Does Midstate Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Midstate Medical Center. In a medical emergency, call 911.

Where is Midstate Medical Center?

435 Lewis Avenue, Meriden, CT 06450, in New Haven County, Connecticut.

What is the phone number of Midstate Medical Center?

(203) 694-8200, as listed by Medicare (CMS).

What is the Medicare star rating of Midstate Medical Center?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Midstate Medical Center for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for Midstate Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.9364; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Midstate Medical Center — Phone, Address & ER

Quick answers

Does Midstate Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Midstate Medical Center. In a medical emergency, call 911.
Where is Midstate Medical Center?: 435 Lewis Avenue, Meriden, CT 06450, in New Haven County, Connecticut.
What is the phone number of Midstate Medical Center?: (203) 694-8200, as listed by Medicare (CMS).
What is the Medicare star rating of Midstate Medical Center?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Midstate Medical Center for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for Midstate Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.9364; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4]

General and minimally invasive surgery
Emergency medicine
Weight management
Oncology
Wound care and hyperbaric medicine
Family birthing and maternal fetal medicine
Sleep care
Digestive health
Pain management
Neurosciences
Cardiac care

Emergency care (hospital website)^[4]

Emergency room	Yes

Visiting and practical information

Patient portal	MyChart

Doctors and clinicians (587)

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

Main specialties

And 563 more: the button below opens the full list.

Other emergency rooms nearby

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

Middlesex Hospital7.6 mi · Middletown, CT · Acute Care Hospital
The Hospital of Central Connecticut7.8 mi · New Britain, CT · Acute Care Hospital
Bristol Hospital11 mi · Bristol, CT · Acute Care Hospital
Saint Mary's Hospital12 mi · Waterbury, CT · Acute Care Hospital
Uconn Health Waterbury Hospital13 mi · Waterbury, CT · Acute Care Hospital

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

Other hospitals near Meriden

Gaylord Hospital Inc6.0 mi · Wallingford, CT · Long-Term Acute Care Hospital
Masonicare Health Center6.0 mi · Wallingford, CT · Psychiatric Hospital
Connecticut Valley Hospital7.6 mi · Middletown, CT · Psychiatric Hospital
Hospital for Special Care9.6 mi · New Britain, CT · Long-Term Acute Care Hospital

Hospitals in New Haven County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Bradley Home Infirmary/Pavilion0.5 mi · Meriden, CT · 3 of 5 stars
Meriden Health and Rehab1.4 mi · Meriden, CT · 1 of 5 stars
The Curtis Home St Elizabeth Center1.6 mi · Meriden, CT · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Franciscan Family Care Center1.2 mi · Meriden, CT
Masonicare Home Health and Hospice Inc6.0 mi · Wallingford, CT · 3 of 5 stars
Middlesex Health Care at Home & Hospice Program7.6 mi · Middletown, CT · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Franciscan Home Care and Hospice Care1.2 mi · Meriden, CT · 2.5 of 5 stars
Berlin Visiting Nurse Association4.0 mi · Berlin, CT · 4 of 5 stars
Keepmehome4.0 mi · Berlin, CT · 1.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

FMC Central Ct Dialysis Center1.8 mi · Meriden, CT · 3 of 5 stars
Fresenius Medical Care of Southington5.8 mi · Plantsville, CT · 3 of 5 stars
Wallingford Dialysis Care LLC6.0 mi · Wallingford, CT · 5 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.

Cheshire Surgery Center5.8 mi · Cheshire, CT
Wallingford Endoscopy Center, LLC6.0 mi · Wallingford, CT
Middlesex Center for Advanced Orthopedic Surgery7.6 mi · Middletown, CT

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

John Barry Elementary School - SBHC0.3 mi · Meriden, CT · Community health center
Community Health Center of Meriden0.7 mi · Meriden, CT · Community health center
Wya at New Beginnings1.0 mi · Meriden, CT · Community health center

Clinics and urgent care

Itopia LLC1.8 mi · Meriden, CT · Urgent care center
Urgent Care of Berlin, LLC4.0 mi · Berlin, CT · Urgent care center
AFC Physicians of Connecticut, PC5.6 mi · Southington, CT · Urgent care center

Pharmacies

Graeber's Pharmacy Inc1.2 mi · Meriden, CT · Community/retail pharmacy
Walgreen Co1.2 mi · Meriden, CT · Pharmacy
The Stop & Shop Supermarket Company LLC1.8 mi · Meriden, CT · Community/retail pharmacy

Assisted living nearby

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

The Village at Kensington Place1.2 mi · Meriden, CT
The Orchards at Southington, Inc.5.6 mi · Southington, CT
Elim Park Baptist Home, Inc5.8 mi · Cheshire, CT
Livewell Connecticut5.8 mi · Plantsville, CT

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Patients got help quickly from staff	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Restfulness of Environment	3 of 5 stars
Care Coordination	3 of 5 stars
Symptoms After Stay	3 of 5 stars
Rated the hospital 9 or 10 out of 10	76%National average: 72%
Would definitely recommend the hospital	76%National average: 71%
Nurses “always” communicated well	84%National average: 80%
Doctors “always” communicated well	80%National average: 80%
“Always” got help as soon as they wanted	67%National average: 64%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	86%National average: 86%
Room and bathroom “always” clean	77%National average: 73%
Completed surveys	1,190Response rate: 25%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.365No different from the national benchmark
Surgical site infections after colon surgery	0.712No different from the national benchmark
MRSA bloodstream infections	0.893No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.618No different from the national benchmark
Not reported to Medicare	Surgical site infections after abdominal hysterectomy

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.2%
Deaths within 30 days: heart failure patients	12.2%
Deaths within 30 days: pneumonia patients	16.5%
Deaths within 30 days: COPD patients	8.9%
Deaths within 30 days: stroke patients	11.8%
Serious complications (patient safety indicator PSI-90)	0.76No different from the national rate
Complications after hip or knee replacement	5.3%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	16.1%
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	21%
Readmitted within 30 days: hip or knee replacement	5.6%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery
Too few cases to report	Readmitted within 30 days: heart attack

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	212 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)	64%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	-0.9364Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart failure	0.9974Fewer readmissions than expected
Pneumonia	0.9939Fewer readmissions than expected
COPD (chronic lung disease)	1.0654More readmissions than expected
Hip or knee replacement	1.2865More readmissions than expected
No result published	Heart attack; Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score	30.33 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	4.00 out of 100
Person and community engagement (patient survey)	54.00 out of 100
Safety (infections and sepsis care)	63.33 out of 100
Efficiency and cost reduction (Medicare spending)	0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio	1.02Above the national median hospital (1.00): Medicare spent more

