Medical emergency?Emergency? Call 911. Nearest emergency roomsNearest ERs

Español Near me My list Help
US Patient GuideUSA
Surprise me
Acute Care Hospital

Montefiore Medical Center

Also listed as: Montefiore Einstein Hospital—Moses Campus

Bronx, New York · Bronx County · Emergency services listed

Montefiore Medical Center is an acute care hospital at 111 East 210th Street, Bronx, NY 10467. Phone: (718) 920-4321. It has an emergency department. Medicare overall rating: 3 of 5 stars (CMS, October 2026).

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

Summary

Montefiore Medical Center is an acute care hospital in Bronx, New York. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 19 services, specialties and programs. Medicare lists 2,212 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(718) 920‑4321 Directions Website Medicare profile
Compare

Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
745Beds (hospital website)
2,212Doctors and clinicians
19Services listed

Quick answers

Does Montefiore Medical Center have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Montefiore Medical Center. In a medical emergency, call 911.
Where is Montefiore Medical Center?
111 East 210th Street, Bronx, NY 10467, in Bronx County, New York.
What is the phone number of Montefiore Medical Center?
(718) 920-4321, as listed by Medicare (CMS).
What is the Medicare star rating of Montefiore Medical Center?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Montefiore Medical Center for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Montefiore Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.7032; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

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

Procedures[5]

  • Interventional cardiology
  • Cardiothoracic surgery
  • Transplant surgery
  • Reimplantation surgery

Programs and centers[5][6][7][8]

  • Comprehensive Stroke Center
  • Adult psychiatric observation suite (emergency department)
  • Pediatric Emergency Department at Children's Hospital at Montefiore Einstein
  • Emergency Medicine Residency
  • Pediatric Emergency Medicine Fellowship

Visiting and practical information

VisitingVisitors allowed 24/7: two at a time 9 am-9 pm, one 9 pm-9 am; one visitor in the ED; visitors must be over 12[9]
Patient portalMontefiore MyChart

Doctors and clinicians (2,212)

2,212 doctors and other clinicians list Montefiore Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (2,212)

And 2,188 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Bronx

All hospitals in Bronx · Hospitals in Bronx County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff1 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment1 of 5 stars
Care Coordination2 of 5 stars
Symptoms After Stay2 of 5 stars
Rated the hospital 9 or 10 out of 1062%National average: 72%
Would definitely recommend the hospital64%National average: 71%
Nurses “always” communicated well75%National average: 80%
Doctors “always” communicated well78%National average: 80%
“Always” got help as soon as they wanted52%National average: 64%
Staff “always” explained medicines before giving them59%National average: 62%
Were given information about recovery at home79%National average: 86%
Room and bathroom “always” clean67%National average: 73%
Completed surveys4,944Response rate: 11%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.696Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.823No different from the national benchmark
Surgical site infections after colon surgery0.994No different from the national benchmark
Surgical site infections after abdominal hysterectomy1.162No different from the national benchmark
MRSA bloodstream infections1.089No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.715Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients10.9%
Deaths within 30 days: heart failure patients5.2%
Deaths within 30 days: pneumonia patients9.2%
Deaths within 30 days: COPD patients7%
Deaths within 30 days: stroke patients7.5%
Deaths within 30 days: coronary bypass surgery (CABG)2.5%
Serious complications (patient safety indicator PSI-90)0.97No different from the national rate
Complications after hip or knee replacement2.8%

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)17.2%
Readmitted within 30 days: heart attack17.8%
Readmitted within 30 days: heart failure21.8%
Readmitted within 30 days: pneumonia18.7%
Readmitted within 30 days: COPD22.3%
Readmitted within 30 days: coronary bypass surgery12.9%
Readmitted within 30 days: hip or knee replacement5.2%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)195 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)21%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 Montefiore Medical Center, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score0.7032Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack1.0970More readmissions than expected
Heart failure0.9349Fewer readmissions than expected
Pneumonia0.9678Fewer readmissions than expected
COPD (chronic lung disease)1.1556More readmissions than expected
Hip or knee replacement0.9730Fewer readmissions than expected
Coronary bypass surgery (CABG)1.0898More readmissions than expected

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score30.00 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)75.00 out of 100
Person and community engagement (patient survey)25.00 out of 100
Safety (infections and sepsis care)20.00 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio1.04Above 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 BronxBest hospitals in Bronx

