behavioral Health — Exchange Plan: $199.64
  • Carelon Behavioral Health — Exchange Plan Silver: $199.64
  • Carelon Behavioral Health — Medicare Advantage HMO: $199.64
  • Emblem Health - GHI — Commercial: $673.56
  • Healthfirst — Medicare Advantage HMO: $217.13
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy, 1 hour Not listed in the file Not listed in the file $56.93 – $147.46
Psychotherapy, 60 minutes: rates for 7 insurance plans
  • Anthem Health Plus — Medicaid HMO: $147.46
  • Fidelis — Medicaid HMO: $132.71
  • Healthfirst — Commercial: $135.27
  • Healthfirst — Essential Plan: $136.91
  • Healthfirst — Medicaid HMO: $117.97
  • Healthfirst — Medicare Advantage HMO: $129.49
  • United Community Plan — Medicaid HMO: $56.93
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: PSYCHOTX 60MIN W/PT $699 $699 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 $60 – $673.56
Family psychotherapy, without the patient: 10 of 15 insurance plan rates
  • Aetna — Medicare Advantage HMO: $221.56
  • Anthem — Commercial HMO: $395.52
  • Anthem — Commercial PPO: $395.52
  • Carelon Behavioral Health — Child Health Plus: $181.60
  • Carelon Behavioral Health — Commercial: $181.60
  • Carelon Behavioral Health — Exchange Plan: $181.60
  • Carelon Behavioral Health — Exchange Plan Silver: $181.60
  • Carelon Behavioral Health — Medicare Advantage HMO: $181.60
  • Emblem Health - GHI — Commercial: $673.56
  • Healthfirst — Medicare Advantage HMO: $217.13
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: Family psychotherapy without patient, 50 minutes Not listed in the file Not listed in the file $74.91 – $140.75
Family psychotherapy, without the patient: rates for 4 insurance plans
  • Aetna — Commercial HMO: $117.98
  • Anthem — Commercial HMO: $111.37
  • Anthem — Commercial PPO: $140.75
  • Metroplus — Medicaid HMO: $74.91
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: FAMILY PSYCHTX WO/ PT 50MIN $587 $587 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 $60 – $673.56
Family psychotherapy, with the patient: 10 of 15 insurance plan rates
  • Aetna — Medicare Advantage HMO: $221.56
  • Anthem — Commercial HMO: $414.36
  • Anthem — Commercial PPO: $414.36
  • Carelon Behavioral Health — Child Health Plus: $235.72
  • Carelon Behavioral Health — Commercial: $235.72
  • Carelon Behavioral Health — Exchange Plan: $235.72
  • Carelon Behavioral Health — Exchange Plan Silver: $235.72
  • Carelon Behavioral Health — Medicare Advantage HMO: $235.72
  • Emblem Health - GHI — Commercial: $673.56
  • Healthfirst — Medicare Advantage HMO: $217.13
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: Family psychotherapy with patient, 50 minutes Not listed in the file Not listed in the file $101.21 – $112.46
Family psychotherapy, with the patient: rates for 3 insurance plans
  • Anthem Health Plus — Medicaid HMO: $112.46
  • Fidelis — Medicaid HMO: $101.21
  • Molina — Medicaid HMO: $112.46
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: FAMILY PSYCHTX W/PT 50MIN $587 $587 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 $35 – $385.51
Group psychotherapy: 10 of 15 insurance plan rates
  • Aetna — Medicare Advantage HMO: $126.81
  • Anthem — Commercial HMO: $99.01
  • Anthem — Commercial PPO: $99.01
  • Carelon Behavioral Health — Child Health Plus: $155.44
  • Carelon Behavioral Health — Commercial: $155.44
  • Carelon Behavioral Health — Exchange Plan: $155.44
  • Carelon Behavioral Health — Exchange Plan Silver: $155.44
  • Carelon Behavioral Health — Medicare Advantage HMO: $155.44
  • Emblem Health - GHI — Commercial: $385.51
  • Healthfirst — Medicare Advantage HMO: $124.28
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $23.94
Group psychotherapy: rates for 1 insurance plan
  • Aetna — Commercial HMO: $23.94
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: GROUP THERAPY $328 $328 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 $3,161 – $14,858.22
Removal of breast growth (open surgery): 10 of 23 insurance plan rates
  • Aetna — Commercial: $5,457
  • Aetna — Commercial HMO: $5,457
  • Aetna — Commercial PPO: $5,457
  • Aetna — Medicare Advantage HMO: $4,887.57
  • Anthem — Commercial HMO: $6,997
