Does Mercy Catholic Medical Center- Mercy Fitzgerald have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mercy Catholic Medical Center- Mercy Fitzgerald. In a medical emergency, call 911.

Where is Mercy Catholic Medical Center- Mercy Fitzgerald?

1500 Lansdowne Ave, Darby, PA 19023, in Delaware County, Pennsylvania.

What is the phone number of Mercy Catholic Medical Center- Mercy Fitzgerald?

(215) 237-4000, as listed by Medicare (CMS).

What is the Medicare star rating of Mercy Catholic Medical Center- Mercy Fitzgerald?

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

Mercy Catholic Medical Center- Mercy Fitzgerald

Quick answers

Does Mercy Catholic Medical Center- Mercy Fitzgerald have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mercy Catholic Medical Center- Mercy Fitzgerald. In a medical emergency, call 911.
Where is Mercy Catholic Medical Center- Mercy Fitzgerald?: 1500 Lansdowne Ave, Darby, PA 19023, in Delaware County, Pennsylvania.
What is the phone number of Mercy Catholic Medical Center- Mercy Fitzgerald?: (215) 237-4000, as listed by Medicare (CMS).
What is the Medicare star rating of Mercy Catholic Medical Center- Mercy Fitzgerald?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][6][7]

Bariatrics
Behavioral Health
Breast Health
Cancer Care
Heart and Vascular Care
Diabetes Care
Digestive Health
Family Medicine
Imaging/Radiology
Neurosciences
Orthopedic Care
Pain Management
Palliative Care
Physical Therapy/Rehabilitation
Respiratory Therapy
Sleep Disorders
Stroke Care
Surgical Services
Urology
Vein Services
Women's Health
Wound Care
Emergency Care
Nutrition Counseling
Pulmonary Rehab
Senior Care

Conditions treated^[9]

Stroke

Treatments^[4][7]

Nutrition Counseling
Pulmonary Rehab
Medication assisted treatment for opiate dependence

Procedures^[10]

Programs and centers^[7][9][11]

Certified Chest Pain Center
FastTrack walk-in service
Dedicated Emergency Medical Service serving Delaware County and Southwest Philadelphia
Stroke Education Class
Acute Rehab program
Mercy Fitzgerald Cancer Care

Emergency care (hospital website)^{[4][6][7][8][9]}

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

Visiting and practical information

Visiting	General inpatient and critical care 8 a.m. to 8 p.m., up to two visitors; behavioral health has limited evening visiting^[5]
Patient portal	MyChart

Recognition^[6][9]

Certified Primary Stroke Center (The Joint Commission)
Acute Rehab program accredited by CARF

Doctors and clinicians (289)

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

Main specialties

And 265 more: the button below opens the full list.

Other emergency rooms nearby

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

Philadelphia VA Medical Center3.9 mi · Philadelphia, PA · Federal/VA Acute Care Hospital
Children's Hospital of Philadelphia4.2 mi · Philadelphia, PA · Children's Hospital
Penn Presbyterian Medical Center4.2 mi · Philadelphia, PA · Acute Care Hospital
Hospital of Univ of Pennsylvania4.3 mi · Philadelphia, PA · Acute Care Hospital
Main Line Hospital Lankenau4.4 mi · Wynnewood, PA · Acute Care Hospital

Other hospitals nearby

Malvern Behavioral Health5.2 mi · Philadelphia, PA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

St Francis Center for Rehabilitation & Healthcare0.1 mi · Darby, PA · 2 of 5 stars
Providence Rehab and Hlthcare Ctratmercyfitzgerald0.3 mi · Yeadon, PA · 3 of 5 stars
Little Flower Manor0.6 mi · Darby, PA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Immediate Homecare and Hospice4.3 mi · Philadelphia, PA
Heartland Hospice (Philadelphia)6.1 mi · Bala Cynwyd, PA
Penn Medicine Hospice6.1 mi · Bala Cynwyd, PA · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Asap Healthcare Services, Inc.0.6 mi · Darby, PA
Best Time Health Services LLC0.6 mi · Collingdale, PA
Bistoy Home Healthcare, Inc.0.6 mi · Darby, PA

All home health agencies in the state →

Dialysis facilities

FKC Sharon Hill1.7 mi · Sharon Hill, PA · 3 of 5 stars
USRC Philadelphia1.9 mi · Philadelphia, PA · 4 of 5 stars
DaVita Upper Darby Dialysis2.3 mi · Upper Darby, PA · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

American Access Care of SP Asc, LLC4.2 mi · Philadelphia, PA
Wills Surgery Center of Philadelphia Stadium Campu4.2 mi · Philadelphia, PA
Advanced Surgical Ambulatory Partners of Havertown4.2 mi · Havertown, PA

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Fairmount Primary Care Center at Sharon Hill-Delaware County1.0 mi · Sharon Hill, PA · Community health center
Outley House1.5 mi · Philadelphia, PA · Community health center
FPCSN at Bartram High School1.8 mi · Philadelphia, PA · Community health center

Clinics and urgent care

On Demand Urgent Care Group PC3.1 mi · Philadelphia, PA · Urgent care center
Clinical Care Associates of the University of Pennsylvania Health Syst4.2 mi · Philadelphia, PA · Urgent care center
American Current Care P.A.4.6 mi · Essington, PA · Urgent care center

Pharmacies

Walgreen Co0.6 mi · Darby, PA · Pharmacy
Extracare Pharmacy, Inc.0.8 mi · Yeadon, PA · Community/retail pharmacy
Planned Parenthood Southeastern Pennsylvania0.8 mi · Yeadon, PA · Clinic pharmacy

Assisted living nearby

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

Accolades Senior Care0.8 mi · East Lansdowne, PA
Blissful Prudence LLC0.8 mi · East Lansdowne, PA
Haskins House1.6 mi · Secane, PA
Benevolent Personal Care Home Inc2.5 mi · Philadelphia, PA

About the Medicare star rating

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

Medicare quality data

What Mercy Catholic Medical Center- Mercy Fitzgerald 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 hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	60%National average: 72%
Would definitely recommend the hospital	57%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	75%National average: 80%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	82%National average: 86%
Room and bathroom “always” clean	62%National average: 74%
Area around the room “always” quiet at night	51%National average: 60%
Completed surveys	527Response rate: 10%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	1.078No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.83No different from the national benchmark
Surgical site infections after colon surgery	1.41No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.521No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.42Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.7%
Deaths within 30 days: heart failure patients	7.8%
Deaths within 30 days: pneumonia patients	16.2%
Deaths within 30 days: COPD patients	7.6%
Deaths within 30 days: stroke patients	9.3%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.36No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.5%
Readmitted within 30 days: heart failure	20.3%
Readmitted within 30 days: pneumonia	17.6%
Readmitted within 30 days: COPD	20.4%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	223 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)	79%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Mercy Catholic Medical Center- Mercy Fitzgerald 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 →