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

ER wait times and Medicare ratings nearby

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

ER wait times in Connecticut

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 58 common services exactly as Midstate Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 58 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFICE O/P NEW LOW 30 MIN	$205	$205	$109.12 – $144.56
New patient office visit (about 30–44 minutes): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $144.56 ANTHEM — ANTHEM INDIVIDUAL: $111.79 ANTHEM — ANTHEM MANAGED CARE: $122.75 CIGNA — CIGNA MANAGED CARE: $126.71 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $130.48 CONNECTICARE — CONNECTICARE MANAGED CARE: $136.72 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $130.07 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $109.12 UNITED — UNITED MANAGED CARE: $109.12
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFICE O/P NEW MOD 45 MIN	$335	$335	$186.61 – $241.50
New patient office visit (about 45–59 minutes): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $241.50 ANTHEM — ANTHEM INDIVIDUAL: $189.53 ANTHEM — ANTHEM MANAGED CARE: $208.11 CIGNA — CIGNA MANAGED CARE: $206.05 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $221.06 CONNECTICARE — CONNECTICARE MANAGED CARE: $227.16 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $192.25 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $186.61 UNITED — UNITED MANAGED CARE: $186.61
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFFICE O/P NEW HI 60 MIN	$455	$455	$242.88 – $314.11
New patient office visit (about 60–74 minutes): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $314.11 ANTHEM — ANTHEM INDIVIDUAL: $242.88 ANTHEM — ANTHEM MANAGED CARE: $266.70 CIGNA — CIGNA MANAGED CARE: $280.42 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $282.85 CONNECTICARE — CONNECTICARE MANAGED CARE: $295.58 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $255.06 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $243.73 UNITED — UNITED MANAGED CARE: $243.73
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: OFF/OP CNSLTJ NEW/EST LOW 30	$370	$370	$135.42 – $206.85
Office consultation with a specialist (moderate): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $206.85 ANTHEM — ANTHEM INDIVIDUAL: $157.85 ANTHEM — ANTHEM MANAGED CARE: $173.33 CIGNA — CIGNA MANAGED CARE: $135.42 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $198.89 CONNECTICARE — CONNECTICARE MANAGED CARE: $194.05 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $167.50 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $139.47 UNITED — UNITED MANAGED CARE: $139.47
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: OFF/OP CNSLTJ NEW/EST MOD 40	$500	$500	$206.37 – $327.29
Office consultation with a specialist (moderate to high): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $327.29 ANTHEM — ANTHEM INDIVIDUAL: $249.61 ANTHEM — ANTHEM MANAGED CARE: $274.09 CIGNA — CIGNA MANAGED CARE: $206.37 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $313.66 CONNECTICARE — CONNECTICARE MANAGED CARE: $303.95 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $248.72 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $224.48 UNITED — UNITED MANAGED CARE: $224.48
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: EMERGENCY DEPT VISIT LOW MDM	$300	$300	$92.98 – $128.48
Emergency room visit (moderate): rates for 4 insurance plans AETNA — AETNA MANAGED CARE: $128.48 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $111.03 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $92.98 UNITED — UNITED MANAGED CARE: $92.98
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPARTMENT VISIT LEVEL 3 - ED	$2,167	$2,167	Not listed in the file
Emergency room visit (moderate): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPARTMENT VISIT LEVEL 3 - URGENT CARE	$2,167	$2,167	Not listed in the file
Emergency room visit (moderate): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: EMERGENCY DEPT VISIT MOD MDM	$510	$510	$170.82 – $239.32
Emergency room visit (moderately high): rates for 4 insurance plans AETNA — AETNA MANAGED CARE: $239.32 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $173.21 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $170.82 UNITED — UNITED MANAGED CARE: $170.82
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPARTMENT VISIT LEVEL 4 - ED	$3,483	$3,483	Not listed in the file
Emergency room visit (moderately high): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier 0 In the file: HC EMERGENCY DEPARTMENT VISIT LEVEL 4 - ED	$3,483	$3,483	$170.52 – $4,638
Emergency room visit (moderately high): 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $4,624 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $4,393 AETNA — AETNA MEDICARE: $174.78 ANTHEM — ANTHEM INDIVIDUAL: $3,478 ANTHEM — ANTHEM MANAGED CARE: $4,638 ANTHEM — ANTHEM MEDICARE: $170.52 CIGNA — CIGNA MANAGED CARE: $3,795 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $170.52 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $170.52 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $3,755
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: EMERGENCY DEPT VISIT HI MDM	$735	$735	$248.05 – $356.16
Emergency room visit (high): rates for 4 insurance plans AETNA — AETNA MANAGED CARE: $356.16 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $269.65 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $248.05 UNITED — UNITED MANAGED CARE: $248.05
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPARTMENT VISIT LEVEL 5 - ED	$4,646	$4,646	Not listed in the file
Emergency room visit (high): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier 0 In the file: HC EMERGENCY DEPARTMENT VISIT LEVEL 5 - ED	$4,646	$4,646	$243.37 – $5,030
Emergency room visit (high): 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $4,624 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $4,393 AETNA — AETNA MEDICARE: $249.46 ANTHEM — ANTHEM INDIVIDUAL: $3,478 ANTHEM — ANTHEM MANAGED CARE: $4,638 ANTHEM — ANTHEM MEDICARE: $243.37 CIGNA — CIGNA MANAGED CARE: $3,795 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $243.37 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $243.37 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $3,755