  • Anthem — Commercial PPO: $7,047
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $14,858.22
  • Healthfirst — Medicare Advantage HMO: $4,789.82
  • Local 1199 — Commercial PPO: $3,161
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION $1,260 $1,260 Not listed in the file
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Removal of growth and tissue of breast, duct, or nipple Not listed in the file Not listed in the file $402.42 – $784.71
Removal of breast growth (open surgery): rates for 9 insurance plans
  • Aetna — Commercial PPO: $687.58
  • Aetna — Medicare Advantage PPO: $492.96
  • Anthem — Commercial PPO: $750.28
  • Cigna — Commercial PPO: $750.64
  • Emblem Health - GHI — Commercial PPO: $784.71
  • Fidelis — Essential Plan 3-4: $488.20
  • Fidelis — Medicaid HMO: $462.50
  • Healthfirst — Medicaid HMO: $402.42
  • Metroplus — Medicaid HMO: $485.06
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 $6,360 – $48,720.01
Total hip replacement: 10 of 23 insurance plan rates
  • Aetna — Commercial: $8,428
  • Aetna — Commercial HMO: $8,428
  • Aetna — Commercial PPO: $8,428
  • Aetna — Medicare Advantage HMO: $16,026.32
  • Anthem — Commercial HMO: $11,319
  • Anthem — Commercial PPO: $11,528
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $48,720.01
  • Healthfirst — Medicare Advantage HMO: $15,705.79
  • Local 1199 — Commercial PPO: $16,520
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: TOTAL HIP JOINT REPLACEMENT $3,795 $3,795 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 $8,428 – $48,720.01
Total knee replacement: 10 of 23 insurance plan rates
  • Aetna — Commercial: $8,428
  • Aetna — Commercial HMO: $8,428
  • Aetna — Commercial PPO: $8,428
  • Aetna — Medicare Advantage HMO: $16,026.32
  • Anthem — Commercial HMO: $12,297
  • Anthem — Commercial PPO: $12,523
  • Centivo — Commercial HMO: $9,010
  • Emblem Health - GHI — Commercial: $48,720.01
  • Healthfirst — Medicare Advantage HMO: $15,705.79
  • Local 1199 — Commercial PPO: $43,884
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 $1,961 – $7,047
Shoulder arthroscopy: shaving of shoulder bone: 10 of 18 insurance plan rates
  • Aetna — Commercial: $5,457
  • Aetna — Commercial HMO: $5,457
  • Aetna — Commercial PPO: $5,457
  • Anthem — Commercial HMO: $6,997
  • Anthem — Commercial PPO: $7,047
  • Centivo — Commercial HMO: $6,360
  • Local 1199 — Commercial PPO: $3,161
  • Magnacare — Commercial: $3,816
  • Oxford Health Plan — Commercial: $1,961
  • Oxford Health Plan — Commercial HMO: $1,961
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 $3,898 – $12,416.53
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates
  • Aetna — Commercial: $6,634
  • Aetna — Commercial HMO: $6,634
  • Aetna — Commercial PPO: $6,634
  • Aetna — Medicare Advantage HMO: $4,084.39
  • Anthem — Commercial HMO: $6,997
  • Anthem — Commercial PPO: $7,047
  • Centivo — Commercial HMO: $9,010
  • Emblem Health - GHI — Commercial: $12,416.53
  • Healthfirst — Medicare Advantage HMO: $4,002.70
  • Local 1199 — Commercial PPO: $3,898
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 $3,161 – $22,464.47
Removal of tonsils and adenoids (under age 12): 10 of 23 insurance plan rates
  • Aetna — Commercial: $5,457
  • Aetna — Commercial HMO: $5,457
  • Aetna — Commercial PPO: $5,457
  • Aetna — Medicare Advantage HMO: $7,389.63
  • Anthem — Commercial HMO: $9,048
  • Anthem — Commercial PPO: $9,148
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $22,464.47
  • Healthfirst — Medicare Advantage HMO: $7,241.84
  • Local 1199 — Commercial PPO: $3,161
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: Removal of tonsils and adenoid glands (younger than 12 years) Not listed in the file Not listed in the file $237.23 – $623.43
Removal of tonsils and adenoids (under age 12): 10 of 15 insurance plan rates
  • Aetna — Commercial PPO: $539.06
  • Anthem — Commercial PPO: $482.41
  • Anthem Health Plus — Child Health Plus: $340.67
  • Anthem Health Plus — Medicaid HMO: $340.67
  • Cigna — Commercial PPO: $494.76
  • Emblem Health - GHI — Commercial PPO: $585.95
  • Emblem Health - HIP — Commercial HMO: $623.43
  • Fidelis — Child Health Plus: $306.60
  • Fidelis — Medicaid HMO: $306.60