$ 8 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$240	$240	$54.25 – $240
New patient office visit (about 30–44 minutes): 10 of 751 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $119.53 AETNA — AETNA: $198.34 AETNA DOMESTIC — AETNA: $198.34 AETNA MEDICAID — AETNA MEDICAID: $78.66 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $131.48 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $131.73 ALLY ALIGN CARE ADV — MEDICARE: $119.53 AMBETTER — AMBETTER: $174.17 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $119.53 AMISH MENNONITE — MEDICAID: $54.25
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$205	$205	$54.25 – $194.75
New patient office visit (about 30–44 minutes): 10 of 751 insurance plan rates AETNA DOMESTIC — AETNA: $145.96 AETNA MEDICAID — AETNA MEDICAID: $78.66 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $72.51 AETNA MEDICARE TRANSPLANT — MEDICARE: $72.51 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.25 ALIGN SENIOR CARE — MEDICARE: $72.51 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $72.51 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.38 ALLY ALIGN CARE ADV — MEDICARE: $72.51 AMBETTER — AMBETTER: $105.66
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Visit New Low Pro 30-44 Mins (Restricted Method II CAH)	Not listed in the file	$3,445	$44.55 – $4,611.48
New patient office visit (about 30–44 minutes): 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $44.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $78.31 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $75.47 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $79.91 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $49.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $79.91 AMBETTER — AMBETTER MARKETPLACE: $132.07 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$360	$360	$90.37 – $342
New patient office visit (about 45–59 minutes): 10 of 674 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $118.50 AETNA — AETNA: $236.03 AETNA MEDICAID — AETNA MEDICAID: $131.04 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.35 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $118.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.37 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.37 ALIGN SENIOR CARE — MEDICARE: $118.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $130.59 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.56
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$360	$360	$84.99 – $151.30
New patient office visit (about 45–59 minutes): 10 of 77 insurance plan rates AMERIHEALTH — AMERIHEALTH: $151.30 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $151.30 BCN DOMESTIC — INDEPENDENCE BLUE CROSS: $151.30 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — INDEPENDENCE BLUE CROSS: $151.30 BLUE CARE NETWORK — INDEPENDENCE BLUE CROSS: $151.30 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS: $151.30 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS: $151.30 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS: $151.30 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS: $151.30 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS: $151.30
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$360	$360	$102.74 – $162.11
New patient office visit (about 45–59 minutes): 10 of 77 insurance plan rates AMERIHEALTH — AMERIHEALTH: $162.11 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $162.11 BCN DOMESTIC — INDEPENDENCE BLUE CROSS: $162.11 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — INDEPENDENCE BLUE CROSS: $162.11 BLUE CARE NETWORK — INDEPENDENCE BLUE CROSS: $162.11 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS: $162.11 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS: $162.11 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS: $162.11 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS: $162.11 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS: $162.11
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$390	$390	$117.54 – $373.59
New patient office visit (about 60–74 minutes): 10 of 674 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.72 AETNA — AETNA: $320.33 AETNA MEDICAID — AETNA MEDICAID: $170.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $178.99 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $117.54 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.72 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $176.31 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $179.32 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $176.31 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $179.32
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$390	$390	$115.66 – $205.50
New patient office visit (about 60–74 minutes): 10 of 77 insurance plan rates AMERIHEALTH — AMERIHEALTH: $205.50 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $205.50 BCN DOMESTIC — INDEPENDENCE BLUE CROSS: $205.50 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — INDEPENDENCE BLUE CROSS: $205.50 BLUE CARE NETWORK — INDEPENDENCE BLUE CROSS: $205.50 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS: $205.50 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS: $205.50 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS: $205.50 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS: $205.50 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS: $205.50
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$390	$390	$132.32 – $220.18
New patient office visit (about 60–74 minutes): 10 of 77 insurance plan rates AMERIHEALTH — AMERIHEALTH: $220.18 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $220.18 BCN DOMESTIC — INDEPENDENCE BLUE CROSS: $220.18 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — INDEPENDENCE BLUE CROSS: $220.18 BLUE CARE NETWORK — INDEPENDENCE BLUE CROSS: $220.18 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS: $220.18 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS: $220.18 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS: $220.18 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS: $220.18 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS: $220.18
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$195	$195	$35 – $195
Established patient office visit (about 20–29 minutes): 10 of 751 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $96.58 AETNA — AETNA: $160.11 AETNA MEDICAID — AETNA MEDICAID: $50.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $106.24 AETNA MEDICARE TRANSPLANT — MEDICARE: $96.58 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $35 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $35 ALIGN SENIOR CARE — MEDICARE: $96.58 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $52.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $106.43
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$140	$140	$35 – $133.34
Established patient office visit (about 20–29 minutes): 10 of 751 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $50.75 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $58.07 AETNA MEDICARE TRANSPLANT — MEDICARE: $58.07 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $35 ALIGN SENIOR CARE — MEDICARE: $58.07 AMBETTER — AMBETTER: $84.62 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $58.07 AMERICAN HEALTH PLAN — MEDICARE: $58.07 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $35 ANDRIE INC — WORKERS COMP: $66.96
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$280	$280	$54.42 – $268.52
Established patient office visit (about 30–39 minutes): 10 of 751 insurance plan rates AETNA — AETNA: $191.47 AETNA DOMESTIC — AETNA: $191.47 AETNA MEDICAID — AETNA MEDICAID: $78.91 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $116.95 AETNA MEDICARE TRANSPLANT — MEDICARE: $116.95 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $54.42 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $116.95 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 ALLY ALIGN CARE ADV — MEDICARE: $116.95
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$205	$205	$54.42 – $196.20
Established patient office visit (about 30–39 minutes): 10 of 751 insurance plan rates AETNA — AETNA: $170.40 AETNA MEDICAID — AETNA MEDICAID: $78.91 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $85.46 AETNA MEDICARE TRANSPLANT — MEDICARE: $85.46 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $54.42 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $85.46 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 ALLY ALIGN CARE ADV — MEDICARE: $85.46 AMERICAN HEALTH PLAN — MEDICARE: $85.46
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$199	$199	$20 – $190.51
Preventive checkup, new patient, age 18–39: 10 of 387 insurance plan rates AETNA — AETNA: $185.07 AETNA DOMESTIC — AETNA: $185.07 AETNA MEDICAID — AETNA MEDICAID: $29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.27 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $20 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $91.44 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $91.44
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$245	$245	$20 – $232.75
Preventive checkup, new patient, age 18–39: 10 of 387 insurance plan rates AETNA — AETNA: $185.07 AETNA DOMESTIC — AETNA: $185.07 AETNA MEDICAID — AETNA MEDICAID: $29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.27 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $20 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $91.44 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $91.44
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$241	$241	$20 – $231.59
Preventive checkup, new patient, age 40–64: 10 of 390 insurance plan rates AETNA — AETNA: $224.27 AETNA DOMESTIC — AETNA: $224.27 AETNA MEDICAID — AETNA MEDICAID: $29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $20 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $111.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $111.16
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$250	$250	$41.98 – $239.32
Emergency room visit (moderate): 10 of 750 insurance plan rates AETNA — AETNA: $125.68 AETNA DOMESTIC — AETNA: $125.68 AETNA MEDICAID — AETNA MEDICAID: $82.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.73 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $56.65 ALIGN SENIOR CARE — MEDICARE: $70.67 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $70.67 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $77.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $77.88
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$148	$148	$44.94 – $148
Emergency room visit (moderate): 10 of 750 insurance plan rates AETNA — AETNA: $125.68 AETNA MEDICAID — AETNA MEDICAID: $82.14 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $70.67 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $56.65 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $56.65 ALIGN SENIOR CARE — MEDICARE: $70.67 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 AMBETTER — AMBETTER: $102.97 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $70.67
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3	$872	$566.80	$52.50 – $1,392
Emergency room visit (moderate): 10 of 101 insurance plan rates AETNA — AETNA: $1,392 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $296.82 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $286.06 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $308.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $52.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $308.49 AMBETTER — AMBETTER MARKETPLACE: $500.60 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $821
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$250	$250	$76.68 – $250
Emergency room visit (moderately high): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.30 AETNA — AETNA: $211.76 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $120.30 AETNA MEDICARE TRANSPLANT — MEDICARE: $120.30 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $95.33 ALIGN SENIOR CARE — MEDICARE: $120.30 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $143 AMBETTER — AMBETTER: $175.30 AMERICAN HEALTH PLAN — MEDICARE: $120.30
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$253	$253	$76.68 – $253
Emergency room visit (moderately high): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.30 AETNA — AETNA: $211.76 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $95.33 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 AMBETTER — AMBETTER: $175.30 AMERIGROUP MEDICAID — MEDICAID: $95.33 AMERIHEALTH — AMERIHEALTH: $145.39 AMERIHEALTH MEDICARE — MEDICARE: $120.30 ANDRIE INC — WORKERS COMP: $138.72 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $95.33
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4	$1,158	$752.70	$75 – $1,684
Emergency room visit (moderately high): 10 of 101 insurance plan rates AETNA — AETNA: $1,392 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $453.71 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $437.25 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $471.55 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $471.55 AMBETTER — AMBETTER MARKETPLACE: $765.19 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $821
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$360	$360	$111.19 – $360
Emergency room visit (high): 10 of 750 insurance plan rates AETNA DOMESTIC — AETNA: $307.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $191.60 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $174.19 AETNA MEDICARE TRANSPLANT — MEDICARE: $174.19 ALIGN SENIOR CARE — MEDICARE: $174.19 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $191.96 AMERICAN HEALTH PLAN — MEDICARE: $174.19 AMERIGROUP MEDICAID — MEDICAID: $138.74 AMERIHEALTH — AMERIHEALTH: $239.32 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $138.74
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$367	$367	$111.19 – $367
Emergency room visit (high): 10 of 750 insurance plan rates AETNA — AETNA: $307.53 AETNA DOMESTIC — AETNA: $307.53 AETNA MEDICAID — AETNA MEDICAID: $201.17 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $174.19 AETNA MEDICARE TRANSPLANT — MEDICARE: $174.19 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $138.74 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $138.74 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $208.11 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $208.11 ALLY ALIGN CARE ADV — MEDICARE: $174.19
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Full Trauma W/O Pre Notification Critical Care - Downgrade	$1,641	$1,066.65	$75 – $1,684
Emergency room visit (high): 10 of 101 insurance plan rates AETNA — AETNA: $1,392 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $647.56 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $624.06 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $673.01 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $673.01 AMBETTER — AMBETTER MARKETPLACE: $1,092.11 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $821