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL	$232	$232	$8.46
Basic metabolic panel (blood test): rates for 8 insurance plans AETNA — AETNA MEDICARE: $8.46 ANTHEM — ANTHEM MEDICARE: $8.46 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $8.46 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $8.46 TUFTS — TUFTS MEDICARE: $8.46 UNITED — UNITED MEDICARE: $8.46 WELLCARE — WELLCARE MEDICARE: $8.46 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · modifier 0 In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL	$232	$232	$8.04 – $11.63
Basic metabolic panel (blood test): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $8.46 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $8.04 ANTHEM — ANTHEM INDIVIDUAL: $8.72 ANTHEM — ANTHEM MANAGED CARE: $11.63 CIGNA — CIGNA MANAGED CARE: $8.47 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $8.46 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $9.15 UNITED — UNITED MANAGED CARE: $8.46 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HC COMPREHENSIVE METABOLIC PANEL	$415	$415	$10.56
Comprehensive metabolic panel (blood test): rates for 8 insurance plans AETNA — AETNA MEDICARE: $10.56 ANTHEM — ANTHEM MEDICARE: $10.56 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $10.56 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $10.56 TUFTS — TUFTS MEDICARE: $10.56 UNITED — UNITED MEDICARE: $10.56 WELLCARE — WELLCARE MEDICARE: $10.56 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · modifier 0 In the file: HC COMPREHENSIVE METABOLIC PANEL	$415	$415	$10.03 – $14.53
Comprehensive metabolic panel (blood test): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $10.56 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $10.03 ANTHEM — ANTHEM INDIVIDUAL: $10.90 ANTHEM — ANTHEM MANAGED CARE: $14.53 CIGNA — CIGNA MANAGED CARE: $10.56 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $10.56 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $11.42 UNITED — UNITED MANAGED CARE: $10.56 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HC LIPID PANEL - LIPID PANEL	$118	$118	$13.39
Cholesterol panel (lipid panel): rates for 8 insurance plans AETNA — AETNA MEDICARE: $13.39 ANTHEM — ANTHEM MEDICARE: $13.39 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $13.39 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $13.39 TUFTS — TUFTS MEDICARE: $13.39 UNITED — UNITED MEDICARE: $13.39 WELLCARE — WELLCARE MEDICARE: $13.39 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · modifier 0 In the file: HC LIPID PANEL - LIPID PANEL	$118	$118	$12.72 – $18.42
Cholesterol panel (lipid panel): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $13.39 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $12.72 ANTHEM — ANTHEM INDIVIDUAL: $13.82 ANTHEM — ANTHEM MANAGED CARE: $18.42 CIGNA — CIGNA MANAGED CARE: $13.40 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $13.39 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $14.48 UNITED — UNITED MANAGED CARE: $13.39 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HC RENAL FUNCTION PANEL	$290	$290	$8.68
Kidney function panel: rates for 8 insurance plans AETNA — AETNA MEDICARE: $8.68 ANTHEM — ANTHEM MEDICARE: $8.68 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $8.68 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $8.68 TUFTS — TUFTS MEDICARE: $8.68 UNITED — UNITED MEDICARE: $8.68 WELLCARE — WELLCARE MEDICARE: $8.68 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · modifier 0 In the file: HC RENAL FUNCTION PANEL	$290	$290	$8.25 – $11.94
Kidney function panel: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $8.68 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $8.25 ANTHEM — ANTHEM INDIVIDUAL: $8.96 ANTHEM — ANTHEM MANAGED CARE: $11.94 CIGNA — CIGNA MANAGED CARE: $8.69 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $8.68 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $9.38 UNITED — UNITED MANAGED CARE: $8.68 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HC HEPATIC FUNCTION PANEL	$213	$213	$8.17
Liver function panel: rates for 8 insurance plans AETNA — AETNA MEDICARE: $8.17 ANTHEM — ANTHEM MEDICARE: $8.17 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $8.17 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $8.17 TUFTS — TUFTS MEDICARE: $8.17 UNITED — UNITED MEDICARE: $8.17 WELLCARE — WELLCARE MEDICARE: $8.17 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · modifier 0 In the file: HC HEPATIC FUNCTION PANEL	$213	$213	$7.76 – $11.23
Liver function panel: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $8.17 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $7.76 ANTHEM — ANTHEM INDIVIDUAL: $8.42 ANTHEM — ANTHEM MANAGED CARE: $11.23 CIGNA — CIGNA MANAGED CARE: $8.18 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $8.17 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $8.83 UNITED — UNITED MANAGED CARE: $8.17 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$26.10	$26.10	$3.48
Urine test (manual, without microscope): rates for 8 insurance plans AETNA — AETNA MEDICARE: $3.48 ANTHEM — ANTHEM MEDICARE: $3.48 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $3.48 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $3.48 TUFTS — TUFTS MEDICARE: $3.48 UNITED — UNITED MEDICARE: $3.48 WELLCARE — WELLCARE MEDICARE: $3.48 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · modifier 0 In the file: HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$26.10	$26.10	$2.64 – $3.76
Urine test (manual, without microscope): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $3.48 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $3.31 ANTHEM — ANTHEM INDIVIDUAL: $2.64 ANTHEM — ANTHEM MANAGED CARE: $3.52 CIGNA — CIGNA MANAGED CARE: $3.48 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $3.48 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $3.76 UNITED — UNITED MANAGED CARE: $3.48 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$24.90	$24.90	$2.25
Urine test (automated, without microscope): rates for 8 insurance plans AETNA — AETNA MEDICARE: $2.25 ANTHEM — ANTHEM MEDICARE: $2.25 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $2.25 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $2.25 TUFTS — TUFTS MEDICARE: $2.25 UNITED — UNITED MEDICARE: $2.25 WELLCARE — WELLCARE MEDICARE: $2.25 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · modifier 0 In the file: HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$24.90	$24.90	$2.14 – $3.09
Urine test (automated, without microscope): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $2.25 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $2.14 ANTHEM — ANTHEM INDIVIDUAL: $2.32 ANTHEM — ANTHEM MANAGED CARE: $3.09 CIGNA — CIGNA MANAGED CARE: $2.25 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $2.25 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $2.43 UNITED — UNITED MANAGED CARE: $2.25 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC ASSAY OF THYROID STIMULATING HORMONE TSH	$101	$101	$16.80
Thyroid stimulating hormone (TSH) test: rates for 8 insurance plans AETNA — AETNA MEDICARE: $16.80 ANTHEM — ANTHEM MEDICARE: $16.80 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $16.80 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $16.80 TUFTS — TUFTS MEDICARE: $16.80 UNITED — UNITED MEDICARE: $16.80 WELLCARE — WELLCARE MEDICARE: $16.80 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · modifier 0 In the file: HC ASSAY OF THYROID STIMULATING HORMONE TSH	$101	$101	$15.96 – $23.10
Thyroid stimulating hormone (TSH) test: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $16.80 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $15.96 ANTHEM — ANTHEM INDIVIDUAL: $17.33 ANTHEM — ANTHEM MANAGED CARE: $23.10 CIGNA — CIGNA MANAGED CARE: $16.82 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $16.80 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $18.16 UNITED — UNITED MANAGED CARE: $16.80 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HC POCT BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$64.73	$64.73	$7.77
Complete blood count (CBC) with differential: rates for 8 insurance plans AETNA — AETNA MEDICARE: $7.77 ANTHEM — ANTHEM MEDICARE: $7.77 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $7.77 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $7.77 TUFTS — TUFTS MEDICARE: $7.77 UNITED — UNITED MEDICARE: $7.77 WELLCARE — WELLCARE MEDICARE: $7.77 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$47	$47	$7.77
Complete blood count (CBC) with differential: rates for 8 insurance plans AETNA — AETNA MEDICARE: $7.77 ANTHEM — ANTHEM MEDICARE: $7.77 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $7.77 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $7.77 TUFTS — TUFTS MEDICARE: $7.77 UNITED — UNITED MEDICARE: $7.77 WELLCARE — WELLCARE MEDICARE: $7.77 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · modifier 0 In the file: HC POCT BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$64.73	$64.73	$7.38 – $10.69
Complete blood count (CBC) with differential: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $7.77 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $7.38 ANTHEM — ANTHEM INDIVIDUAL: $8.02 ANTHEM — ANTHEM MANAGED CARE: $10.69 CIGNA — CIGNA MANAGED CARE: $7.78 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $7.77 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $8.40 UNITED — UNITED MANAGED CARE: $7.77 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HC BLOOD COUNT COMPLETE AUTOMATED	$39	$39	$6.47