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Montefiore 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 86 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $505 $330.27 $34.04 – $477.72
New patient office visit (about 30–44 minutes): 10 of 96 insurance plan rates
  • 1199 — 1199: $83
  • Aetna — Commercial: $353.59
  • Aetna — Commercial Midlevels: $300.55
  • Aetna — Medicare: $91.79
  • Aetna — Medicare Midlevels: $78.02
  • Affinity — Essential Plan 3 & 4: $111.07
  • Affinity — Health Exchange Plan: $118.09
  • Affinity — Medicaid - Specialists: $77.08
  • Amida Care — Amida Care: $133.66
  • BCBC Empre Healthplus — Medicaid & HARP: $91.79
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: HC OFFICE CONSULTATION 30 MINS $485 Not listed in the file $91.79 – $3,375.60
New patient office visit (about 30–44 minutes): 10 of 16 insurance plan rates
  • Aetna — ASA: $793.79
  • Aetna — Commercial: $709.80
  • Anthem — Exchange: $388
  • Anthem — WPH Employees: $194
  • Christian Brothers — Christian Brothers: $793.79
  • Cigna — Commercial: $227.37
  • Cigna — LocalPlus: $280.38
  • Emblem — GHI Commercial: $388
  • Emblem — HIP Commerical EPO PPO: $3,375.60
  • MetroPlus — Default Duals: $91.79
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: Office o p new low 30 min Not listed in the file Not listed in the file $91.79 – $3,375.60
New patient office visit (about 30–44 minutes): rates for 10 insurance plans
  • Anthem — Blue Access: $382
  • Anthem — Connection LG: $382
  • Anthem — Connection SG: $339
  • Anthem — EPO PPO: $424
  • Anthem — Exchange: $296.53
  • Anthem — HMO: $491
  • Anthem — Indemnity: $424
  • Anthem — SG EPO/PPO: $360
  • Anthem — WPH Employees: $164.27
  • UHC — Compass: $695
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $770 $503.58 $56.57 – $727.40
New patient office visit (about 45–59 minutes): 10 of 96 insurance plan rates
  • 1199 — 1199: $142
  • Aetna — Commercial: $565.98
  • Aetna — Commercial Midlevels: $481.09
  • Aetna — Medicare: $149.04
  • Aetna — Medicare Midlevels: $126.68
  • Affinity — Essential Plan 3 & 4: $180.34
  • Affinity — Health Exchange Plan: $201.29
  • Affinity — Medicaid - Specialists: $125.03
  • Amida Care — Amida Care: $200.30
  • BCBC Empre Healthplus — Medicaid & HARP: $149.04
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HC OFFICE CONSULTATION 40 MINS $716 Not listed in the file $149.04 – $4,983.36
New patient office visit (about 45–59 minutes): 10 of 16 insurance plan rates
  • Aetna — ASA: $1,186.86
  • Aetna — Commercial: $1,061.28
  • Anthem — Exchange: $572.80
  • Anthem — WPH Employees: $286.40
  • Christian Brothers — Christian Brothers: $1,186.86
  • Cigna — Commercial: $335.66
  • Cigna — LocalPlus: $413.92
  • Emblem — GHI Commercial: $572.80
  • Emblem — HIP Commerical EPO PPO: $4,983.36
  • MetroPlus — Default Duals: $149.04
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: Office o p new mod 45 min Not listed in the file Not listed in the file $149.04 – $4,983.36
New patient office visit (about 45–59 minutes): rates for 10 insurance plans
  • Anthem — Blue Access: $382
  • Anthem — Connection LG: $382
  • Anthem — Connection SG: $339
  • Anthem — EPO PPO: $424
  • Anthem — Exchange: $296.53
  • Anthem — HMO: $491
  • Anthem — Indemnity: $424
  • Anthem — SG EPO/PPO: $360
  • Anthem — WPH Employees: $164.27
  • UHC — Compass: $695
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $965 $631.11 $64.75 – $933.19
New patient office visit (about 60–74 minutes): 10 of 96 insurance plan rates
  • 1199 — 1199: $182
  • Aetna — Commercial: $767.57
  • Aetna — Commercial Midlevels: $652.44
  • Aetna — Medicare: $203.31
  • Aetna — Medicare Midlevels: $172.81
  • Affinity — Essential Plan 3 & 4: $246.01
  • Affinity — Health Exchange Plan: $257.75
  • Affinity — Medicaid - Specialists: $163.82
  • Amida Care — Amida Care: $250.20
  • BCBC Empre Healthplus — Medicaid & HARP: $203.31
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: PR OVS OFFICE CONSULTATION NEW ESTAB PATIENT 80 MIN $1,103 Not listed in the file $164.27 – $7,676.88
New patient office visit (about 60–74 minutes): 10 of 16 insurance plan rates
  • Aetna — ASA: $1,567.59
  • Aetna — Commercial: $1,401.72
  • Anthem — Exchange: $882.40
  • Anthem — WPH Employees: $441.20
  • Christian Brothers — Christian Brothers: $1,567.59
  • Cigna — Commercial: $517.09
  • Cigna — LocalPlus: $637.64
  • Emblem — GHI Commercial: $882.40
  • Emblem — HIP Commerical EPO PPO: $7,676.88
  • MetroPlus — Default Duals: $203.31
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: Office o p new hi 60 min Not listed in the file Not listed in the file $164.27 – $7,676.88
New patient office visit (about 60–74 minutes): rates for 10 insurance plans
  • Anthem — Blue Access: $382
  • Anthem — Connection LG: $382
  • Anthem — Connection SG: $339
  • Anthem — EPO PPO: $424
  • Anthem — Exchange: $296.53
  • Anthem — HMO: $491
  • Anthem — Indemnity: $424
  • Anthem — SG EPO/PPO: $360
  • Anthem — WPH Employees: $164.27
  • UHC — Compass: $695
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN $400 $261.60 $21.76 – $345.45
Established patient office visit (about 20–29 minutes): 10 of 96 insurance plan rates
  • 1199 — 1199: $55
  • Aetna — Commercial: $275.79
  • Aetna — Commercial Midlevels: $234.42
  • Aetna — Medicare: $73.09
  • Aetna — Medicare Midlevels: $62.13
  • Affinity — Essential Plan 3 & 4: $88.44
  • Affinity — Health Exchange Plan: $77.52
  • Affinity — Medicaid - Specialists: $47.24
  • Amida Care — Amida Care: $85.60
  • BCBC Empre Healthplus — Medicaid & HARP: $73.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC PHONE E M PHYS QHP 21 30 MIN $509 Not listed in the file $73.09 – $3,542.64
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates
  • Aetna — ASA: $646.78
  • Aetna — Commercial: $578.34
  • Anthem — Exchange: $407.20
  • Anthem — WPH Employees: $203.60
  • Christian Brothers — Christian Brothers: $646.78
  • Cigna — Commercial: $238.62
  • Cigna — LocalPlus: $294.25
  • Emblem — GHI Commercial: $407.20
  • Emblem — HIP Commerical EPO PPO: $3,542.64
  • MetroPlus — Default Duals: $73.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: Office o p est low 20 min Not listed in the file Not listed in the file $73.09 – $3,542.64
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans
  • Anthem — Blue Access: $382
  • Anthem — Connection LG: $382
  • Anthem — Connection SG: $339
  • Anthem — EPO PPO: $424
  • Anthem — Exchange: $296.53
  • Anthem — HMO: $491
  • Anthem — Indemnity: $424
  • Anthem — SG EPO/PPO: $360
  • Anthem — WPH Employees: $164.27
  • UHC — Compass: $695
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN $505 $330.27 $34.03 – $494.02
Established patient office visit (about 30–39 minutes): 10 of 96 insurance plan rates
  • 1199 — 1199: $84
  • Aetna — Commercial: $399.48
  • Aetna — Commercial Midlevels: $339.56
  • Aetna — Medicare: $107.63
  • Aetna — Medicare Midlevels: $91.49
  • Affinity — Essential Plan 3 & 4: $130.23
  • Affinity — Health Exchange Plan: $119.34
  • Affinity — Medicaid - Specialists: $74.78
  • Amida Care — Amida Care: $129.56
  • BCBC Empre Healthplus — Medicaid & HARP: $107.63
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC SED OFFICE VISIT EST PAT MOD COMPLX LVL4 20 29 MINUTES $696 Not listed in the file $107.63 – $4,844.16
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates
  • Aetna — ASA: $909.27
  • Aetna — Commercial: $813.06
  • Anthem — Exchange: $556.80
  • Anthem — WPH Employees: $278.40
  • Christian Brothers — Christian Brothers: $909.27
  • Cigna — Commercial: $326.28
  • Cigna — LocalPlus: $402.36
  • Emblem — GHI Commercial: $556.80
  • Emblem — HIP Commerical EPO PPO: $4,844.16
  • MetroPlus — Default Duals: $107.63
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: Office o p est mod 30 min Not listed in the file Not listed in the file $107.63 – $4,844.16
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans
  • Anthem — Blue Access: $382
  • Anthem — Connection LG: $382
  • Anthem — Connection SG: $339
  • Anthem — EPO PPO: $424
  • Anthem — Exchange: $296.53
  • Anthem — HMO: $491
  • Anthem — Indemnity: $424
  • Anthem — SG EPO/PPO: $360
  • Anthem — WPH Employees: $164.27
  • UHC — Compass: $695
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $905 $591.87 $48.30 – $819.21
Office consultation with a specialist (moderate): 10 of 65 insurance plan rates
  • 1199 — 1199: $134
  • Affinity — Essential Plan 3 & 4: $117.36
  • Affinity — Health Exchange Plan: $147.28
  • Affinity — Medicaid - Specialists: $107.15
  • Amida Care — Amida Care: $176.86
  • BCBC Empre Healthplus — Medicaid & HARP: $96.99
  • BCBS — Blue Access: $514.75
  • BCBS — Blue Access Midlevels: $437.53
  • BCBS — Commercial: $541.06
  • BCBS — Commercial Midlevels: $459.90
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Off op cnsltj new est low 30 Not listed in the file Not listed in the file $163.20 – $792.18
Office consultation with a specialist (moderate): 10 of 14 insurance plan rates
  • Aetna — ASA: $792.18
  • Aetna — Commercial: $708.36
  • Anthem — Blue Access: $379
  • Anthem — Connection LG: $379
  • Anthem — Connection SG: $337
  • Anthem — EPO PPO: $421
  • Anthem — Exchange: $239
  • Anthem — HMO: $489
  • Anthem — Indemnity: $427
  • Anthem — SG EPO/PPO: $358
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $1,000 $654 $75.62 – $944.64
Office consultation with a specialist (moderate to high): 10 of 65 insurance plan rates
  • 1199 — 1199: $189
  • Affinity — Essential Plan 3 & 4: $177.64
  • Affinity — Health Exchange Plan: $231.81
  • Affinity — Medicaid - Specialists: $166.25
  • Amida Care — Amida Care: $256.68
  • BCBC Empre Healthplus — Medicaid & HARP: $146.81
  • BCBS — Blue Access: $803.06
  • BCBS — Blue Access Midlevels: $682.60
  • BCBS — Commercial: $844.10
  • BCBS — Commercial Midlevels: $717.48
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Off op cnsltj new est mod 40 Not listed in the file Not listed in the file $163.20 – $1,125.27
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates
  • Aetna — ASA: $1,125.27
  • Aetna — Commercial: $1,006.20
  • Anthem — Blue Access: $379
  • Anthem — Connection LG: $379
  • Anthem — Connection SG: $337
  • Anthem — EPO PPO: $421
  • Anthem — Exchange: $239
  • Anthem — HMO: $489
  • Anthem — Indemnity: $427
  • Anthem — SG EPO/PPO: $358
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $815 $533.01 $37.20 – $740.25
Preventive checkup, new patient, age 18–39: 10 of 92 insurance plan rates
  • 1199 — 1199: $134
  • Aetna — Commercial: $403.94
  • Aetna — Commercial Midlevels: $343.36
  • Aetna — Medicare: $103.29
  • Aetna — Medicare Midlevels: $87.80
  • Affinity — Essential Plan 3 & 4: $124.98
  • Affinity — Health Exchange Plan: $149.88
  • Affinity — Medicaid - Specialists: $99.65
  • Amida Care — Amida Care: $158
  • BCBC Empre Healthplus — Medicaid & HARP: $103.29
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: HC PREV VISIT NEW AGE 18 39 $367 Not listed in the file $100.50 – $2,554.32
Preventive checkup, new patient, age 18–39: 10 of 13 insurance plan rates
  • Aetna — ASA: $915.78
  • Aetna — Commercial: $818.88
  • Anthem — Exchange: $293.60
  • Anthem — WPH Employees: $146.80
  • Christian Brothers — Christian Brothers: $915.78
  • Cigna — Commercial: $172.05
  • Cigna — LocalPlus: $212.16
  • Emblem — GHI Commercial: $293.60
  • Emblem — HIP Commerical EPO PPO: $2,554.32
  • Nat Assoc Letter Carriers — Nat Assoc Letter Carriers: $915.78
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Prev visit new age 18 39 Not listed in the file Not listed in the file $100.50 – $2,554.32
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan
  • UHC — Compass: $695
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $815 $533.01 $45.71 – $740.25
Preventive checkup, new patient, age 40–64: 10 of 92 insurance plan rates
  • 1199 — 1199: $157
  • Aetna — Commercial: $488.42
  • Aetna — Commercial Midlevels: $415.16
  • Aetna — Medicare: $124.86
  • Aetna — Medicare Midlevels: $106.13
  • Affinity — Essential Plan 3 & 4: $151.08
  • Affinity — Health Exchange Plan: $180.98
  • Affinity — Medicaid - Specialists: $117.11
  • Amida Care — Amida Care: $183.57
  • BCBC Empre Healthplus — Medicaid & HARP: $124.86
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: HC PREV VISIT NEW AGE 40 64 $446 Not listed in the file $117.75 – $3,104.16
Preventive checkup, new patient, age 40–64: 10 of 13 insurance plan rates
  • Aetna — ASA: $1,052.80
  • Aetna — Commercial: $941.40
  • Anthem — Exchange: $356.80
  • Anthem — WPH Employees: $178.40
  • Christian Brothers — Christian Brothers: $1,052.80
  • Cigna — Commercial: $209.08
  • Cigna — LocalPlus: $257.83
  • Emblem — GHI Commercial: $356.80
  • Emblem — HIP Commerical EPO PPO: $3,104.16
  • Nat Assoc Letter Carriers — Nat Assoc Letter Carriers: $1,052.80
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Prev visit new age 40 64 Not listed in the file Not listed in the file $117.75 – $3,104.16
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan
  • UHC — Compass: $695
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM $450 $294.30 $24.41 – $419.39
Emergency room visit (moderate): 10 of 90 insurance plan rates
  • 1199 — 1199: $66
  • Aetna — Commercial: $419.39
  • Aetna — Commercial Midlevels: $356.49
  • Aetna — Medicare: $78.59
  • Aetna — Medicare Midlevels: $66.80
  • Affinity — Essential Plan 3 & 4: $95.09
  • Affinity — Health Exchange Plan: $92.29
  • Affinity — Medicaid - Specialists: $68.82
  • Amida Care — Amida Care: $83.77
  • BCBC Empre Healthplus — Medicaid & HARP: $78.59
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPT VISIT LVL 3 $4,822 Not listed in the file $49.50 – $33,561.12
Emergency room visit (moderate): 10 of 31 insurance plan rates
  • Aetna — Medicare: $337.34
  • Agewell — Medicare: $357.79
  • Anthem — Exchange: $3,857.60
  • Anthem — Medicare: $340.75
  • Anthem — WPH Employees: $1,928.80
  • Centerlight — Medicare: $350.97
  • Centerlight — PACE: $350.97
  • CentersPlan — Medicare Advan I SNP: $374.83
  • Emblem — GHI Commercial: $3,857.60
  • Emblem — HIP Commerical EPO PPO: $33,561.12
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency dept visit low mdm Not listed in the file Not listed in the file $49.50 – $33,561.12
Emergency room visit (moderate): 10 of 28 insurance plan rates
  • Aetna — ASA: $2,937
  • Aetna — Commercial: $2,625
  • Anthem — Blue Access: $2,408
  • Anthem — Connection LG: $2,452
  • Anthem — Connection SG: $2,155
  • Anthem — EPO PPO: $2,694
  • Anthem — Exchange: $1,353
  • Anthem — HMO: $2,774
  • Anthem — Indemnity: $2,667
  • Anthem — SG EPO/PPO: $2,290
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM $695 $454.53 $45.02 – $700.74
Emergency room visit (moderately high): 10 of 90 insurance plan rates
  • 1199 — 1199: $104
  • Aetna — Commercial: $700.74
  • Aetna — Commercial Midlevels: $595.63
  • Aetna — Medicare: $134.44
  • Aetna — Medicare Midlevels: $114.27
  • Affinity — Essential Plan 3 & 4: $162.67
  • Affinity — Health Exchange Plan: $177.07
  • Affinity — Medicaid - Specialists: $123.87
  • Amida Care — Amida Care: $151.08
  • BCBC Empre Healthplus — Medicaid & HARP: $134.44
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPT VISIT LVL 4 $5,353 Not listed in the file $78 – $37,256.88
Emergency room visit (moderately high): 10 of 31 insurance plan rates
  • Aetna — Medicare: $515.65
  • Agewell — Medicare: $546.90
  • Anthem — Exchange: $4,282.40
  • Anthem — Medicare: $520.86
  • Anthem — WPH Employees: $2,141.20
  • Centerlight — Medicare: $536.49
  • Centerlight — PACE: $536.49
  • CentersPlan — Medicare Advan I SNP: $572.95
  • Emblem — GHI Commercial: $4,282.40
  • Emblem — HIP Commerical EPO PPO: $37,256.88
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency dept visit mod mdm Not listed in the file Not listed in the file $78 – $37,256.88
Emergency room visit (moderately high): 10 of 28 insurance plan rates
  • Aetna — ASA: $2,937
  • Aetna — Commercial: $2,625
  • Anthem — Blue Access: $2,408
  • Anthem — Connection LG: $2,452
  • Anthem — Connection SG: $2,155
  • Anthem — EPO PPO: $2,694
  • Anthem — Exchange: $1,353
  • Anthem — HMO: $2,774
  • Anthem — Indemnity: $2,667
  • Anthem — SG EPO/PPO: $2,290
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM $1,040 $680.16 $64.75 – $1,020.28
Emergency room visit (high): 10 of 90 insurance plan rates
  • 1199 — 1199: $161
  • Aetna — Commercial: $1,020.28
  • Aetna — Commercial Midlevels: $867.24
  • Aetna — Medicare: $195.04
  • Aetna — Medicare Midlevels: $165.78
  • Affinity — Essential Plan 3 & 4: $236
  • Affinity — Health Exchange Plan: $258.38
  • Affinity — Medicaid - Specialists: $186.18
  • Amida Care — Amida Care: $226.81
  • BCBC Empre Healthplus — Medicaid & HARP: $195.04
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC EMERGENCY DEPT VISIT LVL 5 $5,620 Not listed in the file $120.75 – $39,115.20
Emergency room visit (high): 10 of 31 insurance plan rates
  • Aetna — Medicare: $735.96
  • Agewell — Medicare: $780.56
  • Anthem — Exchange: $4,496
  • Anthem — Medicare: $743.39
  • Anthem — WPH Employees: $2,248
  • Centerlight — Medicare: $765.69
  • Centerlight — PACE: $765.69
  • CentersPlan — Medicare Advan I SNP: $817.73
  • Emblem — GHI Commercial: $4,496
  • Emblem — HIP Commerical EPO PPO: $39,115.20
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency dept visit hi mdm Not listed in the file Not listed in the file $120.75 – $39,115.20
Emergency room visit (high): 10 of 28 insurance plan rates
  • Aetna — ASA: $2,937
  • Aetna — Commercial: $2,625
  • Anthem — Blue Access: $2,408
  • Anthem — Connection LG: $2,452
  • Anthem — Connection SG: $2,155
  • Anthem — EPO PPO: $2,694
  • Anthem — Exchange: $1,353
  • Anthem — HMO: $2,774
  • Anthem — Indemnity: $2,667
  • Anthem — SG EPO/PPO: $2,290