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	$374	$243.10	$8.44 – $374
Basic metabolic panel (blood test): 10 of 100 insurance plan rates AETNA — AETNA: $235.62 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $12.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.63 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.04 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.14 AMBETTER — AMBETTER MARKETPLACE: $15.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $49.07 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $49.07
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	Not listed in the file	$555.75	$8.44 – $118.52
Basic metabolic panel (blood test): 10 of 87 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $12.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.63 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.04 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.14 AMBETTER — AMBETTER MARKETPLACE: $15.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $49.07 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $49.07 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $49.07
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$775	$503.75	$10.53 – $775
Comprehensive metabolic panel (blood test): 10 of 100 insurance plan rates AETNA — AETNA: $488.25 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $15.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $10.77 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $17.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 AMBETTER — AMBETTER MARKETPLACE: $18.85 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $61.23 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $61.23
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	Not listed in the file	$1,106.95	$10.53 – $147.90
Comprehensive metabolic panel (blood test): 10 of 87 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $15.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $10.77 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $17.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 AMBETTER — AMBETTER MARKETPLACE: $18.85 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $61.23 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $61.23 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $61.23
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 92145 Lipid Panel	$236	$153.40	$13.36 – $236
Cholesterol panel (lipid panel): 10 of 100 insurance plan rates AETNA — AETNA: $148.68 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $18.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13.66 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $79.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $79.68
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Lipid Panel	$236	$153.40	$13.36 – $236
Cholesterol panel (lipid panel): 10 of 100 insurance plan rates AETNA — AETNA: $148.68 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $18.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13.66 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $79.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $79.68
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$236	$153.40	$13.36 – $236
Cholesterol panel (lipid panel): 10 of 100 insurance plan rates AETNA — AETNA: $148.68 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $18.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13.66 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $79.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $79.68
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$123	$79.95	$8.66 – $123
Kidney function panel: 10 of 100 insurance plan rates AETNA — AETNA: $77.49 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $12.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9.19 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.85 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.40 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.37 AMBETTER — AMBETTER MARKETPLACE: $15.49 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $50.32 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $50.32
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$324	$210.60	$8.15 – $324
Liver function panel: 10 of 100 insurance plan rates AETNA — AETNA: $204.12 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $12.19 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.65 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.33 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.82 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $13.55 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.82 AMBETTER — AMBETTER MARKETPLACE: $14.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $47.39 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $47.39
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Urinalysis With Microscopy Automated	$168	$109.20	$3.16 – $168
Urine test (automated, with microscope): 10 of 100 insurance plan rates AETNA — AETNA: $105.84 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.23 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$168	$109.20	$3.16 – $168
Urine test (automated, with microscope): 10 of 100 insurance plan rates AETNA — AETNA: $105.84 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.23 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	Not listed in the file	$890.50	$3.16 – $44.57
Urine test (automated, with microscope): 10 of 87 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.23 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $18.45
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Nonautomated	$25	$16.25	$3.47 – $50.65
Urine test (manual, without microscope): 10 of 100 insurance plan rates AETNA — AETNA: $15.75 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.76 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $5.36 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.76 AMBETTER — AMBETTER MARKETPLACE: $6.21 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $20.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $20.97
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$97	$63.05	$2.24 – $97
Urine test (automated, without microscope): 10 of 100 insurance plan rates AETNA — AETNA: $61.11 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.19 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2.30 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 AMBETTER — AMBETTER MARKETPLACE: $4.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $14.26 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $14.26
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	Not listed in the file	$1,029.60	$2.24 – $34.44
Urine test (automated, without microscope): 10 of 87 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.19 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2.30 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 AMBETTER — AMBETTER MARKETPLACE: $4.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $14.26 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $14.26 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $14.26
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde Prostate Specific Antigen Total Ultrasensitive	$219	$142.35	$18.34 – $264.39
PSA (prostate specific antigen) blood test: 10 of 100 insurance plan rates AETNA — AETNA: $137.97 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $32.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $18.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $109.46 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $109.46
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$219	$142.35	$18.34 – $264.39
PSA (prostate specific antigen) blood test: 10 of 100 insurance plan rates AETNA — AETNA: $137.97 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $32.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $18.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $109.46 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $109.46
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 31348 Prostate Specific Antigen Total	$219	$142.35	$18.34 – $264.39
PSA (prostate specific antigen) blood test: 10 of 100 insurance plan rates AETNA — AETNA: $137.97 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $32.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $18.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $109.46 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $109.46
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Thyroid Stimulating Hormone	$322	$209.30	$16.76 – $322
Thyroid stimulating hormone (TSH) test: 10 of 100 insurance plan rates AETNA — AETNA: $202.86 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $31.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $17.14 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $34.82 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 AMBETTER — AMBETTER MARKETPLACE: $29.99 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $109.87 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $109.87
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$322	$209.30	$16.76 – $322
Thyroid stimulating hormone (TSH) test: 10 of 100 insurance plan rates AETNA — AETNA: $202.86 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $31.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $17.14 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $34.82 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 AMBETTER — AMBETTER MARKETPLACE: $29.99 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $109.87 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $109.87
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Cbc Automated/Differential Wbc Automated	$173	$112.45	$7.75 – $173
Complete blood count (CBC) with differential: 10 of 100 insurance plan rates AETNA — AETNA: $108.99 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$173	$112.45	$7.75 – $173
Complete blood count (CBC) with differential: 10 of 100 insurance plan rates AETNA — AETNA: $108.99 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	Not listed in the file	$1,075.10	$7.75 – $111.43
Complete blood count (CBC) with differential: 10 of 86 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $46.13
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated Intrauterine	$157	$102.05	$6.45 – $157
Complete blood count (CBC), automated: 10 of 100 insurance plan rates AETNA — AETNA: $98.91 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $41.94 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $41.94
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$157	$102.05	$6.45 – $157
Complete blood count (CBC), automated: 10 of 100 insurance plan rates AETNA — AETNA: $98.91 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $41.94 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $41.94
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3514930 Prothrombin Time	$159	$103.35	$4.28 – $159
Blood clotting time test (prothrombin time, PT): 10 of 100 insurance plan rates AETNA — AETNA: $100.17 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.54 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $4.38 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $6 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 AMBETTER — AMBETTER MARKETPLACE: $7.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $23.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $23.48
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prothrombin Time	$159	$103.35	$4.28 – $159
Blood clotting time test (prothrombin time, PT): 10 of 100 insurance plan rates AETNA — AETNA: $100.17 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.54 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $4.38 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $6 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 AMBETTER — AMBETTER MARKETPLACE: $7.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $23.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $23.48
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3502730 Thromboplastin Time Partial (Ptt)	$183	$118.95	$5.99 – $183
Blood clotting test (partial thromboplastin time, PTT): 10 of 100 insurance plan rates AETNA — AETNA: $115.29 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $39.42 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $39.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 19790 Thromboplastin Time Partial (Ptt)	$183	$118.95	$5.99 – $183
Blood clotting test (partial thromboplastin time, PTT): 10 of 100 insurance plan rates AETNA — AETNA: $115.29 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $39.42 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $39.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 7079 Thromboplastin Time Partial (Ptt)	$183	$118.95	$5.99 – $183
Blood clotting test (partial thromboplastin time, PTT): 10 of 100 insurance plan rates AETNA — AETNA: $115.29 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $39.42 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $39.42