  • Healthfirst — Medicaid HMO: $272.54
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: REMOVE TONSILS AND ADENOIDS $855 $855 Not listed in the file
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope Not listed in the file Not listed in the file $30.80 – $245.61
Upper GI endoscopy (diagnostic): 10 of 34 insurance plan rates
  • Aetna — Commercial HMO: $197.72
  • Aetna — Commercial PPO: $197.72
  • Aetna — Medicare Advantage HMO: $135.98
  • Aetna — Medicare Advantage PPO: $135.98
  • Anthem — Commercial PPO: $161.64
  • Anthem Health Plus — Essential Plan 1-2: $141.76
  • Anthem Health Plus — Medicaid HMO: $138.76
  • Cigna — Commercial PPO: $214.01
  • Elderplan — Medicare Advantage HMO: $138.76
  • Emblem Health - GHI — Commercial PPO: $245.61
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 $1,109.53 – $6,360
Upper GI endoscopy (diagnostic): 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,066
  • Aetna — Commercial HMO: $4,066
  • Aetna — Commercial PPO: $4,066
  • Aetna — Medicare Advantage HMO: $1,132.18
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $3,441.81
  • Healthfirst — Medicare Advantage HMO: $1,109.53
  • Local 1199 — Commercial PPO: $2,062
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD $3,520 $3,520 Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope Not listed in the file Not listed in the file $31.08 – $267.25
Upper GI endoscopy with biopsy: 10 of 53 insurance plan rates
  • Aetna — Commercial HMO: $146.89
  • Aetna — Commercial PPO: $123.66
  • Aetna — Medicare Advantage HMO: $152.27
  • Aetna — Medicare Advantage PPO: $76.14
  • Anthem — Commercial HMO: $121.81
  • Anthem — Commercial PPO: $109.78
  • Anthem — Medicare Advantage PPO: $78.47
  • Anthem Health Plus — Child Health Plus: $160.13
  • Anthem Health Plus — Essential Plan 1-2: $155.38
  • Anthem Health Plus — Medicaid HMO: $155.38
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 $1,109.53 – $6,360
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $1,132.18
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $3,441.81
  • Healthfirst — Medicare Advantage HMO: $1,109.53
  • Local 1199 — Commercial PPO: $2,830
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD W/BIOPSY $3,585 $3,585 Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: Diagnostic exam of large bowel using a flexible endoscope Not listed in the file Not listed in the file $41.67 – $358.38
Colonoscopy (diagnostic): 10 of 44 insurance plan rates
  • Aetna — Commercial HMO: $331.44
  • Aetna — Commercial PPO: $331.44
  • Aetna — Medicare Advantage HMO: $204.19
  • Aetna — Medicare Advantage PPO: $204.19
  • Anthem — Commercial HMO: $297.59
  • Anthem — Commercial PPO: $264.77
  • Anthem Health Plus — Essential Plan 1-2: $208.36
  • Anthem Health Plus — Medicaid HMO: $208.36
  • Anthem Health Plus — Medicare Advantage HMO: $205.03
  • Anthem Health Plus — Medicare Advantage PPO: $163.36
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 $1,137.63 – $6,360
Colonoscopy (diagnostic): 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $1,160.85
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $3,528.99
  • Healthfirst — Medicare Advantage HMO: $1,137.63
  • Local 1199 — Commercial PPO: $2,830
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: COLONOSCOPY FLEX,DX $3,630 $3,630 Not listed in the file
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy of large bowel using a flexible endoscope Not listed in the file Not listed in the file $45.32 – $535
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial HMO: $323.22
  • Aetna — Commercial PPO: $359.13
  • Aetna — Medicare Advantage HMO: $222.08
  • Aetna — Medicare Advantage PPO: $222.08
  • Anthem — Commercial HMO: $258.57
  • Anthem — Commercial PPO: $290.89
  • Anthem — Medicare Advantage PPO: $45.32
  • Anthem Health Plus — Essential Plan 1-2: $176.61
  • Anthem Health Plus — Medicaid HMO: $226.61
  • Anthem Health Plus — Medicare Advantage PPO: $222.08
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 $1,463.87 – $6,360
Colonoscopy with biopsy: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $1,493.75
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $4,540.99