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: CHG BASIC METABOLIC PANEL CALCIUM TOTAL $115 $75.21 $4.03 – $108.57
Basic metabolic panel (blood test): 10 of 96 insurance plan rates
  • 1199 — 1199: $9
  • Aetna — Commercial: $4.74
  • Aetna — Commercial Midlevels: $4.03
  • Aetna — Medicare: $8.46
  • Aetna — Medicare Midlevels: $8.46
  • Affinity — Essential Plan 3 & 4: $10.24
  • Affinity — Health Exchange Plan: $7.25
  • Affinity — Medicaid - Specialists: $7.25
  • Amida Care — Amida Care: $10.89
  • BCBC Empre Healthplus — Medicaid & HARP: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: HC METABOLIC PANEL TOTAL CA $186 Not listed in the file $6.75 – $261.33
Basic metabolic panel (blood test): 10 of 51 insurance plan rates
  • Aetna — ASA: $57.70
  • Aetna — Commercial: $51.61
  • Agewell — Medicare: $7.69
  • Anthem — Blue Access: $30.27
  • Anthem — Connection LG: $30.27
  • Anthem — Connection SG: $26.92
  • Anthem — EPO PPO: $33.67
  • Anthem — Exchange: $148.80
  • Anthem — HMO: $35.01
  • Anthem — Indemnity: $40
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Metabolic panel total ca Not listed in the file Not listed in the file $6.75 – $261.33
Basic metabolic panel (blood test): rates for 2 insurance plans
  • Cigna — Commercial: $103.32
  • Cigna — LocalPlus: $92.99
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: CHG COMPREHENSIVE METABOLIC PANEL $120 $78.48 $6.04 – $139.17
Comprehensive metabolic panel (blood test): 10 of 96 insurance plan rates
  • 1199 — 1199: $12
  • Aetna — Commercial: $7.10
  • Aetna — Commercial Midlevels: $6.04
  • Aetna — Medicare: $10.56
  • Aetna — Medicare Midlevels: $10.56
  • Affinity — Essential Plan 3 & 4: $12.78
  • Affinity — Health Exchange Plan: $10
  • Affinity — Medicaid - Specialists: $10
  • Amida Care — Amida Care: $16.30
  • BCBC Empre Healthplus — Medicaid & HARP: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HC COMPREHEN METABOLIC PANEL $290 Not listed in the file $9 – $407.45
Comprehensive metabolic panel (blood test): 10 of 51 insurance plan rates
  • Aetna — ASA: $72.02
  • Aetna — Commercial: $64.42
  • Agewell — Medicare: $10.61
  • Anthem — Blue Access: $37.86
  • Anthem — Connection LG: $37.86
  • Anthem — Connection SG: $33.66
  • Anthem — EPO PPO: $42.11
  • Anthem — Exchange: $232
  • Anthem — HMO: $43.79
  • Anthem — Indemnity: $50.02
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehen metabolic panel Not listed in the file Not listed in the file $9 – $407.45
Comprehensive metabolic panel (blood test): rates for 2 insurance plans
  • Cigna — Commercial: $128.30
  • Cigna — LocalPlus: $115.46
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel Not listed in the file Not listed in the file $32.25 – $584.32
Obstetric blood test panel: 10 of 18 insurance plan rates
  • Aetna — ASA: $326.06
  • Aetna — Commercial: $291.64
  • Anthem — Blue Access: $145.42
  • Anthem — Connection LG: $145.42
  • Anthem — Connection SG: $129.32
  • Anthem — EPO PPO: $161.76
  • Anthem — HMO: $168.20
  • Anthem — Indemnity: $192.13
  • Anthem — SG EPO/PPO: $137.37
  • Christian Brothers — Christian Brothers: $326.06
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: CHG LIPID PANEL $146.87 $96.05 $6.04 – $139.17
Cholesterol panel (lipid panel): 10 of 90 insurance plan rates
  • 1199 — 1199: $19
  • Aetna — Commercial: $9.94
  • Aetna — Commercial Midlevels: $8.45
  • Aetna — Medicare: $13.39
  • Aetna — Medicare Midlevels: $13.39
  • Affinity — Essential Plan 3 & 4: $16.20
  • Affinity — Health Exchange Plan: $6.04
  • Affinity — Medicaid - Specialists: $6.04
  • Amida Care — Amida Care: $22.84
  • BCBC Empre Healthplus — Medicaid & HARP: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HC LIPID PANEL $206 Not listed in the file $6.10 – $289.43
Cholesterol panel (lipid panel): 10 of 51 insurance plan rates
  • Aetna — ASA: $91.32
  • Aetna — Commercial: $81.68
  • Agewell — Medicare: $6.41
  • Anthem — Blue Access: $58.52
  • Anthem — Connection LG: $58.52
  • Anthem — Connection SG: $52.04
  • Anthem — EPO PPO: $65.10
  • Anthem — Exchange: $164.80
  • Anthem — HMO: $67.69
  • Anthem — Indemnity: $77.32
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel Not listed in the file Not listed in the file $6.10 – $289.43
Cholesterol panel (lipid panel): rates for 2 insurance plans
  • Cigna — Commercial: $163.91
  • Cigna — LocalPlus: $147.51
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HC RENAL FUNCTION PANEL $104 Not listed in the file $8.68 – $146.12
Kidney function panel: 10 of 51 insurance plan rates
  • Aetna — ASA: $59.20
  • Aetna — Commercial: $52.95
  • Agewell — Medicare: $9.11
  • Anthem — Blue Access: $31.09
  • Anthem — Connection LG: $31.09
  • Anthem — Connection SG: $27.65
  • Anthem — EPO PPO: $34.59
  • Anthem — Exchange: $83.20
  • Anthem — HMO: $35.97
  • Anthem — Indemnity: $41.08
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel Not listed in the file Not listed in the file $8.68 – $146.12
Kidney function panel: rates for 2 insurance plans
  • Cigna — Commercial: $106.93
  • Cigna — LocalPlus: $96.23
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HC HEPATIC FUNCTION PANEL $136 Not listed in the file $7.32 – $191.08
Liver function panel: 10 of 51 insurance plan rates
  • Aetna — ASA: $55.72
  • Aetna — Commercial: $49.84
  • Agewell — Medicare: $7.69
  • Anthem — Blue Access: $29.26
  • Anthem — Connection LG: $29.26
  • Anthem — Connection SG: $26.02
  • Anthem — EPO PPO: $32.55
  • Anthem — Exchange: $108.80
  • Anthem — HMO: $33.85
  • Anthem — Indemnity: $38.66
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel Not listed in the file Not listed in the file $7.32 – $191.08
Liver function panel: rates for 2 insurance plans
  • Cigna — Commercial: $99.81
  • Cigna — LocalPlus: $89.82
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY $40 $26 $2 – $34.55
Urine test (automated, with microscope): 10 of 96 insurance plan rates
  • 1199 — 1199: $5
  • Aetna — Commercial: $2.35
  • Aetna — Commercial Midlevels: $2
  • Aetna — Medicare: $3.17
  • Aetna — Medicare Midlevels: $3.17
  • Affinity — Essential Plan 3 & 4: $3.84
  • Affinity — Health Exchange Plan: $4
  • Affinity — Medicaid - Specialists: $4
  • Amida Care — Amida Care: $5.40
  • BCBC Empre Healthplus — Medicaid & HARP: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HC URINALYSIS AUTO W SCOPE $114 Not listed in the file $3.17 – $160.17
Urine test (automated, with microscope): 10 of 51 insurance plan rates
  • Aetna — ASA: $21.62
  • Aetna — Commercial: $19.34
  • Agewell — Medicare: $3.33
  • Anthem — Blue Access: $11.31
  • Anthem — Connection LG: $11.31
  • Anthem — Connection SG: $10.06
  • Anthem — EPO PPO: $12.58
  • Anthem — Exchange: $91.20
  • Anthem — HMO: $13.08
  • Anthem — Indemnity: $14.95
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis auto w scope Not listed in the file Not listed in the file $3.17 – $160.17
Urine test (automated, with microscope): rates for 2 insurance plans
  • Cigna — Commercial: $39.22
  • Cigna — LocalPlus: $35.29
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $27 $17.55 $1.62 – $20.78
Urine test (manual, without microscope): 10 of 96 insurance plan rates
  • 1199 — 1199: $4
  • Aetna — Commercial: $1.90
  • Aetna — Commercial Midlevels: $1.62
  • Aetna — Medicare: $3.48
  • Aetna — Medicare Midlevels: $3.48
  • Affinity — Essential Plan 3 & 4: $4.21
  • Affinity — Health Exchange Plan: $2
  • Affinity — Medicaid - Specialists: $2
  • Amida Care — Amida Care: $4.36
  • BCBC Empre Healthplus — Medicaid & HARP: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HC URINALYSIS NONAUTO W O SCOPE $56 Not listed in the file $2.02 – $78.68
Urine test (manual, without microscope): 10 of 51 insurance plan rates
  • Aetna — ASA: $23.73
  • Aetna — Commercial: $21.23
  • Agewell — Medicare: $2.12
  • Anthem — Blue Access: $9.16
  • Anthem — Connection LG: $9.16
  • Anthem — Connection SG: $8.15
  • Anthem — EPO PPO: $10.19
  • Anthem — Exchange: $44.80
  • Anthem — HMO: $10.60
  • Anthem — Indemnity: $12.11
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis nonauto w o scope Not listed in the file Not listed in the file $2.02 – $78.68
Urine test (manual, without microscope): rates for 2 insurance plans
  • Cigna — Commercial: $35.61
  • Cigna — LocalPlus: $32.05
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY $23.96 $15.57 $1.42 – $18.70
Urine test (automated, without microscope): 10 of 96 insurance plan rates
  • 1199 — 1199: $4
  • Aetna — Commercial: $1.67
  • Aetna — Commercial Midlevels: $1.42
  • Aetna — Medicare: $2.25
  • Aetna — Medicare Midlevels: $2.25
  • Affinity — Essential Plan 3 & 4: $2.72
  • Affinity — Health Exchange Plan: $2
  • Affinity — Medicaid - Specialists: $2
  • Amida Care — Amida Care: $3.83
  • BCBC Empre Healthplus — Medicaid & HARP: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HC URINALYSIS AUTO W O SCOPE $92 Not listed in the file $2.02 – $129.26
Urine test (automated, without microscope): 10 of 51 insurance plan rates
  • Aetna — ASA: $15.35
  • Aetna — Commercial: $13.73
  • Agewell — Medicare: $2.12
  • Anthem — Blue Access: $8.03
  • Anthem — Connection LG: $8.03
  • Anthem — Connection SG: $7.14
  • Anthem — EPO PPO: $8.93
  • Anthem — Exchange: $73.60
  • Anthem — HMO: $9.28
  • Anthem — Indemnity: $10.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis auto w o scope Not listed in the file Not listed in the file $2.02 – $129.26
Urine test (automated, without microscope): rates for 2 insurance plans
  • Cigna — Commercial: $28.49
  • Cigna — LocalPlus: $25.64
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL $141.60 $92.61 $11.61 – $149.04
PSA (prostate specific antigen) blood test: 10 of 90 insurance plan rates
  • 1199 — 1199: $26
  • Aetna — Commercial: $13.66
  • Aetna — Commercial Midlevels: $11.61
  • Aetna — Medicare: $18.39
  • Aetna — Medicare Midlevels: $18.39
  • Affinity — Essential Plan 3 & 4: $22.25
  • Affinity — Health Exchange Plan: $24.35
  • Affinity — Medicaid - Specialists: $24.35
  • Amida Care — Amida Care: $31.35
  • BCBC Empre Healthplus — Medicaid & HARP: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HC TOTAL PROSTATE SPEC ANTIGEN $258 Not listed in the file $18.39 – $362.49
PSA (prostate specific antigen) blood test: 10 of 51 insurance plan rates
  • Aetna — ASA: $125.42
  • Aetna — Commercial: $112.18
  • Agewell — Medicare: $19.31
  • Anthem — Blue Access: $65.85
  • Anthem — Connection LG: $65.85
  • Anthem — Connection SG: $58.56
  • Anthem — EPO PPO: $73.25
  • Anthem — Exchange: $206.40
  • Anthem — HMO: $76.17
  • Anthem — Indemnity: $87.01
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Assay of psa total Not listed in the file Not listed in the file $18.39 – $362.49
PSA (prostate specific antigen) blood test: rates for 2 insurance plans
  • Cigna — Commercial: $224.50
  • Cigna — LocalPlus: $202.04
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: CHG ASSAY OF THYROID STIMULATING HORMONE TSH $241 $157.61 $9 – $144.60
Thyroid stimulating hormone (TSH) test: 10 of 96 insurance plan rates
  • 1199 — 1199: $24
  • Aetna — Commercial: $12.48
  • Aetna — Commercial Midlevels: $10.61
  • Aetna — Medicare: $16.80
  • Aetna — Medicare Midlevels: $16.80
  • Affinity — Essential Plan 3 & 4: $20.33
  • Affinity — Health Exchange Plan: $9
  • Affinity — Medicaid - Specialists: $9
  • Amida Care — Amida Care: $28.63
  • BCBC Empre Healthplus — Medicaid & HARP: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HC ASSAY THYROID STIM HORMONE $250 Not listed in the file $9.09 – $351.25
Thyroid stimulating hormone (TSH) test: 10 of 51 insurance plan rates
  • Aetna — ASA: $114.58
  • Aetna — Commercial: $102.48
  • Agewell — Medicare: $9.54
  • Anthem — Blue Access: $60.17
  • Anthem — Connection LG: $60.17
  • Anthem — Connection SG: $53.50
  • Anthem — EPO PPO: $66.93
  • Anthem — Exchange: $200
  • Anthem — HMO: $69.59
  • Anthem — Indemnity: $79.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Assay thyroid stim hormone Not listed in the file Not listed in the file $9.09 – $351.25
Thyroid stimulating hormone (TSH) test: rates for 2 insurance plans
  • Cigna — Commercial: $206.65
  • Cigna — LocalPlus: $185.98
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $100 $65.40 $3.17 – $98.70
Complete blood count (CBC) with differential: 10 of 90 insurance plan rates
  • 1199 — 1199: $11
  • Aetna — Commercial: $5.77
  • Aetna — Commercial Midlevels: $4.90
  • Aetna — Medicare: $7.77
  • Aetna — Medicare Midlevels: $7.77
  • Affinity — Essential Plan 3 & 4: $9.40
  • Affinity — Health Exchange Plan: $3.17
  • Affinity — Medicaid - Specialists: $3.17
  • Amida Care — Amida Care: $13.25
  • BCBC Empre Healthplus — Medicaid & HARP: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HC COMPLETE CBC W AUTO DIFF WBC $128 Not listed in the file $3.20 – $179.84
Complete blood count (CBC) with differential: 10 of 51 insurance plan rates
  • Aetna — ASA: $52.99
  • Aetna — Commercial: $47.40
  • Agewell — Medicare: $3.36
  • Anthem — Blue Access: $27.87
  • Anthem — Connection LG: $27.87
  • Anthem — Connection SG: $24.78
  • Anthem — EPO PPO: $31
  • Anthem — Exchange: $102.40
  • Anthem — HMO: $32.24
  • Anthem — Indemnity: $36.82
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Complete cbc w auto diff wbc Not listed in the file Not listed in the file $3.20 – $179.84
Complete blood count (CBC) with differential: rates for 2 insurance plans
  • Cigna — Commercial: $96.20
  • Cigna — LocalPlus: $86.58
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: CHG BLOOD COUNT COMPLETE AUTOMATED $90 $58.86 $3.17 – $88.83
Complete blood count (CBC), automated: 10 of 90 insurance plan rates
  • 1199 — 1199: $9
  • Aetna — Commercial: $4.32
  • Aetna — Commercial Midlevels: $3.67
  • Aetna — Medicare: $6.47
  • Aetna — Medicare Midlevels: $6.47
  • Affinity — Essential Plan 3 & 4: $7.83
  • Affinity — Health Exchange Plan: $3.17
  • Affinity — Medicaid - Specialists: $3.17
  • Amida Care — Amida Care: $9.91
  • BCBC Empre Healthplus — Medicaid & HARP: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: BLOOD COUNT COMPLETE CBC AUTOMATED Not listed in the file Not listed in the file $3.20 – $78.35
Complete blood count (CBC), automated: 10 of 31 insurance plan rates
  • Agewell — Medicare: $3.36
  • CentersPlan — Medicare Advan I SNP: $3.52
  • Emblem — Essential Plan 1 & 2: $3.84
  • Emblem — Essential Plan 3 & 4: $3.20
  • Emblem — Select Care: $3.84
  • Fidelis — Child Health Plus: $3.20
  • Fidelis — Essential Plan 1 & 2: $3.84
  • Fidelis — Essential Plan 3 & 4: $3.20
  • Fidelis — HARP: $3.20
  • Fidelis — Medicaid: $3.20
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Complete cbc automated Not listed in the file Not listed in the file $3.20 – $78.35
Complete blood count (CBC), automated: 10 of 18 insurance plan rates
  • Aetna — ASA: $44.13
  • Aetna — Commercial: $39.47
  • Anthem — Blue Access: $23.19
  • Anthem — Connection LG: $23.19
  • Anthem — Connection SG: $20.63
  • Anthem — EPO PPO: $25.80
  • Anthem — HMO: $26.83
  • Anthem — Indemnity: $30.64
  • Anthem — SG EPO/PPO: $21.91
  • Christian Brothers — Christian Brothers: $44.13
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: CHG PROTHROMBIN TIME $40 $26.16 $2.48 – $31.17
Blood clotting time test (prothrombin time, PT): 10 of 96 insurance plan rates
  • 1199 — 1199: $6
  • Aetna — Commercial: $2.92
  • Aetna — Commercial Midlevels: $2.48
  • Aetna — Medicare: $4.29
  • Aetna — Medicare Midlevels: $4.29
  • Affinity — Essential Plan 3 & 4: $5.19
  • Affinity — Health Exchange Plan: $3.91
  • Affinity — Medicaid - Specialists: $3.91
  • Amida Care — Amida Care: $6.70
  • BCBC Empre Healthplus — Medicaid & HARP: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HC PROTHROMBIN TIME FOR LAB $99 Not listed in the file $3.95 – $139.09
Blood clotting time test (prothrombin time, PT): 10 of 51 insurance plan rates
  • Aetna — ASA: $29.26
  • Aetna — Commercial: $26.17
  • Agewell — Medicare: $4.15
  • Anthem — Blue Access: $14.03
  • Anthem — Connection LG: $14.03
  • Anthem — Connection SG: $12.48
  • Anthem — EPO PPO: $15.61
  • Anthem — Exchange: $79.20
  • Anthem — HMO: $16.23
  • Anthem — Indemnity: $18.54
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time Not listed in the file Not listed in the file $3.95 – $139.09
Blood clotting time test (prothrombin time, PT): rates for 2 insurance plans
  • Cigna — Commercial: $46.34
  • Cigna — LocalPlus: $41.70
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HC THROMBOPLASTIN TIME PART PTT PLASMA WHLE BLD $132 Not listed in the file $6.01 – $185.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 51 insurance plan rates
  • Aetna — ASA: $40.99
  • Aetna — Commercial: $36.66
  • Agewell — Medicare: $6.31
  • Anthem — Blue Access: $21.49
  • Anthem — Connection LG: $21.49
  • Anthem — Connection SG: $19.11
  • Anthem — EPO PPO: $23.90
  • Anthem — Exchange: $105.60
  • Anthem — HMO: $24.85
  • Anthem — Indemnity: $28.39
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time partial Not listed in the file Not listed in the file $6.01 – $185.46
Blood clotting test (partial thromboplastin time, PTT): rates for 2 insurance plans
  • Cigna — Commercial: $74.83
  • Cigna — LocalPlus: $67.34