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	$1,738	$1,129.70	$85.92 – $1,738
CT scan of the head or brain, without contrast: 10 of 47 insurance plan rates AETNA — AETNA: $1,094.94 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $157.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $175.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $107.41 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $290.43
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	Not listed in the file	$1,129.70	$85.92 – $302.25
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $104.63 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $175.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $107.41 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $290.43 CIGNA — CIGNA: $254.71
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Head/Brain W/O Contrast\|TECHNICAL COMPONENT	$1,738	$1,129.70	$85.92 – $1,738
CT scan of the head or brain, without contrast: 10 of 22 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $104.63 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $116.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $107.41 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $108.42 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $128.89 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $110.09
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	$7,069	$4,594.85	$286.74 – $7,069
MRI of the brain, before and after contrast: 10 of 47 insurance plan rates AETNA — AETNA: $2,590 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $457.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $379.35 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $365.59 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $387.09 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $508.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $387.09 AMBETTER — AMBETTER MARKETPLACE: $639.78 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $358.42 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $969.16
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$607	$394.55	$20.05 – $607
Chest X-ray, 2 views: 10 of 101 insurance plan rates AETNA — AETNA: $382.41 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $31.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $94.63 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $91.19 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.56 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $35.46 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.56 AMBETTER — AMBETTER MARKETPLACE: $159.59 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $142.59 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $142.59
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC Xr Chest 2 Views\|TECHNICAL COMPONENT	$607	$394.55	$20.05 – $607
Chest X-ray, 2 views: rates for 6 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.05 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $22.28 KEYSTONE FIRST — KEYSTONE MEDICAID: $57.92 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $57.92 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $57.92 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $22.28
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	$727	$472.55	$36.95 – $727
X-ray of the lower spine, at least 4 views: 10 of 101 insurance plan rates AETNA — AETNA: $458.01 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $49.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $54.93 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $209.69 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $209.69
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$3,645	$2,369.25	$196.10 – $3,645
MRI of the lower back (lumbar spine), without contrast: 10 of 47 insurance plan rates AETNA — AETNA: $2,590 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $345.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $259.45 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $250.03 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $384.23 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 AMBETTER — AMBETTER MARKETPLACE: $437.56 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $245.13 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $662.83
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$3,484	$2,264.60	$116.78 – $3,484
CT scan of the pelvis, with contrast: 10 of 47 insurance plan rates AETNA — AETNA: $2,194.92 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $189.12 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $190.72 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $183.80 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $194.62 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $210.14 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $194.62 AMBETTER — AMBETTER MARKETPLACE: $321.66 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $180.20 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $487.26
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Pelvis W/Contrast\|TECHNICAL COMPONENT	$3,484	$2,264.60	$116.78 – $3,484
CT scan of the pelvis, with contrast: 10 of 22 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $116.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $190.72 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $183.80 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $194.62 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $129.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $194.62 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $180.20 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $181.89 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $216.24 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $184.70
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Bl	$4,049	$2,631.85	$196.10 – $4,049
MRI of a leg joint (such as the knee), without contrast: 10 of 47 insurance plan rates AETNA — AETNA: $2,590 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $447.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $259.45 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $250.03 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 AMBETTER — AMBETTER MARKETPLACE: $437.56 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $245.13 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $662.83
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Lt	$2,699	$1,754.35	$196.10 – $2,699
MRI of a leg joint (such as the knee), without contrast: 10 of 47 insurance plan rates AETNA — AETNA: $2,590 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $447.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $259.45 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $250.03 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 AMBETTER — AMBETTER MARKETPLACE: $437.56 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $245.13 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $662.83
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Rt	$2,699	$1,754.35	$196.10 – $2,699
MRI of a leg joint (such as the knee), without contrast: 10 of 47 insurance plan rates AETNA — AETNA: $2,590 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $447.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $259.45 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $250.03 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $264.74 AMBETTER — AMBETTER MARKETPLACE: $437.56 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $245.13 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $662.83
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	$6,524	$4,240.60	$260.19 – $6,524
CT scan of the abdomen and pelvis, with contrast: 10 of 47 insurance plan rates AETNA — AETNA: $4,110.12 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $355.27 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $379.35 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $365.59 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $387.09 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $394.74 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $387.09 AMBETTER — AMBETTER MARKETPLACE: $639.78 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $358.42 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $969.16
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	Not listed in the file	$6,156.47	$260.19 – $1,046.66
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $260.19 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $394.74 CIGNA — CIGNA: $1,046.66 CIGNA — CIGNA EXCHANGE: $948.13 KEYSTONE FIRST — KEYSTONE MEDICAID: $751.65 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $751.65 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $751.65 UNITED HEALTHCARE MEDICAID — UHC COMMUNITY PLAN MEDICAID: $316.50 UPMC HEALTH PLAN — CIGNA: $1,046.66 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $289.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Abdomen & Pelvis W/Contrast\|TECHNICAL COMPONENT	$6,524	$4,240.60	$260.19 – $6,524
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $260.19 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $289.10 KEYSTONE FIRST — KEYSTONE MEDICAID: $751.65 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $751.65 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $751.65 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $289.10
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$813	$528.45	$85.92 – $813
Ultrasound of the abdomen, complete: 10 of 47 insurance plan rates AETNA — AETNA: $512.19 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $128.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $142.91 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $107.41 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $290.43
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US Abdomen Complete	Not listed in the file	$528.45	$77.63 – $290.43
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $77.63 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $142.91 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $107.41 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $290.43 CIGNA — CIGNA: $254.71
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$439	$285.35	$62.78 – $599.79
Pregnancy ultrasound (after the first trimester): 10 of 100 insurance plan rates AETNA — AETNA: $276.57 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $104.63 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $116.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $419.37 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $419.37
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation\|TECHNICAL COMPONENT	$439	$285.35	$62.78 – $599.79
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $62.78 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $69.75 KEYSTONE FIRST — KEYSTONE MEDICAID: $181.35 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $181.35 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $181.35 UNITED HEALTHCARE — UNITED HEALTHCARE OPTIONS: $286.67 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $69.75
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$604	$392.60	$62.78 – $604
Transvaginal ultrasound: 10 of 101 insurance plan rates AETNA — AETNA: $380.52 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $103.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $109.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $114.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $116 AMBETTER — AMBETTER MARKETPLACE: $191.72 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $390.01 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $390.01
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC US Transvaginal Non Obstetric\|TECHNICAL COMPONENT	$604	$392.60	$62.78 – $604
Transvaginal ultrasound: rates for 6 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $62.78 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $69.75 KEYSTONE FIRST — KEYSTONE MEDICAID: $181.35 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $181.35 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $181.35 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $69.75
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$683	$443.95	$71.81 – $683
Diagnostic mammogram, one breast: 10 of 101 insurance plan rates AETNA — AETNA: $430.29 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $138.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $91.56 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $260.01 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $260.01
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$683	$443.95	$71.81 – $683
Diagnostic mammogram, one breast: 10 of 101 insurance plan rates AETNA — AETNA: $430.29 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $138.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $91.56 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $260.01 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $260.01
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$870	$565.50	$92.15 – $870
Diagnostic mammogram, both breasts: 10 of 101 insurance plan rates AETNA — AETNA: $548.10 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $175.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.92 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $117.49 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $124.41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $194.78 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $124.41 AMBETTER — AMBETTER MARKETPLACE: $205.61 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $331.30 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $331.30
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	Not listed in the file	$1,014	$92.15 – $473.83
Diagnostic mammogram, both breasts: 10 of 88 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $122.62 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.92 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $117.49 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $124.41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $194.78 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $124.41 AMBETTER — AMBETTER MARKETPLACE: $205.61 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $331.30 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $331.30 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $331.30
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$502	$326.30	$75.98 – $502
Screening mammogram, both breasts: 10 of 101 insurance plan rates AETNA — AETNA: $316.26 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $141.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $96.87 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $157.05 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 AMBETTER — AMBETTER MARKETPLACE: $169.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $251.62 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $251.62
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$376	$244.40	$75.98 – $462.77
Screening mammogram, both breasts: 10 of 101 insurance plan rates AETNA — AETNA: $236.88 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $141.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $96.87 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $157.05 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 AMBETTER — AMBETTER MARKETPLACE: $169.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $251.62 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $251.62