  • Healthfirst — Medicare Advantage HMO: $1,463.87
  • Local 1199 — Commercial PPO: $2,830
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee In the file: COLONOSCOPY W/ BIOPSY(s) $4,090 $4,090 Not listed in the file
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: Removal of polyps or growths of large bowel using an endoscope with mechanical snare Not listed in the file Not listed in the file $14.18 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $502.09
Colonoscopy with removal of polyps (snare): 10 of 47 insurance plan rates
  • Aetna — Commercial HMO: $453.35
  • Aetna — Commercial PPO: $453.35
  • Aetna — Medicare Advantage HMO: $278.74
  • Aetna — Medicare Advantage PPO: $278.74
  • Anthem — Commercial HMO: $143.51
  • Anthem — Commercial PPO: $351.83
  • Anthem — Medicare Advantage PPO: $15.21 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Anthem Health Plus — Essential Plan 1-2: $284.43
  • Anthem Health Plus — Medicaid HMO: $284.43
  • Anthem Health Plus — Medicare Advantage HMO: $278.74
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 $1,463.87 – $6,360
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $1,493.75
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $4,540.99
  • Healthfirst — Medicare Advantage HMO: $1,463.87
  • Local 1199 — Commercial PPO: $2,830
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: COLON W/ REM POLYP/TUM,SNARE $4,090 $4,090 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 $1,463.87 – $6,360
Ultrasound of the lower bowel by endoscope: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $1,493.75
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $4,540.99
  • Healthfirst — Medicare Advantage HMO: $1,463.87
  • Local 1199 — Commercial PPO: $2,830
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: Ultrasound exam of large bowel using a flexible endoscope Not listed in the file Not listed in the file $63.12 – $230.04
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans
  • Healthfirst — Medicaid HMO: $230.04
  • United Healthcare — Medicare Advantage HMO: $63.12
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Hospital (facility) fee In the file: COLONOSCOPY W/ EUS $4,510 $4,510 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 $365 – $6,360
Screening colonoscopy (not high risk): 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $1,160.85
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $3,528.99
  • Healthfirst — Medicare Advantage HMO: $1,137.63
  • Local 1199 — Commercial PPO: $815
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $345.01
Screening colonoscopy (not high risk): rates for 1 insurance plan
  • Fidelis — Essential Plan 1-2: $345.01
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: SCREENING COLONSCPY,NON HI RSK $3,960 $3,960 Not listed in the file
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: Removal of gallbladder using an endoscope Not listed in the file Not listed in the file $333.58 – $1,395.16
Gallbladder removal by laparoscope: 10 of 47 insurance plan rates
  • Aetna — Commercial HMO: $1,276.82
  • Aetna — Commercial PPO: $1,276.82
  • Aetna — Medicare Advantage HMO: $713.86
  • Aetna — Medicare Advantage PPO: $777.32
  • Anthem — Commercial HMO: $1,226.26
  • Anthem — Commercial PPO: $1,061.86
  • Anthem Health Plus — Child Health Plus: $793.18
  • Anthem Health Plus — Essential Plan 1-2: $761.14
  • Anthem Health Plus — Medicaid HMO: $793.18
  • Anthem Health Plus — Medicare Advantage PPO: $635.93
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 $6,169 – $22,941.47
Gallbladder removal by laparoscope: 10 of 23 insurance plan rates
  • Aetna — Commercial: $7,597
  • Aetna — Commercial HMO: $7,597
  • Aetna — Commercial PPO: $7,597
  • Aetna — Medicare Advantage HMO: $7,546.53
  • Anthem — Commercial HMO: $9,681
  • Anthem — Commercial PPO: $9,727
  • Centivo — Commercial HMO: $9,010
  • Emblem Health - GHI — Commercial: $22,941.47
  • Healthfirst — Medicare Advantage HMO: $7,395.60
  • Local 1199 — Commercial PPO: $6,169
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: CHOLECYSTECTOMY $1,985 $1,985 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 $3,898 – $13,586.84
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates