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL $1,870 $1,222.98 $35.17 – $1,122
CT scan of the head or brain, without contrast: 10 of 88 insurance plan rates
  • 1199 — 1199: $54
  • Aetna — Medicare: $123.59
  • Aetna — Medicare Midlevels: $37.22
  • Affinity — Essential Plan 3 & 4: $52.99
  • Affinity — Health Exchange Plan: $63.11
  • Affinity — Medicaid - Specialists: $46.09
  • Amida Care — Amida Care: $56.39
  • BCBC Empre Healthplus — Medicaid & HARP: $43.79
  • BCBS — Medicare: $43.12
  • BCBS — Medicare Midlevels: $36.65
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: HC CT HEAD BRAIN W O DYE $2,295 Not listed in the file $110.93 – $15,973.20
CT scan of the head or brain, without contrast: 10 of 55 insurance plan rates
  • Aetna — ASA: $607.67
  • Aetna — Commercial: $543.09
  • Aetna — Medicare: $129.20
  • Agewell — Medicare: $137.03
  • Anthem — Exchange: $1,836
  • Anthem — Medicare: $130.50
  • Anthem — WPH Employees: $918
  • Centerlight — Medicare: $134.42
  • Centerlight — PACE: $134.42
  • CentersPlan — Medicare Advan I SNP: $143.55
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Ct head brain w o dye Not listed in the file Not listed in the file $110.93 – $15,973.20
CT scan of the head or brain, without contrast: rates for 4 insurance plans
  • Cigna — Commercial: $738.34
  • Cigna — LocalPlus: $664.50
  • Emblem — HIP HMO: $536.36
  • UHC — Compass: $695
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $8,555 $5,594.97 $95.21 – $5,133
MRI of the brain, before and after contrast: 10 of 96 insurance plan rates
  • 1199 — 1199: $150
  • Aetna — Commercial: $1,877.88
  • Aetna — Commercial Midlevels: $1,596.20
  • Aetna — Medicare: $370.58
  • Aetna — Medicare Midlevels: $100.94
  • Affinity — Essential Plan 3 & 4: $143.69
  • Affinity — Health Exchange Plan: $176.60
  • Affinity — Medicaid - Specialists: $127.64
  • Amida Care — Amida Care: $156.31
  • BCBC Empre Healthplus — Medicaid & HARP: $118.75
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HC MRI BRAIN STEM W O W DYE $6,526.50 Not listed in the file $333.52 – $45,424.44
MRI of the brain, before and after contrast: 10 of 55 insurance plan rates
  • Aetna — ASA: $1,917.81
  • Aetna — Commercial: $1,713.99
  • Aetna — Medicare: $431.14
  • Agewell — Medicare: $457.26
  • Anthem — Exchange: $5,221.20
  • Anthem — Medicare: $435.49
  • Anthem — WPH Employees: $2,610.60
  • Centerlight — Medicare: $448.55
  • Centerlight — PACE: $448.55
  • CentersPlan — Medicare Advan I SNP: $479.04
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Mri brain stem w o w dye Not listed in the file Not listed in the file $333.52 – $45,424.44
MRI of the brain, before and after contrast: rates for 4 insurance plans
  • Cigna — Commercial: $2,659.65
  • Cigna — LocalPlus: $2,393.68
  • Emblem — HIP HMO: $1,789.86
  • UHC — Compass: $695
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS $220 $143.88 $9.15 – $132
Chest X-ray, 2 views: 10 of 93 insurance plan rates
  • 1199 — 1199: $12
  • Aetna — Commercial: $189
  • Aetna — Commercial Midlevels: $160.65
  • Aetna — Medicare: $38.70
  • Aetna — Medicare Midlevels: $9.61
  • Affinity — Essential Plan 3 & 4: $13.67
  • Affinity — Health Exchange Plan: $17.49
  • Affinity — Medicaid - Specialists: $12.49
  • Amida Care — Amida Care: $14.77
  • BCBC Empre Healthplus — Medicaid & HARP: $11.30
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HC X RAY EXAM CHEST 2 VIEWS $903 Not listed in the file $15.15 – $6,284.88
Chest X-ray, 2 views: 10 of 53 insurance plan rates
  • Aetna — ASA: $207.83
  • Aetna — Commercial: $185.74
  • Aetna — Medicare: $107.54
  • Agewell — Medicare: $114.06
  • Anthem — Medicare: $108.63
  • Centerlight — Medicare: $111.89
  • Centerlight — PACE: $111.89
  • CentersPlan — Medicare Advan I SNP: $119.49
  • Christian Brothers — Christian Brothers: $207.83
  • Emblem — Essential Plan 1 & 2: $18.18
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: X ray exam chest 2 views Not listed in the file Not listed in the file $15.15 – $6,284.88
Chest X-ray, 2 views: rates for 3 insurance plans
  • Cigna — Commercial: $196.75
  • Cigna — LocalPlus: $177.07
  • Emblem — HIP HMO: $446.47
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $330 $215.82 $10.90 – $198
X-ray of the lower spine, at least 4 views: 10 of 88 insurance plan rates
  • 1199 — 1199: $20
  • Aetna — Medicare: $59.88
  • Aetna — Medicare Midlevels: $11.76
  • Affinity — Essential Plan 3 & 4: $16.75
  • Affinity — Health Exchange Plan: $24.47
  • Affinity — Medicaid - Specialists: $16.69
  • Amida Care — Amida Care: $20.48
  • BCBC Empre Healthplus — Medicaid & HARP: $13.84
  • BCBS — Medicare: $13.64
  • BCBS — Medicare Midlevels: $11.59
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HC X RAY EXAM L 2 SPINE 4 VWS $989 Not listed in the file $30.30 – $1,557.68
X-ray of the lower spine, at least 4 views: 10 of 52 insurance plan rates
  • Aetna — ASA: $350
  • Aetna — Commercial: $312.80
  • Aetna — Medicare: $129.20
  • Agewell — Medicare: $137.03
  • Anthem — Medicare: $130.50
  • Centerlight — Medicare: $134.42
  • Centerlight — PACE: $134.42
  • CentersPlan — Medicare Advan I SNP: $143.55
  • Christian Brothers — Christian Brothers: $350
  • Emblem — Essential Plan 1 & 2: $36.36
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: X ray exam l 2 spine 4 vws Not listed in the file Not listed in the file $30.30 – $1,557.68
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • Cigna — Commercial: $332.17
  • Cigna — LocalPlus: $298.95
  • Emblem — HIP HMO: $536.36
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $3,005 $1,965.27 $61.78 – $1,803
MRI of the lower back (lumbar spine), without contrast: 10 of 88 insurance plan rates
  • 1199 — 1199: $94
  • Aetna — Medicare: $221.51
  • Aetna — Medicare Midlevels: $64.83
  • Affinity — Essential Plan 3 & 4: $92.29
  • Affinity — Health Exchange Plan: $111.99
  • Affinity — Medicaid - Specialists: $81.02
  • Amida Care — Amida Care: $99.13
  • BCBC Empre Healthplus — Medicaid & HARP: $76.27
  • BCBS — Medicare: $75.10
  • BCBS — Medicare Midlevels: $63.84
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HC MRI LUMBAR SPINE W O DYE $4,218 Not listed in the file $199.36 – $29,357.28
MRI of the lower back (lumbar spine), without contrast: 10 of 55 insurance plan rates
  • Aetna — ASA: $1,105.79
  • Aetna — Commercial: $988.27
  • Aetna — Medicare: $294.86
  • Agewell — Medicare: $312.73
  • Anthem — Exchange: $3,374.40
  • Anthem — Medicare: $297.84
  • Anthem — WPH Employees: $1,687.20
  • Centerlight — Medicare: $306.78
  • Centerlight — PACE: $306.78
  • CentersPlan — Medicare Advan I SNP: $327.62
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Mri lumbar spine w o dye Not listed in the file Not listed in the file $199.36 – $29,357.28
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans
  • Cigna — Commercial: $1,515.15
  • Cigna — LocalPlus: $1,363.63
  • Emblem — HIP HMO: $1,224.12
  • UHC — Compass: $695
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CHG CT PELVIS W/CONTRAST MATERIAL $1,457.36 $953.11 $48.07 – $874.42
CT scan of the pelvis, with contrast: 10 of 94 insurance plan rates
  • 1199 — 1199: $73
  • Aetna — Medicare: $264.37
  • Aetna — Medicare Midlevels: $50.45
  • Affinity — Essential Plan 3 & 4: $71.81
  • Affinity — Health Exchange Plan: $87.01
  • Affinity — Medicaid - Specialists: $62.78
  • Amida Care — Amida Care: $76.87
  • BCBC Empre Healthplus — Medicaid & HARP: $59.35
  • BCBS — Blue Access: $306.96
  • BCBS — Blue Access Midlevels: $260.92
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HC CT PELVIS W DYE $3,132 Not listed in the file $171.70 – $21,798.72
CT scan of the pelvis, with contrast: 10 of 53 insurance plan rates
  • Aetna — ASA: $1,561.94
  • Aetna — Commercial: $1,395.94
  • Aetna — Medicare: $216.76
  • Agewell — Medicare: $229.90
  • Anthem — Medicare: $218.95
  • Centerlight — Medicare: $225.52
  • Centerlight — PACE: $225.52
  • CentersPlan — Medicare Advan I SNP: $240.85
  • Christian Brothers — Christian Brothers: $1,561.94
  • Emblem — Essential Plan 1 & 2: $206.04
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Ct pelvis w dye Not listed in the file Not listed in the file $171.70 – $21,798.72
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • Cigna — Commercial: $1,686.18
  • Cigna — LocalPlus: $1,517.56
  • Emblem — HIP HMO: $899.88
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $2,450.13 $1,602.39 $56.39 – $1,470.08
MRI of a leg joint (such as the knee), without contrast: 10 of 88 insurance plan rates
  • 1199 — 1199: $80
  • Aetna — Medicare: $236.44
  • Aetna — Medicare Midlevels: $59.18
  • Affinity — Essential Plan 3 & 4: $84.24
  • Affinity — Health Exchange Plan: $103.75
  • Affinity — Medicaid - Specialists: $73.14
  • Amida Care — Amida Care: $89.54
  • BCBC Empre Healthplus — Medicaid & HARP: $69.62
  • BCBS — Medicare: $68.58
  • BCBS — Medicare Midlevels: $58.29
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HC MRI JNT OF LWR EXTRE W O DYE $3,847.50 Not listed in the file $212.80 – $26,778.60
MRI of a leg joint (such as the knee), without contrast: 10 of 55 insurance plan rates
  • Aetna — ASA: $1,269.16
  • Aetna — Commercial: $1,134.27
  • Aetna — Medicare: $294.86
  • Agewell — Medicare: $312.73
  • Anthem — Exchange: $3,078
  • Anthem — Medicare: $297.84
  • Anthem — WPH Employees: $1,539
  • Centerlight — Medicare: $306.78
  • Centerlight — PACE: $306.78
  • CentersPlan — Medicare Advan I SNP: $327.62
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Mri jnt of lwr extre w o dye Not listed in the file Not listed in the file $212.80 – $26,778.60
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans
  • Cigna — Commercial: $1,708.29
  • Cigna — LocalPlus: $1,537.46
  • Emblem — HIP HMO: $1,224.12
  • UHC — Compass: $695
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $2,300 $1,504.20 $76.04 – $1,380
CT scan of the abdomen and pelvis, with contrast: 10 of 94 insurance plan rates
  • 1199 — 1199: $99.21
  • Aetna — Medicare: $351.53
  • Aetna — Medicare Midlevels: $80.33
  • Affinity — Essential Plan 3 & 4: $114.35
  • Affinity — Health Exchange Plan: $135.90
  • Affinity — Medicaid - Specialists: $99.43
  • Amida Care — Amida Care: $119.05
  • BCBC Empre Healthplus — Medicaid & HARP: $94.50
  • BCBS — Blue Access: $458.15
  • BCBS — Blue Access Midlevels: $389.43
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HC CT ABD PELV W CONTRAST $4,914 Not listed in the file $109.01 – $34,201.44
CT scan of the abdomen and pelvis, with contrast: 10 of 55 insurance plan rates
  • Aetna — ASA: $1,958.88
  • Aetna — Commercial: $1,750.69
  • Aetna — Medicare: $431.14
  • Agewell — Medicare: $457.26
  • Anthem — Exchange: $3,931.20
  • Anthem — Medicare: $435.49
  • Anthem — WPH Employees: $1,965.60
  • Centerlight — Medicare: $448.55
  • Centerlight — PACE: $448.55
  • CentersPlan — Medicare Advan I SNP: $479.04
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Ct abd pelvis w contrast Not listed in the file Not listed in the file $109.01 – $34,201.44
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans
  • Cigna — Commercial: $2,217.04
  • Cigna — LocalPlus: $1,995.33
  • Emblem — HIP HMO: $1,789.86
  • UHC — Compass: $695
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $1,040 $680.16 $33.72 – $624
Ultrasound of the abdomen, complete: 10 of 88 insurance plan rates
  • 1199 — 1199: $52
  • Aetna — Medicare: $132.15
  • Aetna — Medicare Midlevels: $35.39
  • Affinity — Essential Plan 3 & 4: $50.37
  • Affinity — Health Exchange Plan: $60.54
  • Affinity — Medicaid - Specialists: $44.41
  • Amida Care — Amida Care: $54.31
  • BCBC Empre Healthplus — Medicaid & HARP: $41.63
  • BCBS — Medicare: $40.98
  • BCBS — Medicare Midlevels: $34.83
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HC US EXAM ABDOM COMPLETE $1,357 Not listed in the file $60.60 – $9,444.72
Ultrasound of the abdomen, complete: 10 of 55 insurance plan rates
  • Aetna — ASA: $688.07
  • Aetna — Commercial: $614.94
  • Aetna — Medicare: $129.20
  • Agewell — Medicare: $137.03
  • Anthem — Exchange: $1,085.60
  • Anthem — Medicare: $130.50
  • Anthem — WPH Employees: $542.80
  • Centerlight — Medicare: $134.42
  • Centerlight — PACE: $134.42
  • CentersPlan — Medicare Advan I SNP: $143.55
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Us exam abdom complete Not listed in the file Not listed in the file $60.60 – $9,444.72
Ultrasound of the abdomen, complete: rates for 4 insurance plans
  • Cigna — Commercial: $834.54
  • Cigna — LocalPlus: $751.08
  • Emblem — HIP HMO: $536.36
  • UHC — Compass: $695
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $1,130 $739.02 $41.58 – $678
Pregnancy ultrasound (after the first trimester): 10 of 96 insurance plan rates
  • 1199 — 1199: $63
  • Aetna — Commercial: $755.57
  • Aetna — Commercial Midlevels: $642.23
  • Aetna — Medicare: $153.10
  • Aetna — Medicare Midlevels: $43.63
  • Affinity — Essential Plan 3 & 4: $62.11
  • Affinity — Health Exchange Plan: $74.62
  • Affinity — Medicaid - Specialists: $54.19
  • Amida Care — Amida Care: $66.39
  • BCBC Empre Healthplus — Medicaid & HARP: $51.33
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HC OB US 14 WKS SNGL FETUS $943 Not listed in the file $55.55 – $6,563.28
Pregnancy ultrasound (after the first trimester): 10 of 55 insurance plan rates
  • Aetna — ASA: $774.01
  • Aetna — Commercial: $691.75
  • Aetna — Medicare: $129.20
  • Agewell — Medicare: $137.03
  • Anthem — Exchange: $754.40
  • Anthem — Medicare: $130.50
  • Anthem — WPH Employees: $377.20
  • Centerlight — Medicare: $134.42
  • Centerlight — PACE: $134.42
  • CentersPlan — Medicare Advan I SNP: $143.55
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ob us 14 wks sngl fetus Not listed in the file Not listed in the file $55.55 – $6,563.28
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans
  • Cigna — Commercial: $934.34
  • Cigna — LocalPlus: $840.90
  • Emblem — HIP HMO: $536.36
  • UHC — Compass: $695
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: CHG US TRANSVAGINAL $885 $578.79 $28.93 – $531
Transvaginal ultrasound: 10 of 96 insurance plan rates
  • 1199 — 1199: $45
  • Aetna — Commercial: $680.04
  • Aetna — Commercial Midlevels: $578.03
  • Aetna — Medicare: $135.16
  • Aetna — Medicare Midlevels: $30.36
  • Affinity — Essential Plan 3 & 4: $43.22
  • Affinity — Health Exchange Plan: $52.12
  • Affinity — Medicaid - Specialists: $37.41
  • Amida Care — Amida Care: $45.81
  • BCBC Empre Healthplus — Medicaid & HARP: $35.72
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HC TRANSVAGINAL US NON OB $1,454 Not listed in the file $58.50 – $10,119.84
Transvaginal ultrasound: 10 of 55 insurance plan rates
  • Aetna — ASA: $756.21
  • Aetna — Commercial: $675.84
  • Aetna — Medicare: $129.20
  • Agewell — Medicare: $137.03
  • Anthem — Exchange: $1,163.20
  • Anthem — Medicare: $130.50
  • Anthem — WPH Employees: $581.60
  • Centerlight — Medicare: $134.42
  • Centerlight — PACE: $134.42
  • CentersPlan — Medicare Advan I SNP: $143.55
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Transvaginal us non ob Not listed in the file Not listed in the file $58.50 – $10,119.84
Transvaginal ultrasound: rates for 4 insurance plans
  • Cigna — Commercial: $888
  • Cigna — LocalPlus: $799.20
  • Emblem — HIP HMO: $536.36
  • UHC — Compass: $695
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $780 $510.12 $33.72 – $726.44
Diagnostic mammogram, one breast: 10 of 87 insurance plan rates
  • 1199 — 1199: $44
  • Aetna — Commercial: $726.44
  • Aetna — Commercial Midlevels: $178.59
  • Aetna — Medicare: $144.18
  • Aetna — Medicare Midlevels: $35.39
  • Affinity — Essential Plan 3 & 4: $50.37
  • Affinity — Health Exchange Plan: $63.13
  • Affinity — Medicaid - Specialists: $45.09
  • Amida Care — Amida Care: $52.98
  • BCBC Empre Healthplus — Medicaid & HARP: $41.63
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: HC DX MAMMO INCL CAD UNI $913 Not listed in the file $84 – $6,354.48
Diagnostic mammogram, one breast: 10 of 31 insurance plan rates
  • Aetna — ASA: $779.89
  • Aetna — Commercial: $697.01
  • Anthem — Exchange: $730.40
  • Anthem — WPH Employees: $365.20
  • Christian Brothers — Christian Brothers: $779.89
  • Emblem — Essential Plan 1 & 2: $117.56
  • Emblem — Essential Plan 3 & 4: $97.97
  • Emblem — GHI Commercial: $730.40
  • Emblem — HIP Commerical EPO PPO: $6,354.48
  • Emblem — Medicaid FHP CHP: $97.97
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $84 – $6,354.48
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • Cigna — Commercial: $952.10
  • Cigna — LocalPlus: $856.89
  • UHC — Compass: $695
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: HC DX MAMMO INCL CAD BI $1,178 Not listed in the file $97.97 – $8,198.88
Diagnostic mammogram, both breasts: 10 of 31 insurance plan rates
  • Aetna — ASA: $993.19
  • Aetna — Commercial: $887.63
  • Anthem — Exchange: $942.40
  • Anthem — WPH Employees: $471.20
  • Christian Brothers — Christian Brothers: $993.19
  • Emblem — Essential Plan 1 & 2: $117.56
  • Emblem — Essential Plan 3 & 4: $97.97
  • Emblem — GHI Commercial: $942.40
  • Emblem — HIP Commerical EPO PPO: $8,198.88
  • Emblem — Medicaid FHP CHP: $97.97
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $97.97 – $8,198.88
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • Cigna — Commercial: $1,215.82
  • Cigna — LocalPlus: $1,094.23
  • UHC — Compass: $695
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier 26 In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $500 $327 $41.23 – $450.76
Diagnostic mammogram, both breasts: 10 of 87 insurance plan rates
  • 1199 — 1199: $55
  • Aetna — Commercial: $260.07
  • Aetna — Commercial Midlevels: $221.06
  • Aetna — Medicare: $50.90
  • Aetna — Medicare Midlevels: $43.27
  • Affinity — Essential Plan 3 & 4: $61.59
  • Affinity — Health Exchange Plan: $78.44
  • Affinity — Medicaid - Specialists: $56.03
  • Amida Care — Amida Care: $65.86
  • BCBC Empre Healthplus — Medicaid & HARP: $50.90
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $1,125 $735.75 $32.01 – $741.60
Screening mammogram, both breasts: 10 of 93 insurance plan rates
  • 1199 — 1199: $42
  • Aetna — Commercial: $741.60
  • Aetna — Commercial Midlevels: $168.15
  • Aetna — Medicare: $147.27
  • Aetna — Medicare Midlevels: $33.59
  • Affinity — Essential Plan 3 & 4: $47.82
  • Affinity — Health Exchange Plan: $59.42
  • Affinity — Medicaid - Specialists: $42.44
  • Amida Care — Amida Care: $49.98
  • BCBC Empre Healthplus — Medicaid & HARP: $39.52
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: HC SCR MAMMO BI INCL CAD $906 Not listed in the file $88.50 – $6,305.76
Screening mammogram, both breasts: 10 of 31 insurance plan rates
  • Aetna — ASA: $820.96
  • Aetna — Commercial: $733.71
  • Anthem — Exchange: $724.80
  • Anthem — WPH Employees: $362.40
  • Christian Brothers — Christian Brothers: $820.96
  • Emblem — Essential Plan 1 & 2: $117.56
  • Emblem — Essential Plan 3 & 4: $97.97
  • Emblem — GHI Commercial: $724.80
  • Emblem — HIP Commerical EPO PPO: $6,305.76
  • Emblem — Medicaid FHP CHP: $97.97
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $88.50 – $6,305.76
Screening mammogram, both breasts: rates for 3 insurance plans
  • Cigna — Commercial: $1,005.57
  • Cigna — LocalPlus: $905.01
  • UHC — Compass: $695