Complete blood count (CBC), automated: rates for 8 insurance plans AETNA — AETNA MEDICARE: $6.47 ANTHEM — ANTHEM MEDICARE: $6.47 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $6.47 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $6.47 TUFTS — TUFTS MEDICARE: $6.47 UNITED — UNITED MEDICARE: $6.47 WELLCARE — WELLCARE MEDICARE: $6.47 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · modifier 0 In the file: HC BLOOD COUNT COMPLETE AUTOMATED	$39	$39	$6.15 – $8.89
Complete blood count (CBC), automated: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $6.47 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $6.15 ANTHEM — ANTHEM INDIVIDUAL: $6.67 ANTHEM — ANTHEM MANAGED CARE: $8.89 CIGNA — CIGNA MANAGED CARE: $6.48 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $6.47 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $6.99 UNITED — UNITED MANAGED CARE: $6.47 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC PROTHROMBIN TIME	$32.78	$32.78	$4.29
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans AETNA — AETNA MEDICARE: $4.29 ANTHEM — ANTHEM MEDICARE: $4.29 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $4.29 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $4.29 TUFTS — TUFTS MEDICARE: $4.29 UNITED — UNITED MEDICARE: $4.29 WELLCARE — WELLCARE MEDICARE: $4.29 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · modifier 0 In the file: HC PROTHROMBIN TIME	$32.78	$32.78	$4.05 – $5.40
Blood clotting time test (prothrombin time, PT): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $4.29 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $4.08 ANTHEM — ANTHEM INDIVIDUAL: $4.05 ANTHEM — ANTHEM MANAGED CARE: $5.40 CIGNA — CIGNA MANAGED CARE: $4.30 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $4.29 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $4.64 UNITED — UNITED MANAGED CARE: $4.29 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$50.03	$50.03	$6.01
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans AETNA — AETNA MEDICARE: $6.01 ANTHEM — ANTHEM MEDICARE: $6.01 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $6.01 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $6.01 TUFTS — TUFTS MEDICARE: $6.01 UNITED — UNITED MEDICARE: $6.01 WELLCARE — WELLCARE MEDICARE: $6.01 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD - LUPUS ANTICOAGULANT SCREEN W/ REFLEX	$50.03	$50.03	$6.01
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans AETNA — AETNA MEDICARE: $6.01 ANTHEM — ANTHEM MEDICARE: $6.01 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $6.01 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $6.01 TUFTS — TUFTS MEDICARE: $6.01 UNITED — UNITED MEDICARE: $6.01 WELLCARE — WELLCARE MEDICARE: $6.01 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · modifier 0 In the file: HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$50.03	$50.03	$5.71 – $8.25
Blood clotting test (partial thromboplastin time, PTT): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $6.01 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $5.71 ANTHEM — ANTHEM INDIVIDUAL: $6.19 ANTHEM — ANTHEM MANAGED CARE: $8.25 CIGNA — CIGNA MANAGED CARE: $6.02 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $6.01 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $6.50 UNITED — UNITED MANAGED CARE: $6.01 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier 0 In the file: HC MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$2,504	$2,504	$142.57 – $1,050.82
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $627.55 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $595.60 AETNA — AETNA MEDICARE: $146.14 ANTHEM — ANTHEM INDIVIDUAL: $788.12 ANTHEM — ANTHEM MANAGED CARE: $1,050.82 ANTHEM — ANTHEM MEDICARE: $142.57 CIGNA — CIGNA MANAGED CARE: $834.57 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $142.57 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $142.57 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $731.10
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier TC In the file: HC MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$2,504	$2,504	Not listed in the file
MRI of the brain, before and after contrast: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier 0 In the file: HC CHEST 2 VIEWS, RADIOLOGIC EXAM	$374	$374	$35.56 – $138.53
Chest X-ray, 2 views: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $68.39 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $64.91 AETNA — AETNA MEDICARE: $36.45 ANTHEM — ANTHEM INDIVIDUAL: $73.18 ANTHEM — ANTHEM MANAGED CARE: $97.57 ANTHEM — ANTHEM MEDICARE: $35.56 CIGNA — CIGNA MANAGED CARE: $61.25 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $35.56 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $35.56 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $76.14
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: HC CHEST 2 VIEWS, RADIOLOGIC EXAM	$374	$374	Not listed in the file
Chest X-ray, 2 views: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier 0 In the file: HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$567	$567	$42.72 – $167.60
X-ray of the lower spine, at least 4 views: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $120.81 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $114.66 AETNA — AETNA MEDICARE: $43.79 ANTHEM — ANTHEM INDIVIDUAL: $123.29 ANTHEM — ANTHEM MANAGED CARE: $164.39 ANTHEM — ANTHEM MEDICARE: $42.72 CIGNA — CIGNA MANAGED CARE: $99.40 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $127.27
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$567	$567	Not listed in the file
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier 0 In the file: HC CT PELVIS W/CONTRAST MATERIAL	$2,192	$2,192	$71.68 – $658.62
CT scan of the pelvis, with contrast: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $510.70 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $484.70 AETNA — AETNA MEDICARE: $73.47 ANTHEM — ANTHEM INDIVIDUAL: $493.96 ANTHEM — ANTHEM MANAGED CARE: $658.62 ANTHEM — ANTHEM MEDICARE: $71.68 CIGNA — CIGNA MANAGED CARE: $466.83 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $71.68 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $71.68 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $603.86
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier TC In the file: HC CT PELVIS W/CONTRAST MATERIAL	$2,192	$2,192	Not listed in the file
CT scan of the pelvis, with contrast: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier 0 In the file: HC MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,619	$1,619	$97.51 – $695.29
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $419.68 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $398.31 AETNA — AETNA MEDICARE: $99.95 ANTHEM — ANTHEM INDIVIDUAL: $521.47 ANTHEM — ANTHEM MANAGED CARE: $695.29 ANTHEM — ANTHEM MEDICARE: $97.51 CIGNA — CIGNA MANAGED CARE: $539.55 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $97.51 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $97.51 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $477.63
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier TC In the file: HC MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,619	$1,619	Not listed in the file
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier 0 In the file: HC US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$378	$378	$42.72 – $278.74
Ultrasound of the abdomen, complete: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $227.78 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $216.19 AETNA — AETNA MEDICARE: $43.79 ANTHEM — ANTHEM INDIVIDUAL: $196.50 ANTHEM — ANTHEM MANAGED CARE: $261.99 ANTHEM — ANTHEM MEDICARE: $42.72 CIGNA — CIGNA MANAGED CARE: $231.95 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $257.84
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: HC US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$378	$378	Not listed in the file
Ultrasound of the abdomen, complete: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier 0 In the file: HC US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$420	$420	$42.72 – $314.02
Pregnancy ultrasound (after the first trimester): 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $263.39 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $249.99 AETNA — AETNA MEDICARE: $43.79 ANTHEM — ANTHEM INDIVIDUAL: $221.03 ANTHEM — ANTHEM MANAGED CARE: $294.70 ANTHEM — ANTHEM MEDICARE: $42.72 CIGNA — CIGNA MANAGED CARE: $255.05 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $290.48
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier 26 In the file: OB US >= 14 WKS SNGL FETUS	$270	$270	$76.12 – $110.58
Pregnancy ultrasound (after the first trimester): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $110.58 ANTHEM — ANTHEM INDIVIDUAL: $77.86 ANTHEM — ANTHEM MANAGED CARE: $85.50 CIGNA — CIGNA MANAGED CARE: $92.28 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $86.63 CONNECTICARE — CONNECTICARE MANAGED CARE: $87.67 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $93.90 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $76.12 UNITED — UNITED MANAGED CARE: $76.12
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier TC In the file: HC US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$420	$420	Not listed in the file
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier 0 In the file: HC ULTRASOUND TRANSVAGINAL	$413	$413	$42.72 – $308.16