  • Aetna — Commercial: $6,634
  • Aetna — Commercial HMO: $6,634
  • Aetna — Commercial PPO: $6,634
  • Aetna — Medicare Advantage HMO: $4,469.36
  • Anthem — Commercial HMO: $6,997
  • Anthem — Commercial PPO: $7,047
  • Centivo — Commercial HMO: $9,010
  • Emblem Health - GHI — Commercial: $13,586.84
  • Healthfirst — Medicare Advantage HMO: $4,379.97
  • Local 1199 — Commercial PPO: $3,898
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: Repair of groin hernia (5 years or older) Not listed in the file Not listed in the file $620.05
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan
  • Metroplus — Medicaid HMO: $620.05
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: REPAIR INGUINAL HERNIA. $1,575 $1,575 Not listed in the file
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy of prostate gland Not listed in the file Not listed in the file $29.12 – $292.67
Prostate biopsy: 10 of 41 insurance plan rates
  • Aetna — Commercial HMO: $219.53
  • Aetna — Commercial PPO: $231.60
  • Aetna — Medicare Advantage HMO: $142.67
  • Aetna — Medicare Advantage PPO: $142.67
  • Anthem — Commercial HMO: $292.67
  • Anthem — Commercial PPO: $209.94
  • Anthem — Medicare Advantage PPO: $35.66
  • Anthem Health Plus — Essential Plan 1-2: $95.58
  • Anthem Health Plus — Medicaid HMO: $145.58
  • Anthem Health Plus — Medicare Advantage PPO: $99.87
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 $2,830 – $7,735
Prostate biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $7,735
  • Aetna — Commercial HMO: $7,735
  • Aetna — Commercial PPO: $7,735
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $6,360
  • Local 1199 — Commercial PPO: $2,830
  • Magnacare — Commercial: $5,830
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: BIOPSY OF PROSTATE $365 $365 Not listed in the file
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 $7,597 – $43,884
Prostate removal by laparoscope (radical prostatectomy): 10 of 23 insurance plan rates
  • Aetna — Commercial: $7,597
  • Aetna — Commercial HMO: $7,597
  • Aetna — Commercial PPO: $7,597
  • Aetna — Medicare Advantage HMO: $13,269.05
  • Anthem — Commercial HMO: $12,297
  • Anthem — Commercial PPO: $12,523
  • Centivo — Commercial HMO: $9,010
  • Emblem Health - GHI — Commercial: $40,337.91
  • Healthfirst — Medicare Advantage HMO: $13,003.67
  • Local 1199 — Commercial PPO: $43,884
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: Surgical removal of prostate and surrounding lymph nodes using an endoscope Not listed in the file Not listed in the file $881.41 – $2,543.50
Prostate removal by laparoscope (radical prostatectomy): 10 of 18 insurance plan rates
  • Aetna — Medicare Advantage HMO: $1,325.93
  • Aetna — Medicare Advantage PPO: $1,325.93
  • Anthem — Commercial PPO: $2,543.50
  • Anthem Health Plus — Medicaid HMO: $1,352.99
  • Cigna — Commercial PPO: $2,433.53
  • Elderplan — Medicaid HMO: $1,352.99
  • Elderplan — Medicare Advantage HMO: $1,352.99
  • Emblem Health - GHI — Commercial PPO: $2,394.79
  • Emblem Health - HIP — Essential Plan 1-2: $881.41
  • Fidelis — Essential Plan 3-4: $1,285.34
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: LAP PROSTATECTOMY $3,385 $3,385 Not listed in the file
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy of lining of uterus and/or removal of polyp using an endoscope Not listed in the file Not listed in the file $159.31 – $2,863.67
Hysteroscopy with biopsy of the uterus lining: 10 of 40 insurance plan rates
  • Aetna — Commercial HMO: $429.81
  • Aetna — Commercial PPO: $429.81
  • Aetna — Medicare Advantage HMO: $268.99
  • Aetna — Medicare Advantage PPO: $262.15
  • Anthem — Commercial HMO: $1,631.42
  • Anthem — Commercial PPO: $409.28
  • Anthem Health Plus — Essential Plan 1-2: $267.50
  • Anthem Health Plus — Medicaid HMO: $1,446.73
  • Cigna — Commercial HMO: $2,074.63
  • Cigna — Commercial PPO: $395.15
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 $3,161 – $12,284.19
Hysteroscopy with biopsy of the uterus lining: 10 of 23 insurance plan rates
  • Aetna — Commercial: $5,457
  • Aetna — Commercial HMO: $5,457
  • Aetna — Commercial PPO: $5,457
  • Aetna — Medicare Advantage HMO: $4,040.85