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Lt Heart Catheterization Incl Intraproc Inj for Lt Ventriculography Img	$2,085	$2,085	$73.38 – $1,980.75
Left heart catheterization (diagnostic): 10 of 490 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $447.82 AETNA — AETNA: $1,244.15 AETNA MEDICAID — AETNA MEDICAID: $1,042.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $492.61 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $447.82 AETNA MEDICARE TRANSPLANT — MEDICARE: $447.82 ALIGN SENIOR CARE — MEDICARE: $447.82 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $447.82 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,042.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $493.52
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$24,023	$15,614.95	$1,047.60 – $24,023
Left heart catheterization (diagnostic): 10 of 99 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,525.14 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,397.24 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,597.08 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,597.08 AMBETTER — AMBETTER MARKETPLACE: $5,945.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $9,230.20 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $9,230.20 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $9,230.20
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR Lt Heart Catheterization Incl Intraproc Inj for Lt Ventriculography Img\|PROFESSIONAL COMPONENT	$630	$630	$73.38 – $1,980.75
Left heart catheterization (diagnostic): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $118.36 AETNA — AETNA: $302.89 AETNA MEDICAID — AETNA MEDICAID: $151.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $118.36 AETNA MEDICARE TRANSPLANT — MEDICARE: $118.36 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $104.51 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $156.76 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $130.44 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $156.76
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Comprehensive Rt Atrial/Ventricular Pacing/Record W/O Arrhythmia	$10,332	$6,715.80	$1,047.60 – $21,667.33
Heart rhythm study (electrophysiology evaluation): 10 of 99 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8,481.03 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8,173.33 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8,654.11 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8,654.11 AMBETTER — AMBETTER MARKETPLACE: $14,303.32 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $6,340.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $6,340.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $6,340.40
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	$2,675	$2,675	$295.22 – $2,541.25
Heart rhythm study with ablation for atrial fibrillation: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $414.94 AETNA DOMESTIC — AETNA: $1,442.57 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $414.94 AETNA MEDICARE TRANSPLANT — MEDICARE: $414.94 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $437.25 ALIGN SENIOR CARE — MEDICARE: $414.94 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $414.94 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $457.29 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $457.29 ALLY ALIGN CARE ADV — MEDICARE: $414.94
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Electrophysiologic Comprehensive Transeptal Atrial Fibrillation	$27,178	$17,665.70	$1,047.60 – $72,610.51
Heart rhythm study with ablation for atrial fibrillation: 10 of 99 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28,421.21 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $27,390.06 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $29,001.24 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $29,001.24 AMBETTER — AMBETTER MARKETPLACE: $47,932.60 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $9,230.20 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $9,230.20 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $9,230.20
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	Not listed in the file	$2,675	$295.22 – $2,441.40
Heart rhythm study with ablation for atrial fibrillation: 10 of 750 insurance plan rates AETNA — AETNA: $1,442.57 AETNA MEDICAID — AETNA MEDICAID: $634.02 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $456.44 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $414.94 AETNA MEDICARE TRANSPLANT — MEDICARE: $414.94 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $437.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $437.25 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $414.94 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $655.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $655.88
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$5,195	$3,376.75	$443.92 – $5,195
Sleep study (overnight, in a sleep lab): 10 of 101 insurance plan rates AETNA — AETNA: $3,954 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $467.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $933.76 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $899.88 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $952.81 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $519.84 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $952.81 AMBETTER — AMBETTER MARKETPLACE: $1,574.79 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $3,248.05 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $3,248.05