Transvaginal ultrasound: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $252.50 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $239.65 AETNA — AETNA MEDICARE: $43.79 ANTHEM — ANTHEM INDIVIDUAL: $215.95 ANTHEM — ANTHEM MANAGED CARE: $287.92 ANTHEM — ANTHEM MEDICARE: $42.72 CIGNA — CIGNA MANAGED CARE: $250.03 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $42.72 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $285.06
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: HC ULTRASOUND TRANSVAGINAL	$413	$413	Not listed in the file
Transvaginal ultrasound: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier 0 In the file: HC DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$407	$407	$137.26 – $310.84
Diagnostic mammogram, one breast: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $255.34 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $242.34 ANTHEM — ANTHEM INDIVIDUAL: $233.13 ANTHEM — ANTHEM MANAGED CARE: $310.84 CIGNA — CIGNA MANAGED CARE: $263.08 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $285.06 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $308.16 UNITED — UNITED MANAGED CARE: $137.26 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC In the file: HC DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$407	$407	$92.85
Diagnostic mammogram, one breast: rates for 8 insurance plans AETNA — AETNA MEDICARE: $92.85 ANTHEM — ANTHEM MEDICARE: $92.85 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $92.85 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $92.85 TUFTS — TUFTS MEDICARE: $92.85 UNITED — UNITED MEDICARE: $92.85 WELLCARE — WELLCARE MEDICARE: $92.85 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier 0 In the file: HC DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$521	$521	$176.03 – $395.87
Diagnostic mammogram, both breasts: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $327.69 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $311.01 ANTHEM — ANTHEM INDIVIDUAL: $296.90 ANTHEM — ANTHEM MANAGED CARE: $395.87 CIGNA — CIGNA MANAGED CARE: $335.38 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $363.41 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $392.87 UNITED — UNITED MANAGED CARE: $176.03 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: HC DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$521	$521	$119.16
Diagnostic mammogram, both breasts: rates for 8 insurance plans AETNA — AETNA MEDICARE: $119.16 ANTHEM — ANTHEM MEDICARE: $119.16 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $119.16 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $119.16 TUFTS — TUFTS MEDICARE: $119.16 UNITED — UNITED MEDICARE: $119.16 WELLCARE — WELLCARE MEDICARE: $119.16 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 0 In the file: HC SCR MAMMO BI INCL CAD	$430	$430	$145.12 – $327.23
Screening mammogram, both breasts: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $270.19 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $256.43 ANTHEM — ANTHEM INDIVIDUAL: $245.42 ANTHEM — ANTHEM MANAGED CARE: $327.23 CIGNA — CIGNA MANAGED CARE: $278.15 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $301.37 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $325.80 UNITED — UNITED MANAGED CARE: $145.12 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: HC SCR MAMMO BI INCL CAD	$430	$430	$98.25
Screening mammogram, both breasts: rates for 8 insurance plans AETNA — AETNA MEDICARE: $98.25 ANTHEM — ANTHEM MEDICARE: $98.25 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $98.25 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $98.25 TUFTS — TUFTS MEDICARE: $98.25 UNITED — UNITED MEDICARE: $98.25 WELLCARE — WELLCARE MEDICARE: $98.25 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier 0 In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$5,287.76	$5,287.76	$350.94 – $3,000
Sleep study (overnight, in a sleep lab): 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $3,000 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $2,850 AETNA — AETNA MEDICARE: $359.71 ANTHEM — ANTHEM MEDICARE: $350.94 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $350.94 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $350.94 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $2,775 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $3,000 TUFTS — TUFTS MEDICARE: $350.94 UNITED — UNITED MEDICARE: $350.94
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · modifier 26 In the file: POLYSOM 6/> YRS 4/> PARAM	$1,040	$1,040	$183.25 – $448.26
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $448.26 ANTHEM — ANTHEM INDIVIDUAL: $227.16 ANTHEM — ANTHEM MANAGED CARE: $249.44 CIGNA — CIGNA MANAGED CARE: $309.06 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $261.18 CONNECTICARE — CONNECTICARE MANAGED CARE: $377.95 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $331.20 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $183.25 UNITED — UNITED MANAGED CARE: $183.25
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier TC In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$5,287.76	$5,287.76	Not listed in the file
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$123.12	$123.12	$30.48
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans AETNA — AETNA MEDICARE: $30.48 ANTHEM — ANTHEM MEDICARE: $30.48 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $30.48 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $30.48 TUFTS — TUFTS MEDICARE: $30.48 UNITED — UNITED MEDICARE: $30.48 WELLCARE — WELLCARE MEDICARE: $30.48 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier 0 In the file: HC THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$123.12	$123.12	$159 – $233
Physical therapy: therapeutic exercise (each 15 minutes): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $210 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $199.50 ANTHEM — ANTHEM INDIVIDUAL: $159 ANTHEM — ANTHEM MANAGED CARE: $212 CIGNA — CIGNA MANAGED CARE: $226 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $215 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $233 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount) UNITED — UNITED MANAGED CARE: 83.44% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC PT EVAL LOW COMPLEX 20 MIN	$412.56	$412.56	$102.51
Physical therapy evaluation (low complexity): rates for 8 insurance plans AETNA — AETNA MEDICARE: $102.51 ANTHEM — ANTHEM MEDICARE: $102.51 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $102.51 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $102.51 TUFTS — TUFTS MEDICARE: $102.51 UNITED — UNITED MEDICARE: $102.51 WELLCARE — WELLCARE MEDICARE: $102.51 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier 0 In the file: HC PT EVAL LOW COMPLEX 20 MIN	$412.56	$412.56	$159 – $233
Physical therapy evaluation (low complexity): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $210 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $199.50 ANTHEM — ANTHEM INDIVIDUAL: $159 ANTHEM — ANTHEM MANAGED CARE: $212 CIGNA — CIGNA MANAGED CARE: $226 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $215 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $233 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount) UNITED — UNITED MANAGED CARE: 83.44% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC PT EVAL MOD COMPLEX 30 MIN	$412.56	$412.56	$102.51
Physical therapy evaluation (moderate complexity): rates for 8 insurance plans AETNA — AETNA MEDICARE: $102.51 ANTHEM — ANTHEM MEDICARE: $102.51 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $102.51 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $102.51 TUFTS — TUFTS MEDICARE: $102.51 UNITED — UNITED MEDICARE: $102.51 WELLCARE — WELLCARE MEDICARE: $102.51 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier 0 In the file: HC PT EVAL MOD COMPLEX 30 MIN	$412.56	$412.56	$159 – $233
Physical therapy evaluation (moderate complexity): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $210 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $199.50 ANTHEM — ANTHEM INDIVIDUAL: $159 ANTHEM — ANTHEM MANAGED CARE: $212 CIGNA — CIGNA MANAGED CARE: $226 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $215 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $233 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount) UNITED — UNITED MANAGED CARE: 83.44% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC PT EVAL HIGH COMPLEX 45 MIN	$412.56	$412.56	$102.51
Physical therapy evaluation (high complexity): rates for 8 insurance plans AETNA — AETNA MEDICARE: $102.51 ANTHEM — ANTHEM MEDICARE: $102.51 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $102.51 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $102.51 TUFTS — TUFTS MEDICARE: $102.51 UNITED — UNITED MEDICARE: $102.51 WELLCARE — WELLCARE MEDICARE: $102.51 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier 0 In the file: HC PT EVAL HIGH COMPLEX 45 MIN	$412.56	$412.56	$159 – $233
Physical therapy evaluation (high complexity): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $210 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $199.50 ANTHEM — ANTHEM INDIVIDUAL: $159 ANTHEM — ANTHEM MANAGED CARE: $212 CIGNA — CIGNA MANAGED CARE: $226 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $215 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $233 AETNA — AETNA SIGNATURE ADMINISTRATORS: 88.72% (a percentage in the contract, not a dollar amount) UNITED — UNITED MANAGED CARE: 83.44% (a percentage in the contract, not a dollar amount)