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $305 $198.25 $16.41
Electrocardiogram (ECG/EKG) with reading: 10 of 96 insurance plan rates
  • 1199 — 1199: $32
  • Aetna — Commercial: $59.67
  • Aetna — Commercial Midlevels: $50.72
  • Aetna — Medicare: $16.41
  • Aetna — Medicare Midlevels: $13.95
  • Affinity — Essential Plan 3 & 4: $19.86
  • Affinity — Health Exchange Plan: $30.07
  • Affinity — Medicaid - Specialists: $30.83
  • Amida Care — Amida Care: $37.69
  • BCBC Empre Healthplus — Medicaid & HARP: $16.41
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram complete Not listed in the file Not listed in the file $15.15 – $146
Electrocardiogram (ECG/EKG) with reading: 10 of 12 insurance plan rates
  • Aetna — ASA: $125.52
  • Aetna — Commercial: $112.18
  • Christian Brothers — Christian Brothers: $125.52
  • Emblem — HIP Commerical EPO PPO: $146
  • Emblem — HIP HMO: $87
  • MetroPlus — Default Duals: $16.41
  • MetroPlus — Exchange Products: $21.33
  • MetroPlus — Medicaid Advantage Plus: $16.41
  • MetroPlus — Medicare: $16.41
  • Nat Assoc Letter Carriers — Nat Assoc Letter Carriers: $125.52
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: ELECTROCARDIOGRAM ROUTINE ECG WITH AT L Not listed in the file Not listed in the file $15.15 – $146
Electrocardiogram (ECG/EKG) with reading: 10 of 12 insurance plan rates
  • Emblem — Essential Plan 1 & 2: $18.18
  • Emblem — Essential Plan 3 & 4: $15.15
  • Emblem — Medicaid FHP CHP: $15.15
  • Fidelis — Child Health Plus: $15.15
  • Fidelis — Essential Plan 1 & 2: $18.18
  • Fidelis — Essential Plan 3 & 4: $15.15
  • Fidelis — HARP: $15.15
  • Fidelis — Medicaid: $15.15
  • HealthFirst — Child Health Plus: $15.15
  • HealthFirst — Medicaid HARP: $15.15
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $4,792.04 $3,133.99 $216.17 – $4,159.40
Left heart catheterization (diagnostic): 10 of 96 insurance plan rates
  • 1199 — 1199: $292
  • Aetna — Commercial: $4,159.40
  • Aetna — Commercial Midlevels: $911.19
  • Aetna — Medicare: $996.37
  • Aetna — Medicare Midlevels: $226.85
  • Affinity — Essential Plan 3 & 4: $322.92
  • Affinity — Health Exchange Plan: $410.55
  • Affinity — Medicaid - Specialists: $297.87
  • Amida Care — Amida Care: $350.27
  • BCBC Empre Healthplus — Medicaid & HARP: $266.88
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left hrt cath w ventrclgrphy Not listed in the file Not listed in the file $556.37 – $24,105
Left heart catheterization (diagnostic): 10 of 89 insurance plan rates
  • Aetna — ASA: $16,443
  • Aetna — Commercial: $14,700
  • Aetna — Medicare: $4,006.38
  • Agewell — Medicare: $4,249.19
  • Anthem — Blue Access: $17,539
  • Anthem — Child Health Plus: $4,132.24
  • Anthem — Connection LG: $17,539
  • Anthem — Connection SG: $15,590
  • Anthem — EPO PPO: $19,488
  • Anthem — Essential 1, 2, 3, 4: $4,648.77
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · modifier 26 In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $2,165 $3,133.99 $216.17 – $4,159.40
Left heart catheterization (diagnostic): 10 of 96 insurance plan rates
  • 1199 — 1199: $292
  • Aetna — Commercial: $1,071.98
  • Aetna — Commercial Midlevels: $911.19
  • Aetna — Medicare: $266.88
  • Aetna — Medicare Midlevels: $226.85
  • Affinity — Essential Plan 3 & 4: $322.92
  • Affinity — Health Exchange Plan: $410.55
  • Affinity — Medicaid - Specialists: $297.87
  • Amida Care — Amida Care: $350.27
  • BCBC Empre Healthplus — Medicaid & HARP: $266.88
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $3,771.54 $2,466.59 $350.57 – $3,066.51
Heart rhythm study (electrophysiology evaluation): 10 of 96 insurance plan rates
  • 1199 — 1199: $435
  • Aetna — Commercial: $659.29
  • Aetna — Commercial Midlevels: $1,492.62
  • Aetna — Medicare: $659.29
  • Aetna — Medicare Midlevels: $367.88
  • Affinity — Essential Plan 3 & 4: $523.69
  • Affinity — Health Exchange Plan: $638.92
  • Affinity — Medicaid - Specialists: $459.73
  • Amida Care — Amida Care: $560.96
  • BCBC Empre Healthplus — Medicaid & HARP: $432.80
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive ep evaluation Not listed in the file Not listed in the file $285.75 – $40,015.74
Heart rhythm study (electrophysiology evaluation): 10 of 46 insurance plan rates
  • Aetna — ASA: $29,950
  • Aetna — Commercial: $26,775
  • Aetna — Medicare: $9,638.83
  • Agewell — Medicare: $10,223
  • Anthem — Blue Access: $17,539
  • Anthem — Connection LG: $17,539
  • Anthem — Connection SG: $15,590
  • Anthem — EPO PPO: $19,488
  • Anthem — Exchange: $9,765
  • Anthem — HMO: $20,010
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Electrophysiology evaluation Not listed in the file Not listed in the file $285.75 – $40,015.74
Heart rhythm study (electrophysiology evaluation): 10 of 41 insurance plan rates
  • Anthem — Child Health Plus: $1,155.16
  • Anthem — Essential 1, 2, 3, 4: $1,299.56
  • Anthem — HARP: $577.58
  • Anthem — Medicaid: $577.58
  • Emblem — Essential Plan 1 & 2: $693.10
  • Emblem — Essential Plan 3 & 4: $577.58
  • Emblem — Medicaid FHP CHP: $577.58
  • Fidelis — Child Health Plus: $577.58
  • Fidelis — Essential Plan 1 & 2: $693.10
  • Fidelis — Essential Plan 3 & 4: $577.58
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION $16,170 $10,575.18 $573.30 – $14,696.43
Heart rhythm study with ablation for atrial fibrillation: 10 of 96 insurance plan rates
  • 1199 — 1199: $1,224
  • Aetna — Commercial: $5,205.29
  • Aetna — Commercial Midlevels: $4,424.52
  • Aetna — Medicare: $1,089.36
  • Aetna — Medicare Midlevels: $925.96
  • Affinity — Essential Plan 3 & 4: $1,318.13
  • Affinity — Health Exchange Plan: $1,755.66
  • Affinity — Medicaid - Specialists: $1,254.04
  • Amida Care — Amida Care: $1,469.09
  • BCBC Empre Healthplus — Medicaid & HARP: $1,089.36
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Compre ep eval abltj atr fib Not listed in the file Not listed in the file $878.29 – $134,098.90
Heart rhythm study with ablation for atrial fibrillation: 10 of 87 insurance plan rates
  • Aetna — ASA: $29,950
  • Aetna — Commercial: $26,775
  • Aetna — Medicare: $32,301.20
  • Agewell — Medicare: $34,258.84
  • Anthem — Blue Access: $17,539
  • Anthem — Child Health Plus: $2,116.36
  • Anthem — Connection LG: $17,539
  • Anthem — Connection SG: $15,590
  • Anthem — EPO PPO: $19,488
  • Anthem — Essential 1, 2, 3, 4: $2,380.91
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $3,985 $2,606.19 $101.74 – $2,614.53
Sleep study (overnight, in a sleep lab): 10 of 96 insurance plan rates
  • 1199 — 1199: $197
  • Aetna — Commercial: $2,614.53
  • Aetna — Commercial Midlevels: $401.78
  • Aetna — Medicare: $724.73
  • Aetna — Medicare Midlevels: $106.77
  • Affinity — Essential Plan 3 & 4: $151.99
  • Affinity — Health Exchange Plan: $184.90
  • Affinity — Medicaid - Specialists: $192.15
  • Amida Care — Amida Care: $235.05
  • BCBC Empre Healthplus — Medicaid & HARP: $125.61
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: HC POLYSOM 6 YRS 4 PARAM $12,500 Not listed in the file $579 – $10,000
Sleep study (overnight, in a sleep lab): 10 of 85 insurance plan rates
  • Aetna — ASA: $4,551.02
  • Aetna — Commercial: $4,067.34
  • Aetna — Medicare: $1,061.23
  • Agewell — Medicare: $1,125.55
  • Anthem — Child Health Plus: $1,847.42
  • Anthem — Essential 1, 2, 3, 4: $2,078.35
  • Anthem — Exchange: $10,000
  • Anthem — HARP: $923.71
  • Anthem — Medicaid: $923.71
  • Anthem — Medicare: $1,071.95
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysom 6 yrs 4 param Not listed in the file Not listed in the file $579 – $10,000
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans
  • Emblem — HIP HMO: $4,405.71
  • UHC — Compass: $695