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $12,284.19
  • Healthfirst — Medicare Advantage HMO: $3,960.03
  • Local 1199 — Commercial PPO: $3,161
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: HYSTEROSC W/POLYPEC UTER $9,719 $9,719 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 $815 – $6,360
Spinal injection, lower back (epidural), with imaging guidance: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,066
  • Aetna — Commercial HMO: $4,066
  • Aetna — Commercial PPO: $4,066
  • Aetna — Medicare Advantage HMO: $881.14
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $2,678.67
  • Healthfirst — Medicare Advantage HMO: $863.52
  • Local 1199 — Commercial PPO: $815
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: Injection of substance into lower spine canal using imaging guidance Not listed in the file Not listed in the file $89.06
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan
  • Healthfirst — Essential Plan: $89.06
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: INJ EPIDURAL LUMB/SACR W/ IMAG $4,155 $4,155 Not listed in the file
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 $1,081.99 – $6,360
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,066
  • Aetna — Commercial HMO: $4,066
  • Aetna — Commercial PPO: $4,066
  • Aetna — Medicare Advantage HMO: $1,104.07
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $3,356.38
  • Healthfirst — Medicare Advantage HMO: $1,081.99
  • Local 1199 — Commercial PPO: $2,062
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: INJ EPIDURAL LUMB/SACR SGL LEV $3,190 $3,190 Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: INJ ANESTH/STEROID EPIDURAL, L $2,978 $2,978 Not listed in the file
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 $2,388.80 – $7,410.17
Carpal tunnel release: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $2,437.56
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $7,410.17
  • Healthfirst — Medicare Advantage HMO: $2,388.80
  • Local 1199 — Commercial PPO: $2,830
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: REVISE MEDIAN NERVE AT WRIST $1,315 $1,315 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 $672.82 – $6,360
Laser treatment of clouding after cataract surgery: 10 of 23 insurance plan rates
  • Aetna — Commercial: $4,173
  • Aetna — Commercial HMO: $4,173
  • Aetna — Commercial PPO: $4,173
  • Aetna — Medicare Advantage HMO: $686.55
  • Anthem — Commercial HMO: $4,113
  • Anthem — Commercial PPO: $4,181
  • Centivo — Commercial HMO: $6,360
  • Emblem Health - GHI — Commercial: $2,087.12
  • Healthfirst — Medicare Advantage HMO: $672.82
  • Local 1199 — Commercial PPO: $2,830
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: LASERING, SECONDARY CATARACT $875 $875 Not listed in the file
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: OST-CATARACT LASER SURGERY $4,000 $4,000 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 $2,823.20 – $10,600
Cataract removal with lens implant: 10 of 23 insurance plan rates
  • Aetna — Commercial: $7,597
  • Aetna — Commercial HMO: $7,597
  • Aetna — Commercial PPO: $7,597
  • Aetna — Medicare Advantage HMO: $2,880.82
  • Anthem — Commercial HMO: $6,160
  • Anthem — Commercial PPO: $6,226
  • Centivo — Commercial HMO: $10,600
  • Emblem Health - GHI — Commercial: $8,757.69
  • Healthfirst — Medicare Advantage HMO: $2,823.20
  • Local 1199 — Commercial PPO: $5,983
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP $5,600 $5,600 Not listed in the file

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: Vaginal delivery with care before and after delivery Not listed in the file Not listed in the file $2,123.62
Vaginal delivery, with care before and after: rates for 1 insurance plan
  • Oxford Health Plan — Commercial HMO: $2,123.62
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 $3,000
Vaginal delivery, with care before and after: rates for 1 insurance plan
  • Local 1199 — Commercial PPO: $3,000
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRICAL CARE $7,245 $7,245 Not listed in the file
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: Cesarean delivery with care before and after delivery Not listed in the file Not listed in the file $5,967.91