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	Not listed in the file
Removal of breast growth (open surgery): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 0 In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$1,600.10 – $8,935
Removal of breast growth (open surgery): 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $1,640.10 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $1,600.10 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $1,600.10 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $1,600.10 TUFTS — TUFTS MEDICARE: $1,600.10 UNITED — UNITED MEDICARE: $1,600.10 WELLCARE — WELLCARE MEDICARE: $1,632.10 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: TOTAL HIP ARTHROPLASTY	$7,400	$7,400	$2,038.23 – $3,903.57
Total hip replacement: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $3,853.31 ANTHEM — ANTHEM INDIVIDUAL: $3,260.37 ANTHEM — ANTHEM MANAGED CARE: $3,580.11 CIGNA — CIGNA MANAGED CARE: $3,027.78 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $3,903.57 CONNECTICARE — CONNECTICARE MANAGED CARE: $3,105.29 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $2,509.37 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $2,038.23 UNITED — UNITED MANAGED CARE: $2,038.23
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	Not listed in the file
Total hip replacement: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier 0 In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$5,246.70 – $37,843
Total hip replacement: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $28,000 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $26,600 AETNA — AETNA MEDICARE: $5,377.87 ANTHEM — ANTHEM INDIVIDUAL: $26,250 ANTHEM — ANTHEM MANAGED CARE: $35,000 ANTHEM — ANTHEM MEDICARE: $5,246.70 CIGNA — CIGNA MANAGED CARE: $25,800 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $5,246.70 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $5,246.70 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $35,005
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: TOTAL KNEE ARTHROPLASTY	$7,390	$7,390	$2,035.53 – $4,170.18
Total knee replacement: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $4,127.94 ANTHEM — ANTHEM INDIVIDUAL: $3,495.57 ANTHEM — ANTHEM MANAGED CARE: $3,838.38 CIGNA — CIGNA MANAGED CARE: $3,022.81 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $4,170.18 CONNECTICARE — CONNECTICARE MANAGED CARE: $3,336.58 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $2,701.62 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $2,035.53 UNITED — UNITED MANAGED CARE: $2,035.53
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	Not listed in the file
Total knee replacement: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier 0 In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$5,246.70 – $37,843
Total knee replacement: 10 of 16 insurance plan rates AETNA — AETNA MANAGED CARE: $28,000 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $26,600 AETNA — AETNA MEDICARE: $5,377.87 ANTHEM — ANTHEM INDIVIDUAL: $26,250 ANTHEM — ANTHEM MANAGED CARE: $35,000 ANTHEM — ANTHEM MEDICARE: $5,246.70 CIGNA — CIGNA MANAGED CARE: $25,800 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $5,246.70 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $5,246.70 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $35,005
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: SHO ARTHRS SRG DECOMPRESSION	$975	$975	$261.11 – $1,778.09
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $1,778.09 ANTHEM — ANTHEM INDIVIDUAL: $423.51 ANTHEM — ANTHEM MANAGED CARE: $465.04 CIGNA — CIGNA MANAGED CARE: $398.05 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $527.98 CONNECTICARE — CONNECTICARE MANAGED CARE: $1,462.35 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $1,235.97 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $261.11 UNITED — UNITED MANAGED CARE: $261.11
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: KNEE ARTHROSCOPY/SURGERY	$3,175	$3,175	$816.14 – $1,689.30
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $1,689.30 ANTHEM — ANTHEM INDIVIDUAL: $1,306.07 ANTHEM — ANTHEM MANAGED CARE: $1,434.15 CIGNA — CIGNA MANAGED CARE: $1,297.31 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $1,640.95 CONNECTICARE — CONNECTICARE MANAGED CARE: $1,379.58 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $1,100.19 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $816.14 UNITED — UNITED MANAGED CARE: $816.14
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	Not listed in the file
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 0 In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	Not listed in the file	$1,337.15 – $8,935
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $1,370.58 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $1,337.15 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $1,337.15 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $1,337.15 TUFTS — TUFTS MEDICARE: $1,337.15 UNITED — UNITED MEDICARE: $1,337.15 WELLCARE — WELLCARE MEDICARE: $1,363.89 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$3,288.29	$3,288.29	Not listed in the file
Upper GI endoscopy (diagnostic): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 0 In the file: HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$3,288.29	$3,288.29	$370.65 – $8,935
Upper GI endoscopy (diagnostic): 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $379.92 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $370.65 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $370.65 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $370.65 TUFTS — TUFTS MEDICARE: $370.65 UNITED — UNITED MEDICARE: $370.65 WELLCARE — WELLCARE MEDICARE: $378.07 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: HC EDG TRANSORAL BIOPSY SINGLE/MULTIPLE	$3,288.29	$3,288.29	Not listed in the file
Upper GI endoscopy with biopsy: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 0 In the file: HC EDG TRANSORAL BIOPSY SINGLE/MULTIPLE	$3,288.29	$3,288.29	$370.65 – $8,935
Upper GI endoscopy with biopsy: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $379.92 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $370.65 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $370.65 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $370.65 TUFTS — TUFTS MEDICARE: $370.65 UNITED — UNITED MEDICARE: $370.65 WELLCARE — WELLCARE MEDICARE: $378.07 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: HC COLONOSCOPY FLX DX W/WO COLLJ SPECIMENS	$3,224.78	$3,224.78	Not listed in the file
Colonoscopy (diagnostic): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 0 In the file: HC COLONOSCOPY FLX DX W/WO COLLJ SPECIMENS	$3,224.78	$3,224.78	$380.04 – $8,935
Colonoscopy (diagnostic): 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $389.54 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $380.04 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $380.04 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $380.04 TUFTS — TUFTS MEDICARE: $380.04 UNITED — UNITED MEDICARE: $380.04 WELLCARE — WELLCARE MEDICARE: $387.64 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$4,213.56	$4,213.56	Not listed in the file
Colonoscopy with biopsy: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 0 In the file: HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$4,213.56	$4,213.56	$489.02 – $8,935
Colonoscopy with biopsy: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $501.25 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $489.02 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $489.02 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $489.02 TUFTS — TUFTS MEDICARE: $489.02 UNITED — UNITED MEDICARE: $489.02 WELLCARE — WELLCARE MEDICARE: $498.80 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: HC COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ	$4,213.56	$4,213.56	Not listed in the file
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 0 In the file: HC COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ	$4,213.56	$4,213.56	$489.02 – $8,935