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC OT THERAPEUTIC EXERCISES $396 Not listed in the file $32.48 – $795
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 74 insurance plan rates
  • Aetna — Commercial: $229.55
  • Aetna — Medicare: $32.48
  • Anthem — Child Health Plus: $153.52
  • Anthem — Essential 1, 2, 3, 4: $172.71
  • Anthem — Exchange: $316.80
  • Anthem — HARP: $76.76
  • Anthem — Medicaid: $76.76
  • Anthem — Medicare: $32.81
  • Anthem — WPH Employees: $158.40
  • Centerlight — Medicare: $33.79
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic exercises Not listed in the file Not listed in the file $32.48 – $795
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates
  • Aetna — ASA: $235
  • Anthem — Blue Access: $579
  • Anthem — Connection LG: $579
  • Anthem — Connection SG: $514
  • Anthem — EPO PPO: $643
  • Anthem — HMO: $659
  • Anthem — Indemnity: $641
  • Anthem — SG EPO/PPO: $547
  • Christian Brothers — Christian Brothers: $235
  • Cigna — Commercial: $558
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC PT EVAL LOW COMPLEX 20 MIN $511 Not listed in the file $110.69 – $795
Physical therapy evaluation (low complexity): 10 of 74 insurance plan rates
  • Aetna — Commercial: $781.59
  • Aetna — Medicare: $110.69
  • Anthem — Child Health Plus: $269.56
  • Anthem — Essential 1, 2, 3, 4: $303.26
  • Anthem — Exchange: $408.80
  • Anthem — HARP: $134.78
  • Anthem — Medicaid: $134.78
  • Anthem — Medicare: $111.81
  • Anthem — WPH Employees: $204.40
  • Centerlight — Medicare: $115.16
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $110.69 – $795
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates
  • Aetna — ASA: $235
  • Anthem — Blue Access: $579
  • Anthem — Connection LG: $579
  • Anthem — Connection SG: $514
  • Anthem — EPO PPO: $643
  • Anthem — HMO: $659
  • Anthem — Indemnity: $641
  • Anthem — SG EPO/PPO: $547
  • Christian Brothers — Christian Brothers: $235
  • Cigna — Commercial: $558
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: PR PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS $500 $327 $64.75 – $513.21
Physical therapy evaluation (moderate complexity): 10 of 85 insurance plan rates
  • Aetna — Commercial: $413.32
  • Aetna — Commercial Midlevels: $351.33
  • Aetna — Medicare: $111.81
  • Aetna — Medicare Midlevels: $95.04
  • Affinity — Essential Plan 3 & 4: $135.29
  • Affinity — Health Exchange Plan: $133.34
  • Affinity — Medicaid - Specialists: $95.24
  • Amida Care — Amida Care: $111.19
  • BCBC Empre Healthplus — Medicaid & HARP: $111.81
  • BCBS — Blue Access: $431.78
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC PT EVAL MOD COMPLEX 30 MIN $1,171 Not listed in the file $110.69 – $936.80
Physical therapy evaluation (moderate complexity): 10 of 74 insurance plan rates
  • Aetna — Commercial: $781.59
  • Aetna — Medicare: $110.69
  • Anthem — Child Health Plus: $269.56
  • Anthem — Essential 1, 2, 3, 4: $303.26
  • Anthem — Exchange: $936.80
  • Anthem — HARP: $134.78
  • Anthem — Medicaid: $134.78
  • Anthem — Medicare: $111.81
  • Anthem — WPH Employees: $468.40
  • Centerlight — Medicare: $115.16
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $110.69 – $936.80
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates
  • Aetna — ASA: $235
  • Anthem — Blue Access: $579
  • Anthem — Connection LG: $579
  • Anthem — Connection SG: $514
  • Anthem — EPO PPO: $643
  • Anthem — HMO: $659
  • Anthem — Indemnity: $641
  • Anthem — SG EPO/PPO: $547
  • Christian Brothers — Christian Brothers: $235
  • Cigna — Commercial: $558
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: PR PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS $500 $327 $64.75 – $513.21
Physical therapy evaluation (high complexity): 10 of 85 insurance plan rates
  • Aetna — Commercial: $413.32
  • Aetna — Commercial Midlevels: $351.33
  • Aetna — Medicare: $111.81
  • Aetna — Medicare Midlevels: $95.04
  • Affinity — Essential Plan 3 & 4: $135.29
  • Affinity — Health Exchange Plan: $133.34
  • Affinity — Medicaid - Specialists: $95.24
  • Amida Care — Amida Care: $111.19
  • BCBC Empre Healthplus — Medicaid & HARP: $111.81
  • BCBS — Blue Access: $431.78
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC PT EVAL HIGH COMPLEX 45 MIN $1,252 Not listed in the file $110.69 – $1,001.60
Physical therapy evaluation (high complexity): 10 of 74 insurance plan rates
  • Aetna — Commercial: $781.59
  • Aetna — Medicare: $110.69
  • Anthem — Child Health Plus: $269.56
  • Anthem — Essential 1, 2, 3, 4: $303.26
  • Anthem — Exchange: $1,001.60
  • Anthem — HARP: $134.78
  • Anthem — Medicaid: $134.78
  • Anthem — Medicare: $111.81
  • Anthem — WPH Employees: $500.80
  • Centerlight — Medicare: $115.16
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $110.69 – $1,001.60
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates
  • Aetna — ASA: $235
  • Anthem — Blue Access: $579
  • Anthem — Connection LG: $579
  • Anthem — Connection SG: $514
  • Anthem — EPO PPO: $643
  • Anthem — HMO: $659
  • Anthem — Indemnity: $641
  • Anthem — SG EPO/PPO: $547
  • Christian Brothers — Christian Brothers: $235
  • Cigna — Commercial: $558
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES $600 $392.40 $52.84 – $542.85
Psychotherapy, 30 minutes: 10 of 96 insurance plan rates
  • 1199 — 1199: $61.77
  • Aetna — Commercial: $267.83
  • Aetna — Commercial Midlevels: $227.66
  • Aetna — Medicare: $75.48
  • Aetna — Medicare Midlevels: $64.16
  • Affinity — Essential Plan 3 & 4: $91.33
  • Affinity — Health Exchange Plan: $73.98
  • Affinity — Medicaid - Specialists: $52.84
  • Amida Care — Amida Care: $82.42
  • BCBC Empre Healthplus — Medicaid & HARP: $75.48
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: HC PSYTX PATIENT 30 MINUTES $468 Not listed in the file $53.25 – $910.61
Psychotherapy, 30 minutes: 10 of 82 insurance plan rates
  • Aetna — ASA: $730.93
  • Aetna — Commercial: $653.34
  • Aetna — Medicare: $219.34
  • Agewell — Medicare: $232.64
  • Anthem — Child Health Plus: $245.06
  • Anthem — Essential 1, 2, 3, 4: $275.69
  • Anthem — Exchange: $374.40
  • Anthem — HARP: $122.53
  • Anthem — Medicaid: $122.53
  • Anthem — Medicare: $221.56
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psytx w pt 30 minutes Not listed in the file Not listed in the file $53.25 – $910.61
Psychotherapy, 30 minutes: 10 of 11 insurance plan rates
  • Anthem — Blue Access: $249
  • Anthem — Connection LG: $249
  • Anthem — Connection SG: $222
  • Anthem — EPO PPO: $277
  • Anthem — Exchange: $158
  • Anthem — HMO: $325
  • Anthem — Indemnity: $277
  • Anthem — SG EPO/PPO: $235
  • Anthem — WPH Employees: $107.55
  • Emblem — HIP HMO: $910.61
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES $1,130 $739.02 $71.09 – $1,026.48
Psychotherapy, 45 minutes: 10 of 96 insurance plan rates
  • 1199 — 1199: $87
  • Aetna — Commercial: $352.21
  • Aetna — Commercial Midlevels: $299.38
  • Aetna — Medicare: $99.52
  • Aetna — Medicare Midlevels: $84.59
  • Affinity — Essential Plan 3 & 4: $120.42
  • Affinity — Health Exchange Plan: $110.78
  • Affinity — Medicaid - Specialists: $79.13
  • Amida Care — Amida Care: $105.04
  • BCBC Empre Healthplus — Medicaid & HARP: $99.52
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HC SED PSYTX PATIENT 45 MINUTES $649 Not listed in the file $75 – $1,050.67
Psychotherapy, 45 minutes: 10 of 82 insurance plan rates
  • Aetna — ASA: $1,050.67
  • Aetna — Commercial: $939.14
  • Aetna — Medicare: $219.34
  • Agewell — Medicare: $232.64
  • Anthem — Child Health Plus: $326.74
  • Anthem — Essential 1, 2, 3, 4: $367.58
  • Anthem — Exchange: $519.20
  • Anthem — HARP: $163.37
  • Anthem — Medicaid: $163.37
  • Anthem — Medicare: $221.56
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psytx w pt 45 minutes Not listed in the file Not listed in the file $75 – $1,050.67
Psychotherapy, 45 minutes: 10 of 11 insurance plan rates
  • Anthem — Blue Access: $379
  • Anthem — Connection LG: $379
  • Anthem — Connection SG: $337
  • Anthem — EPO PPO: $421
  • Anthem — Exchange: $239
  • Anthem — HMO: $489
  • Anthem — Indemnity: $421
  • Anthem — SG EPO/PPO: $358
  • Anthem — WPH Employees: $163.20
  • Emblem — HIP HMO: $910.61
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES $1,130 $739.02 $106.12 – $1,026.48
Psychotherapy, 60 minutes: 10 of 96 insurance plan rates
  • 1199 — 1199: $110.49
  • Aetna — Commercial: $511.78
  • Aetna — Commercial Midlevels: $435.02
  • Aetna — Medicare: $147.46
  • Aetna — Medicare Midlevels: $125.34
  • Affinity — Essential Plan 3 & 4: $178.43
  • Affinity — Health Exchange Plan: $167.43
  • Affinity — Medicaid - Specialists: $119.59
  • Amida Care — Amida Care: $153.55
  • BCBC Empre Healthplus — Medicaid & HARP: $147.46
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: HC PSYTX PT FAMILY 60 MINUTES $601 Not listed in the file $95.25 – $1,333.78
Psychotherapy, 60 minutes: 10 of 82 insurance plan rates
  • Aetna — ASA: $1,333.78
  • Aetna — Commercial: $1,192.19
  • Aetna — Medicare: $219.34
  • Agewell — Medicare: $232.64
  • Anthem — Child Health Plus: $326.74
  • Anthem — Essential 1, 2, 3, 4: $367.58
  • Anthem — Exchange: $480.80
  • Anthem — HARP: $163.37
  • Anthem — Medicaid: $163.37
  • Anthem — Medicare: $221.56
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psytx w pt 60 minutes Not listed in the file Not listed in the file $95.25 – $1,333.78
Psychotherapy, 60 minutes: 10 of 11 insurance plan rates
  • Anthem — Blue Access: $379
  • Anthem — Connection LG: $379
  • Anthem — Connection SG: $337
  • Anthem — EPO PPO: $421
  • Anthem — Exchange: $239
  • Anthem — HMO: $489
  • Anthem — Indemnity: $421
  • Anthem — SG EPO/PPO: $358
  • Anthem — WPH Employees: $163.20
  • Emblem — HIP HMO: $910.61
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $980 $640.92 $85.96 – $888.30
Family psychotherapy, without the patient: 10 of 96 insurance plan rates
  • 1199 — 1199: $106
  • Aetna — Commercial: $378.13
  • Aetna — Commercial Midlevels: $321.41
  • Aetna — Medicare: $107.90
  • Aetna — Medicare Midlevels: $91.72
  • Affinity — Essential Plan 3 & 4: $130.56
  • Affinity — Health Exchange Plan: $119.34
  • Affinity — Medicaid - Specialists: $97.62
  • Amida Care — Amida Care: $121.24
  • BCBC Empre Healthplus — Medicaid & HARP: $107.90
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: HC SED FAMILY PSYTX W O PATIENT 50 MN $642 Not listed in the file $56.25 – $1,096.35
Family psychotherapy, without the patient: 10 of 80 insurance plan rates
  • Aetna — ASA: $1,096.35
  • Aetna — Commercial: $979.97
  • Aetna — Medicare: $219.34
  • Agewell — Medicare: $232.64
  • Anthem — Child Health Plus: $245.06
  • Anthem — Essential 1, 2, 3, 4: $275.69
  • Anthem — Exchange: $513.60
  • Anthem — HARP: $122.53
  • Anthem — Medicaid: $122.53
  • Anthem — Medicare: $221.56
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psytx w o pt 50 min Not listed in the file Not listed in the file $56.25 – $1,096.35
Family psychotherapy, without the patient: 10 of 13 insurance plan rates
  • Anthem — Blue Access: $312
  • Anthem — Connection LG: $312
  • Anthem — Connection SG: $278
  • Anthem — EPO PPO: $347
  • Anthem — Exchange: $195
  • Anthem — HMO: $403
  • Anthem — Indemnity: $348
  • Anthem — SG EPO/PPO: $295
  • Anthem — WPH Employees: $134.31
  • Centerlight — Medicare: $175
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $635 $415.29 $55.50 – $574.36
Family psychotherapy, with the patient: 10 of 96 insurance plan rates
  • 1199 — 1199: $65
  • Aetna — Commercial: $392.11
  • Aetna — Commercial Midlevels: $333.29
  • Aetna — Medicare: $112.46
  • Aetna — Medicare Midlevels: $95.59
  • Affinity — Essential Plan 3 & 4: $136.08
  • Affinity — Health Exchange Plan: $140.17
  • Affinity — Medicaid - Specialists: $116.21
  • Amida Care — Amida Care: $149.50
  • BCBC Empre Healthplus — Medicaid & HARP: $112.46
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: HC SED FAMILY PSYTX W PATIENT 50 MIN $863 Not listed in the file $56.25 – $1,096.35
Family psychotherapy, with the patient: 10 of 80 insurance plan rates
  • Aetna — ASA: $1,096.35
  • Aetna — Commercial: $979.97
  • Aetna — Medicare: $219.34
  • Agewell — Medicare: $232.64
  • Anthem — Child Health Plus: $245.06
  • Anthem — Essential 1, 2, 3, 4: $275.69
  • Anthem — Exchange: $690.40
  • Anthem — HARP: $122.53
  • Anthem — Medicaid: $122.53
  • Anthem — Medicare: $221.56
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psytx w pt 50 min Not listed in the file Not listed in the file $56.25 – $1,096.35
Family psychotherapy, with the patient: 10 of 13 insurance plan rates
  • Anthem — Blue Access: $312
  • Anthem — Connection LG: $312
  • Anthem — Connection SG: $278
  • Anthem — EPO PPO: $347
  • Anthem — Exchange: $195
  • Anthem — HMO: $403
  • Anthem — Indemnity: $348
  • Anthem — SG EPO/PPO: $295
  • Anthem — WPH Employees: $134.31
  • Centerlight — Medicare: $175
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: PR GROUP PSYCHOTHERAPY $275 $179.85 $21.47 – $246.75
Group psychotherapy: 10 of 96 insurance plan rates
  • 1199 — 1199: $35
  • Aetna — Commercial: $92.09
  • Aetna — Commercial Midlevels: $78.28
  • Aetna — Medicare: $26.73
  • Aetna — Medicare Midlevels: $22.72
  • Affinity — Essential Plan 3 & 4: $32.34
  • Affinity — Health Exchange Plan: $37.31
  • Affinity — Medicaid - Specialists: $32.49
  • Amida Care — Amida Care: $42.41
  • BCBC Empre Healthplus — Medicaid & HARP: $26.73
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HC GROUP PSYCHOTHERAPY OFF SITE $343 Not listed in the file $26.25 – $695
Group psychotherapy: 10 of 80 insurance plan rates
  • Aetna — ASA: $548.22
  • Aetna — Commercial: $490.02
  • Aetna — Medicare: $125.54
  • Agewell — Medicare: $133.15
  • Anthem — Child Health Plus: $126.62
  • Anthem — Essential 1, 2, 3, 4: $142.45
  • Anthem — Exchange: $274.40
  • Anthem — HARP: $63.31
  • Anthem — Medicaid: $63.31
  • Anthem — Medicare: $126.81
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy Not listed in the file Not listed in the file $26.25 – $695
Group psychotherapy: 10 of 13 insurance plan rates
  • Anthem — Blue Access: $113
  • Anthem — Connection LG: $113
  • Anthem — Connection SG: $100
  • Anthem — EPO PPO: $125
  • Anthem — Exchange: $70
  • Anthem — HMO: $146
  • Anthem — Indemnity: $130
  • Anthem — SG EPO/PPO: $106
  • Anthem — WPH Employees: $48.16
  • Centerlight — Medicare: $175