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$294	$191.10	$23.97 – $370.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 98 insurance plan rates AETNA — AETNA: $185.22 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $102.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $30.70 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $337.09 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $337.09 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $337.09
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$294	$191.10	$23.97 – $370.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 98 insurance plan rates AETNA — AETNA: $185.22 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $102.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $30.70 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $337.09 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $337.09 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $337.09
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier CQ In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes\|CQ	$294	$191.10	$23.97 – $370.10
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $30.70 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 AMBETTER — AMBETTER MARKETPLACE: $53.73 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $30.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $81.39 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $30.38 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $36.12 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $30.85
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$331	$215.15	$80.59 – $493.47
Physical therapy evaluation (low complexity): 10 of 99 insurance plan rates AETNA — AETNA: $208.53 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $115.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $103.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $449.45 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $449.45 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $449.45
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$424	$275.60	$41.60 – $616.84
Physical therapy evaluation (moderate complexity): 10 of 99 insurance plan rates AETNA — AETNA: $267.12 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $148.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $103.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $561.82 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $561.82 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $561.82
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$562	$365.30	$80.59 – $740.20
Physical therapy evaluation (high complexity): 10 of 99 insurance plan rates AETNA — AETNA: $354.06 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $196.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $103.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $674.18 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $674.18 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $674.18