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan
  • Emblem Health - GHI — Commercial PPO: $5,967.91
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 $3,000
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan
  • Local 1199 — Commercial PPO: $3,000
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: CESAREAN DELIVERY $8,110 $8,110 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 $3,000
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan
  • Local 1199 — Commercial PPO: $3,000
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: VAGINAL DEL TOTAL,POST CSECTION $7,655 $7,655 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 · modifier U7 In the file: Vaginal delivery and care before and after delivery after previous cesarean delivery Not listed in the file Not listed in the file $2,880.99
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan
  • Anthem — Commercial PPO: $2,880.99

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 $118,450.07 – $337,017.46
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 59 insurance plan rates
  • Aetna — Commercial: $285,246.88
  • Aetna — Commercial HMO: $285,246.88
  • Aetna — Commercial PPO: $285,246.88
  • Aetna — Medicare Advantage HMO: $127,365.67
  • Aetna — Medicare Advantage PPO: $127,365.67
  • Aetna FIDA — Medicare Advantage HMO: $127,365.67
  • Anthem — Commercial HMO: $301,476.55
  • Anthem — Commercial PPO: $306,925.57
  • Anthem — Medicare Advantage HMO: $127,365.67
  • Anthem — Medicare Advantage PPO: $127,365.67
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 Not listed in the file
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • MultiPlan — Commercial PPO: 85% (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 $23,873.46 – $66,450.60
Hip or knee replacement (major joint of the leg), without major complications: 10 of 59 insurance plan rates
  • Aetna — Commercial: $56,242.87
  • Aetna — Commercial HMO: $56,242.87
  • Aetna — Commercial PPO: $56,242.87
  • Aetna — Medicare Advantage HMO: $25,670.39
  • Aetna — Medicare Advantage PPO: $25,670.39
  • Aetna FIDA — Medicare Advantage HMO: $25,670.39
  • Anthem — Commercial HMO: $59,442.91
  • Anthem — Commercial PPO: $60,517.31
  • Anthem — Medicare Advantage HMO: $25,670.39
  • Anthem — Medicare Advantage PPO: $25,670.39
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 $30,043.78 – $84,102.78
Neck (cervical) spinal fusion, without complications: 10 of 59 insurance plan rates
  • Aetna — Commercial: $71,183.43
  • Aetna — Commercial HMO: $71,183.43
  • Aetna — Commercial PPO: $71,183.43
  • Aetna — Medicare Advantage HMO: $32,305.14
  • Aetna — Medicare Advantage PPO: $32,305.14
  • Aetna FIDA — Medicare Advantage HMO: $32,305.14
  • Anthem — Commercial HMO: $75,233.54
  • Anthem — Commercial PPO: $76,593.35
  • Anthem — Medicare Advantage HMO: $32,305.14
  • Anthem — Medicare Advantage PPO: $32,305.14
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 $15,586.16 – $42,742.12
Uterus and ovary surgery (not for cancer), without complications: 10 of 59 insurance plan rates
  • Aetna — Commercial: $36,176.33
  • Aetna — Commercial HMO: $36,176.33
  • Aetna — Commercial PPO: $36,176.33
  • Aetna — Medicare Advantage HMO: $16,759.31
  • Aetna — Medicare Advantage PPO: $16,759.31
  • Aetna FIDA — Medicare Advantage HMO: $16,759.31
  • Anthem — Commercial HMO: $38,234.65
  • Anthem — Commercial PPO: $38,925.72
  • Anthem — Medicare Advantage HMO: $16,759.31
  • Anthem — Medicare Advantage PPO: $16,759.31

Source: Maimonides Medical Center’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
Address4802 Tenth Avenue, Brooklyn, NY 11219
CountyKings County
StateNew York
Phone(718) 283‑6000
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number330194
Name in Medicare recordsMAIMONIDES MEDICAL CENTER
Profile levelMedicare data + hospital website
Official websitemaimo.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 ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

  1. Treatments & Care — maimo.org
  2. Emergency and Trauma Centers — maimo.org
  3. Emergency Medicine | Maimonides Health — maimo.org
  4. Patients & Visitors | Maimonides Health — maimo.org