Colonoscopy with removal of polyps (snare): 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $501.25 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $489.02 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $489.02 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $489.02 TUFTS — TUFTS MEDICARE: $489.02 UNITED — UNITED MEDICARE: $489.02 WELLCARE — WELLCARE MEDICARE: $498.80 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: HC CRCTAL SRN-NOHRSK	$3,224.78	$3,224.78	Not listed in the file
Screening colonoscopy (not high risk): rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 0 In the file: HC CRCTAL SRN-NOHRSK	$3,224.78	$3,224.78	$380.04 – $8,935
Screening colonoscopy (not high risk): 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $389.54 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $380.04 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $380.04 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $380.04 TUFTS — TUFTS MEDICARE: $380.04 UNITED — UNITED MEDICARE: $380.04 WELLCARE — WELLCARE MEDICARE: $387.64 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: LAPAROSCOPIC CHOLECYSTECTOMY	$3,820	$3,820	$1,005.39 – $1,713.06
Gallbladder removal by laparoscope: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $1,713.06 ANTHEM — ANTHEM INDIVIDUAL: $1,497.31 ANTHEM — ANTHEM MANAGED CARE: $1,644.15 CIGNA — CIGNA MANAGED CARE: $1,457.61 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $1,645.89 CONNECTICARE — CONNECTICARE MANAGED CARE: $1,481.45 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $1,175.69 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $1,005.39 UNITED — UNITED MANAGED CARE: $1,005.39
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	Not listed in the file
Gallbladder removal by laparoscope: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 0 In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$2,470.59 – $15,551
Gallbladder removal by laparoscope: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $2,532.35 ANTHEM — ANTHEM INDIVIDUAL: $11,663 ANTHEM — ANTHEM MANAGED CARE: $15,551 ANTHEM — ANTHEM MEDICARE: $2,470.59 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $2,470.59 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $2,470.59 TUFTS — TUFTS MEDICARE: $2,470.59 UNITED — UNITED MEDICARE: $2,470.59 WELLCARE — WELLCARE MEDICARE: $2,520 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: PRP I/HERN INIT REDUC >5 YR	$3,040	$3,040	$766.53 – $1,197.49
Groin (inguinal) hernia repair, age 5 or older: rates for 9 insurance plans AETNA — AETNA MANAGED CARE: $1,197.49 ANTHEM — ANTHEM INDIVIDUAL: $766.53 ANTHEM — ANTHEM MANAGED CARE: $841.70 CIGNA — CIGNA MANAGED CARE: $1,158.59 CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $1,141.85 CONNECTICARE — CONNECTICARE MANAGED CARE: $1,039.41 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: $840.05 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $796.17 UNITED — UNITED MANAGED CARE: $796.17
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	Not listed in the file
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 0 In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$1,463.18 – $8,935
Groin (inguinal) hernia repair, age 5 or older: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $1,499.76 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $1,463.18 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $1,463.18 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $1,463.18 TUFTS — TUFTS MEDICARE: $1,463.18 UNITED — UNITED MEDICARE: $1,463.18 WELLCARE — WELLCARE MEDICARE: $1,492.44 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	Not listed in the file
Prostate biopsy: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 0 In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$819.40 – $8,935
Prostate biopsy: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $839.89 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $819.40 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $819.40 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $819.40 TUFTS — TUFTS MEDICARE: $819.40 UNITED — UNITED MEDICARE: $819.40 WELLCARE — WELLCARE MEDICARE: $835.79 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient In the file: LAPS SURG PRST8ECT RPBIC RAD	$6,250	$6,250	$2,173.14 – $4,297.45
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans CONNECTICARE — CONNECTICARE EXCHANGE/MARKETPLACE: $4,297.45 CONNECTICARE — CONNECTICARE MANAGED CARE: $3,926.08 OXFORD — UNITED MANAGED CARE - OXFORD ONLY: $2,173.14 UNITED — UNITED MANAGED CARE: $2,173.14
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	Not listed in the file
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 0 In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$1,322.90 – $8,935
Hysteroscopy with biopsy of the uterus lining: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $1,355.97 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $1,322.90 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $1,322.90 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $1,322.90 TUFTS — TUFTS MEDICARE: $1,322.90 UNITED — UNITED MEDICARE: $1,322.90 WELLCARE — WELLCARE MEDICARE: $1,349.35 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$3,726.37	$3,726.37	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier 0 In the file: HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$3,726.37	$3,726.37	$288.47 – $8,935
Spinal injection, lower back (epidural), with imaging guidance: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $295.68 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $288.47 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $288.47 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $288.47 TUFTS — TUFTS MEDICARE: $288.47 UNITED — UNITED MEDICARE: $288.47 WELLCARE — WELLCARE MEDICARE: $294.24 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HC NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$2,454.73	$2,454.73	Not listed in the file
Nerve root injection, lower back, with imaging guidance: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 0 In the file: HC NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$2,454.73	$2,454.73	$361.45 – $8,935
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $370.49 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $361.45 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $361.45 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $361.45 TUFTS — TUFTS MEDICARE: $361.45 UNITED — UNITED MEDICARE: $361.45 WELLCARE — WELLCARE MEDICARE: $368.68 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 50 In the file: HC NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$4,295.78	$4,295.78	$361.45 – $8,935
Nerve root injection, lower back, with imaging guidance: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $370.49 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $361.45 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $361.45 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $361.45 TUFTS — TUFTS MEDICARE: $361.45 UNITED — UNITED MEDICARE: $361.45 WELLCARE — WELLCARE MEDICARE: $368.68 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	Not listed in the file
Carpal tunnel release: rates for 1 insurance plan HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MANAGED CARE: 65.46% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier 0 In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$798.01 – $8,935
Carpal tunnel release: 10 of 16 insurance plan rates AETNA — AETNA MEDICARE: $817.96 ANTHEM — ANTHEM INDIVIDUAL: $6,701 ANTHEM — ANTHEM MANAGED CARE: $8,935 ANTHEM — ANTHEM MEDICARE: $798.01 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $798.01 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $798.01 TUFTS — TUFTS MEDICARE: $798.01 UNITED — UNITED MEDICARE: $798.01 WELLCARE — WELLCARE MEDICARE: $813.97 AETNA — AETNA MANAGED CARE: 81% (a percentage in the contract, not a dollar amount)