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$920	$920	$86.50 – $883.50
Removal of breast growth (open surgery): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $209.46 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $209.46 AETNA MEDICARE TRANSPLANT — MEDICARE: $209.46 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $209.46 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $129.75 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $230.84 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $129.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $230.84 AMBETTER — AMBETTER: $305.22 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $209.46
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$930	$930	$86.50 – $1,767
Removal of breast growth (open surgery): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $209.46 AETNA MEDICAID — AETNA MEDICAID: $125.43 ALIGN SENIOR CARE — MEDICARE: $209.46 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $209.46 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $230.84 ALLY ALIGN CARE ADV — MEDICARE: $209.46 AMBETTER — AMBETTER: $305.22 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $209.46 AMERIHEALTH — AMERIHEALTH: $235.18 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $86.50
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt	Not listed in the file	$17,809.86	$1,124.55 – $10,877.01
Removal of breast growth (open surgery): 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,124.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,257.48 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $4,103.01 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,344.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,249.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,344.37 AMBETTER — AMBETTER MARKETPLACE: $7,180.27 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$3,030	$3,030	$414.61 – $2,878.50
Total hip replacement: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $595.42 AETNA DOMESTIC — AETNA: $1,497.74 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $500 ALIGN SENIOR CARE — MEDICARE: $595.42 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $656.18 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $656.18 ALLY ALIGN CARE ADV — MEDICARE: $595.42 AMBETTER — AMBETTER: $867.61
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$2,825	$2,825	$32.54 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,683.75
Total hip replacement: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $595.42 AETNA — AETNA: $1,497.74 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE TRANSPLANT — MEDICARE: $595.42 ALIGN SENIOR CARE — MEDICARE: $595.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $595.42 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $656.18 ALLY ALIGN CARE ADV — MEDICARE: $595.42 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $595.42 AMERICAN HEALTH PLAN — MEDICARE: $595.42
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH)	Not listed in the file	$56,858.43	$1,047.60 – $37,704
Total hip replacement: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,960.24 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13,453.75 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,245.15 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,245.15 AMBETTER — AMBETTER MARKETPLACE: $23,544.06 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $6,525.12 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $6,525.12 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $6,525.12
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$3,030	$3,030	$414.07 – $2,878.50
Total knee replacement: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $594.35 AETNA DOMESTIC — AETNA: $1,496.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $653.78 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $594.35 AETNA MEDICARE TRANSPLANT — MEDICARE: $594.35 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $500 ALIGN SENIOR CARE — MEDICARE: $594.35 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $594.35 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $655 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $655
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$2,821	$2,821	$414.07 – $2,679.95
Total knee replacement: 10 of 750 insurance plan rates AETNA — AETNA: $1,496.10 AETNA DOMESTIC — AETNA: $1,496.10 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $594.35 AETNA MEDICARE TRANSPLANT — MEDICARE: $594.35 ALIGN SENIOR CARE — MEDICARE: $594.35 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $594.35 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $655 ALLY ALIGN CARE ADV — MEDICARE: $594.35 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $594.35
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH)	Not listed in the file	$50,158.09	$1,047.60 – $37,704
Total knee replacement: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,960.24 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13,453.75 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,245.15 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,245.15 AMBETTER — AMBETTER MARKETPLACE: $23,544.06 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $5,709.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $5,709.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $5,709.48
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,215	$1,215	$177.22 – $1,159
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $264.14 AETNA MEDICAID — AETNA MEDICAID: $394.04 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $290.55 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $264.14 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $271.75 ALIGN SENIOR CARE — MEDICARE: $264.14 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $291.09 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $407.63 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $291.09 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $264.14
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,220	$1,220	$14.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,159
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $264.14 AETNA DOMESTIC — AETNA: $636.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $290.55 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $271.75 ALIGN SENIOR CARE — MEDICARE: $264.14 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $264.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $407.63 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $291.09 AMBETTER — AMBETTER: $384.88 AMERICAN HEALTH PLAN — MEDICARE: $264.14
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH)	Not listed in the file	$18,825.97	$1,258.20 – $9,089.56
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,258.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,557.84 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,428.75 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,630.45 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,398 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,630.45 AMBETTER — AMBETTER MARKETPLACE: $6,000.32 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $5,709.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $5,709.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $5,709.48
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$285	$285	$38.88 – $270.75
Upper GI endoscopy (diagnostic): 10 of 750 insurance plan rates AETNA DOMESTIC — AETNA: $143.29 AETNA MEDICAID — AETNA MEDICAID: $90.79 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $62.61 ALIGN SENIOR CARE — MEDICARE: $56.23 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $56.23 AMERICAN HEALTH PLAN — MEDICARE: $56.23 AMERIGROUP MEDICAID — MEDICAID: $62.61 AMERIHEALTH — AMERIHEALTH: $80.89 AMERIHEALTH MEDICARE — MEDICARE: $56.23
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$267	$267	$38.88 – $253.65
Upper GI endoscopy (diagnostic): 10 of 750 insurance plan rates AETNA — AETNA: $143.29 AETNA MEDICAID — AETNA MEDICAID: $90.79 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $56.23 AETNA MEDICARE TRANSPLANT — MEDICARE: $56.23 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $62.61 ALIGN SENIOR CARE — MEDICARE: $56.23 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $56.23 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $61.96
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	Not listed in the file	$6,764.55	$9 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,759
Upper GI endoscopy (diagnostic): 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $986.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $950.44 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,006.34 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,006.34 AMBETTER — AMBETTER MARKETPLACE: $1,663.26 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$350	$350	$43.67 – $332.50
Upper GI endoscopy with biopsy: 10 of 750 insurance plan rates AETNA — AETNA: $161.11 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $62.84 AETNA MEDICARE TRANSPLANT — MEDICARE: $62.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $74.29 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $74.29 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $111.44 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $69.25 ALLY ALIGN CARE ADV — MEDICARE: $62.84 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $62.84 AMERICAN HEALTH PLAN — MEDICARE: $62.84
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$301	$301	$43.67 – $285.95
Upper GI endoscopy with biopsy: 10 of 750 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $69.12 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $74.29 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $74.29 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $111.44 ALLY ALIGN CARE ADV — MEDICARE: $62.84 AMBETTER — AMBETTER: $91.56 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $62.84 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $74.29 AMISH MENNONITE — MEDICAID: $74.29 ANDRIE INC — WORKERS COMP: $72.45
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	Not listed in the file	$10,083.42	$176.68 – $4,611.48
Upper GI endoscopy with biopsy: 10 of 22 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $379.35 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $178.53 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $189.03 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $421.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $189.03 AMBETTER — AMBETTER MARKETPLACE: $312.43 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $176.68 GROUP PENSION ADMINISTRATORS — REEDMAN TOLL MANAGEMENT GROUP: $393.82 HEALTH AMERICA ADVANTRA — HEALTH AMERICA MEDICARE ADVANTAGE: $210.04 HEALTH PARTNERS MEDICARE ADVANTAGE — HEALTH PARTNERS MEDICARE ADVANTAGE: $185.53
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$475	$475	$58.36 – $451.25
Colonoscopy (diagnostic): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $83.82 AETNA DOMESTIC — AETNA: $215.36 AETNA MEDICAID — AETNA MEDICAID: $130.87 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.20 AETNA MEDICARE TRANSPLANT — MEDICARE: $83.82 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.38 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37 ALLY ALIGN CARE ADV — MEDICARE: $83.82 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $83.82
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	Not listed in the file	$475	$58.36 – $626.95
Colonoscopy (diagnostic): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $83.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $83.82 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.25 ALIGN SENIOR CARE — MEDICARE: $83.82 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $83.82 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.38 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37 ALLY ALIGN CARE ADV — MEDICARE: $83.82
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	Not listed in the file	$5,796.60	$153 – $4,611.48
Colonoscopy (diagnostic): 10 of 86 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,011.20 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $974.51 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,031.83 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,031.83 AMBETTER — AMBETTER MARKETPLACE: $1,705.39 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$560	$560	$63.48 – $532
Colonoscopy with biopsy: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $90.38 AETNA MEDICAID — AETNA MEDICAID: $163.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.42 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $112.71 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $112.71 ALIGN SENIOR CARE — MEDICARE: $90.38 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $99.60 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $99.60 AMBETTER — AMBETTER: $131.69 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $90.38
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	Not listed in the file	$560	$63.48 – $729.26
Colonoscopy with biopsy: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $90.38 AETNA DOMESTIC — AETNA: $233.55 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $90.38 AETNA MEDICARE TRANSPLANT — MEDICARE: $90.38 ALIGN SENIOR CARE — MEDICARE: $90.38 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $90.38 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $99.60 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLY ALIGN CARE ADV — MEDICARE: $90.38
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	Not listed in the file	$9,387.01	$51 – $4,611.48
Colonoscopy with biopsy: 10 of 88 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,301.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $1,253.97 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,327.73 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $102 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,327.73 AMBETTER — AMBETTER MARKETPLACE: $2,194.45 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$660	$660	$79.98 – $627
Colonoscopy with removal of polyps (snare): 10 of 750 insurance plan rates AETNA — AETNA: $296.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $124.93 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $113.57 AETNA MEDICARE TRANSPLANT — MEDICARE: $113.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $113.57 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06 ALLY ALIGN CARE ADV — MEDICARE: $113.57 AMBETTER — AMBETTER: $165.49 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $113.57 AMERICAN HEALTH PLAN — MEDICARE: $113.57
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$551	$551	$79.98 – $523.45
Colonoscopy with removal of polyps (snare): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $113.57 AETNA — AETNA: $296.90 AETNA DOMESTIC — AETNA: $296.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $124.93 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $113.57 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $134.04 ALIGN SENIOR CARE — MEDICARE: $113.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $113.57 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $125.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)	Not listed in the file	$9,687.59	$54.04 – $3,759
Colonoscopy with removal of polyps (snare): 10 of 22 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $513 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $54.61 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $57.82 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $570 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $57.82 AMBETTER — AMBETTER MARKETPLACE: $95.56 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $54.04 GROUP PENSION ADMINISTRATORS — REEDMAN TOLL MANAGEMENT GROUP: $120.46 HEALTH AMERICA ADVANTRA — HEALTH AMERICA MEDICARE ADVANTAGE: $64.24 HEALTH PARTNERS MEDICARE ADVANTAGE — HEALTH PARTNERS MEDICARE ADVANTAGE: $56.75
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	$470	$470	$58.47 – $446.50
Screening colonoscopy (not high risk): 10 of 491 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $84.01 AETNA — AETNA: $231.39 AETNA DOMESTIC — AETNA: $231.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.01 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.01 ALIGN SENIOR CARE — MEDICARE: $84.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.01 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $235
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	Not listed in the file	$470	$58.47 – $553.07
Screening colonoscopy (not high risk): 10 of 491 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $84.01 AETNA — AETNA: $231.39 AETNA DOMESTIC — AETNA: $231.39 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.01 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.01 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $291.09 ALLY ALIGN CARE ADV — MEDICARE: $84.01 AMBETTER — AMBETTER: $122.42
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	Not listed in the file	$5,785.55	$955.40 – $4,611.48
Screening colonoscopy (not high risk): 10 of 86 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,011.20 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $974.51 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,031.83 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,031.83 AMBETTER — AMBETTER MARKETPLACE: $1,705.39 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,990.68
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,460	$1,460	$213.64 – $1,387
Gallbladder removal by laparoscope: 10 of 750 insurance plan rates AETNA — AETNA: $796.46 AETNA DOMESTIC — AETNA: $796.46 AETNA MEDICAID — AETNA MEDICAID: $427.28 AETNA MEDICARE TRANSPLANT — MEDICARE: $324.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $294.68 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $294.68 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $324.96 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLY ALIGN CARE ADV — MEDICARE: $324.96
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,451	$1,451	$16.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,378.45
Gallbladder removal by laparoscope: 10 of 750 insurance plan rates AETNA — AETNA: $796.46 AETNA DOMESTIC — AETNA: $796.46 AETNA MEDICAID — AETNA MEDICAID: $427.28 AETNA MEDICARE TRANSPLANT — MEDICARE: $324.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $294.68 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $294.68 ALIGN SENIOR CARE — MEDICARE: $324.96 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $358.11
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)	Not listed in the file	$23,767.42	$1,047.60 – $16,794.37
Gallbladder removal by laparoscope: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,573.65 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6,335.15 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6,707.81 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6,707.81 AMBETTER — AMBETTER MARKETPLACE: $11,086.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $11,076.24 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $11,076.24 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $11,076.24
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,155	$1,155	$158.75 – $2,194.50
Groin (inguinal) hernia repair, age 5 or older: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $261.12 AETNA — AETNA: $631.60 AETNA MEDICAID — AETNA MEDICAID: $230.19 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $261.12 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $158.75 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $158.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $261.12 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,157	$1,157	$13.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,198.30
Groin (inguinal) hernia repair, age 5 or older: 10 of 750 insurance plan rates AETNA DOMESTIC — AETNA: $631.60 ALIGN SENIOR CARE — MEDICARE: $261.12 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 AMERIGROUP MEDICAID — MEDICAID: $158.75 AMERIHEALTH — AMERIHEALTH: $295.74 AMERIHEALTH MEDICARE — MEDICARE: $261.12 ANTHEM MYCARE OHIO — MEDICARE: $261.12 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $158.75 AURORA SPECIAL NEEDS — MEDICARE: $261.12
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH)	Not listed in the file	$20,684.57	$1,088.10 – $16,864.85
Groin (inguinal) hernia repair, age 5 or older: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,088.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,893.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,751.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,972.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,209 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,972.63 AMBETTER — AMBETTER MARKETPLACE: $6,565.88 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $5,165.72 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $5,165.72 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $5,165.72
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$325	$325	$26.67 – $308.75
Prostate biopsy: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.50 AETNA — AETNA: $127.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $162.50 AETNA MEDICARE TRANSPLANT — MEDICARE: $162.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $44.75 ALIGN SENIOR CARE — MEDICARE: $162.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $162.50 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $67.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $162.50
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$5,486	$3,565.90	$120.83 – $5,486
Prostate biopsy: 10 of 87 insurance plan rates AETNA — AETNA: $3,456.18 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $120.83 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,618.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $134.25 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $5,486 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $5,486 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $5,486 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $5,486 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $5,486 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS HMO/PPO: $5,486
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach	Not listed in the file	$325	$26.67 – $308.75
Prostate biopsy: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.50 AETNA — AETNA: $127.06 AETNA DOMESTIC — AETNA: $127.06 AETNA MEDICAID — AETNA MEDICAID: $64.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $162.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $44.75 ALIGN SENIOR CARE — MEDICARE: $162.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.50 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $67.13 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $162.50
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst	$3,965	$3,965	$380.85 – $3,766.75
Prostate removal by laparoscope (radical prostatectomy): 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $550.45 AETNA DOMESTIC — AETNA: $1,414.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $605.49 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $550.45 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $500 ALIGN SENIOR CARE — MEDICARE: $550.45 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $550.45 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $606.62 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst	$2,557	$2,557	$380.85 – $2,429.15
Prostate removal by laparoscope (radical prostatectomy): 10 of 750 insurance plan rates AETNA DOMESTIC — AETNA: $1,414.99 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $605.49 AETNA MEDICARE TRANSPLANT — MEDICARE: $550.45 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $500 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $500 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $550.45 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLY ALIGN CARE ADV — MEDICARE: $550.45
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee · modifier 80 In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst\|ASSISTANT SURGEON	$409.12	$409.12	$29.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,429.15
Prostate removal by laparoscope (radical prostatectomy): 10 of 754 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $88.07 AETNA — AETNA: $226.40 AETNA DOMESTIC — AETNA: $226.40 AETNA MEDICAID — AETNA MEDICAID: $145 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $96.88 AETNA MEDICARE TRANSPLANT — MEDICARE: $88.07 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $100 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $88.07 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $97.06 ALLY ALIGN CARE ADV — MEDICARE: $88.07
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$660	$660	$73.91 – $627
Hysteroscopy with biopsy of the uterus lining: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $104.53 AETNA — AETNA: $229.75 AETNA DOMESTIC — AETNA: $229.75 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $119.39 ALIGN SENIOR CARE — MEDICARE: $104.53 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $179.08 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $115.20 AMBETTER — AMBETTER: $152.31 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $119.39 AMERIHEALTH MEDICARE — MEDICARE: $104.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$498	$498	$5.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $473.10
Hysteroscopy with biopsy of the uterus lining: 10 of 750 insurance plan rates AETNA DOMESTIC — AETNA: $229.75 AETNA MEDICARE TRANSPLANT — MEDICARE: $104.53 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $119.39 ALIGN SENIOR CARE — MEDICARE: $104.53 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $104.53 ALLY ALIGN CARE ADV — MEDICARE: $104.53 AMBETTER — AMBETTER: $152.31 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $104.53 AMERICAN HEALTH PLAN — MEDICARE: $104.53 AMERIGROUP MEDICAID — MEDICAID: $119.39
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	Not listed in the file	$15,195.98	$1,047.60 – $8,992.68
Hysteroscopy with biopsy of the uterus lining: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,519.91 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,392.21 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,591.75 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,591.75 AMBETTER — AMBETTER MARKETPLACE: $5,936.36 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt	Not listed in the file	$7,437.01	$370.66 – $3,742
Nerve root injection, lower back, with imaging guidance: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $961.74 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $926.85 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $981.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $981.37 AMBETTER — AMBETTER MARKETPLACE: $1,621.98 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt\|BILATERAL PROCEDURE	Not listed in the file	$7,245.35	$370.66 – $3,742
Nerve root injection, lower back, with imaging guidance: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,047.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $961.74 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $926.85 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $981.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $981.37 AMBETTER — AMBETTER MARKETPLACE: $1,621.98 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,631.28
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$960	$960	$122.01 – $912
Carpal tunnel release: 10 of 750 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $216.50 AETNA — AETNA: $502.39 AETNA DOMESTIC — AETNA: $502.39 AETNA MEDICAID — AETNA MEDICAID: $217.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $238.15 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $216.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $238.60 AMBETTER — AMBETTER: $315.48 AMERICAN HEALTH PLAN — MEDICARE: $216.50 AMERIGROUP MEDICAID — MEDICAID: $150
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$995	$995	$122.01 – $945.25
Carpal tunnel release: 10 of 750 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $217.50 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $216.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $150 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $150 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $225 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $238.60 AMBETTER — AMBETTER: $315.48 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $216.50 AMERICAN HEALTH PLAN — MEDICARE: $216.50 AMERIGROUP MEDICAID — MEDICAID: $150
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Neuroplasty Median Nerve Carpal Rt	Not listed in the file	$13,810.94	$896.40 – $5,449.93
Carpal tunnel release: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $896.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,123.31 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2,046.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2,166.64 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $996 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2,166.64 AMBETTER — AMBETTER MARKETPLACE: $3,580.98 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $3,534.44