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) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$40,526.12	$40,526.12	$8,828.97 – $42,198
Hip or knee replacement (major joint of the leg), without major complications: 10 of 17 insurance plan rates AETNA — AETNA MANAGED CARE: $40,104 AETNA — AETNA MANAGED CARE - MIDDLESEX ONLY: $38,098.80 AETNA — AETNA MEDICARE: $9,049.69 ANTHEM — ANTHEM INDIVIDUAL: $29,592.75 ANTHEM — ANTHEM MANAGED CARE: $39,457 ANTHEM — ANTHEM MEDICARE: $8,828.97 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $8,828.97 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $8,828.97 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $39,033.15 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $42,198
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	$77,074.58	$77,074.58	$8,828.97 – $21,900
Neck (cervical) spinal fusion, without complications: 10 of 17 insurance plan rates AETNA — AETNA MEDICARE: $9,049.69 ANTHEM — ANTHEM INDIVIDUAL: $16,425 ANTHEM — ANTHEM MANAGED CARE: $21,900 ANTHEM — ANTHEM MEDICARE: $8,828.97 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $8,828.97 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $8,828.97 TUFTS — TUFTS MEDICARE: $8,828.97 UNITED — UNITED MEDICARE: $8,828.97 WELLCARE — WELLCARE MEDICARE: $9,005.55 AETNA — AETNA MANAGED CARE: 76% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	$34,819.53	$34,819.53	$8,828.97 – $22,071
Uterus and ovary surgery (not for cancer), without complications: 10 of 17 insurance plan rates AETNA — AETNA MEDICARE: $9,049.69 ANTHEM — ANTHEM INDIVIDUAL: $16,425 ANTHEM — ANTHEM MANAGED CARE: $21,900 ANTHEM — ANTHEM MEDICARE: $8,828.97 HEALTH NEW ENGLAND — HEALTH NEW ENGLAND MEDICARE: $8,828.97 MOLINA dba CONNECTICARE — MOLINA dba CONNECTICARE MEDICARE: $8,828.97 MOLINA dba CONNECTICARE — MOLINA EXCHANGE/MARKETPLACE: $20,415.67 MOLINA dba CONNECTICARE — MOLINA MANAGED CARE: $22,071 TUFTS — TUFTS MEDICARE: $8,828.97 UNITED — UNITED MEDICARE: $8,828.97

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

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

Hospital information

Hospital type	Acute Care Hospital
Address	435 Lewis Avenue, Meriden, CT 06450
County	New Haven County
State	Connecticut
Phone	(203) 694‑8200
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	070017
Name in Medicare records	MIDSTATE MEDICAL CENTER
Profile level	Medicare data + hospital website
Name on the hospital’s website	MidState Medical Center
Official website	midstatemedical.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
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.

About | midstatemedical.org | MidState Medical Center | Meriden, CT — midstatemedical.org

Midstate Medical Center

Summary

Profile from official sources

At a glance