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	$58,751.09	$1,234 – $45,495.54
Hip or knee replacement (major joint of the leg), without major complications: 10 of 85 insurance plan rates AETNA — AETNA: $25,519.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17,293.67 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $16,666.24 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $17,646.61 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $17,646.61 AMBETTER — AMBETTER MARKETPLACE: $29,165.92 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $32,598.37 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $32,598.37 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $32,598.37 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $32,598.37
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	$47,443.73	$1,234 – $30,220.29
Uterus and ovary surgery (not for cancer), without complications: 10 of 85 insurance plan rates AETNA — AETNA: $16,414.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11,573.66 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $11,153.75 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11,809.85 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11,809.85 AMBETTER — AMBETTER MARKETPLACE: $19,519.06 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $20,516.91 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $20,516.91 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $20,516.91 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $20,516.91

Source: Mercy Catholic Medical Center- Mercy Fitzgerald’s standard charges file (hpt.trinity-health.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1500 Lansdowne Ave, Darby, PA 19023
County	Delaware County
State	Pennsylvania
Phone	(215) 237‑4000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
CMS Certification Number	390156
Name in Medicare records	MERCY CATHOLIC MEDICAL CENTER- MERCY FITZGERALD
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(610) 237‑4000^[4]
Name on the hospital’s website	Mercy Fitzgerald Hospital
Official website	trinityhealthma.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Mercy Fitzgerald Hospital — trinityhealthma.org
Visitor Guidelines — trinityhealthma.org
Mercy Fitzgerald Hospital — trinityhealthma.org
Mercy Fitzgerald Emergency Department | Trinity Health Mid-Atlantic — trinityhealthma.org
Emergency Care | Trinity Health Mid-Atlantic — trinityhealthma.org
Stroke Centers | Trinity Health Mid-Atlantic — trinityhealthma.org
Mercy Fitzgerald Bariatrics | Trinity Health Mid-Atlantic — trinityhealthma.org
Mercy Cancer Care | Trinity Health Mid-Atlantic — trinityhealthma.org