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $5,700 $3,727.80 $183.82 – $5,181.75
Removal of breast growth (open surgery): 10 of 96 insurance plan rates
  • 1199 — 1199: $387
  • Aetna — Commercial: $1,948.47
  • Aetna — Commercial Midlevels: $1,656.21
  • Aetna — Medicare: $503.02
  • Aetna — Medicare Midlevels: $427.57
  • Affinity — Essential Plan 3 & 4: $608.65
  • Affinity — Health Exchange Plan: $674.87
  • Affinity — Medicaid - Specialists: $410.56
  • Amida Care — Amida Care: $589.15
  • BCBC Empre Healthplus — Medicaid & HARP: $503.02
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 $433.50 – $20,087.91
Removal of breast growth (open surgery): 10 of 92 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Aetna — Medicare: $4,838.69
  • Agewell — Medicare: $5,131.95
  • Anthem — Blue Access: $8,010
  • Anthem — Child Health Plus: $3,606.98
  • Anthem — Connection LG: $8,010
  • Anthem — Connection SG: $7,120
  • Anthem — EPO PPO: $8,900
  • Anthem — Essential 1, 2, 3, 4: $4,057.85
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: CPT 19120 Not listed in the file Not listed in the file $433.50 – $20,087.91
Removal of breast growth (open surgery): rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $22,500 $14,715 $697.27 – $20,450.64
Total hip replacement: 10 of 96 insurance plan rates
  • 1199 — 1199: $1,559
  • Aetna — Commercial: $5,863.70
  • Aetna — Commercial Midlevels: $4,984.18
  • Aetna — Medicare: $1,517.27
  • Aetna — Medicare Midlevels: $1,289.68
  • Affinity — Essential Plan 3 & 4: $1,835.90
  • Affinity — Health Exchange Plan: $2,345.59
  • Affinity — Medicaid - Specialists: $1,638.77
  • Amida Care — Amida Care: $1,976.38
  • BCBC Empre Healthplus — Medicaid & HARP: $1,517.27
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 $1,517.27 – $65,868.18
Total hip replacement: 10 of 49 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Aetna — Medicare: $15,866.06
  • Agewell — Medicare: $16,827.64
  • Anthem — Blue Access: $11,308
  • Anthem — Connection LG: $11,308
  • Anthem — Connection SG: $10,051
  • Anthem — EPO PPO: $12,564
  • Anthem — Exchange: $6,298
  • Anthem — HMO: $12,906
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: CPT 27130 Not listed in the file Not listed in the file $1,517.27 – $65,868.18
Total hip replacement: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $24,225 $15,843.15 $749.09 – $22,019.97
Total knee replacement: 10 of 96 insurance plan rates
  • 1199 — 1199: $1,679
  • Aetna — Commercial: $5,856.09
  • Aetna — Commercial Midlevels: $4,977.71
  • Aetna — Medicare: $1,515.10
  • Aetna — Medicare Midlevels: $1,287.84
  • Affinity — Essential Plan 3 & 4: $1,833.27
  • Affinity — Health Exchange Plan: $2,504.14
  • Affinity — Medicaid - Specialists: $1,766.47
  • Amida Care — Amida Care: $2,130.17
  • BCBC Empre Healthplus — Medicaid & HARP: $1,515.10
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 $1,515.10 – $65,868.18
Total knee replacement: 10 of 49 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Aetna — Medicare: $15,866.06
  • Agewell — Medicare: $16,827.64
  • Anthem — Blue Access: $11,308
  • Anthem — Connection LG: $11,308
  • Anthem — Connection SG: $10,051
  • Anthem — EPO PPO: $12,564
  • Anthem — Exchange: $6,298
  • Anthem — HMO: $12,906
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: CPT 27447 Not listed in the file Not listed in the file $1,515.10 – $65,868.18
Total knee replacement: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $11,110 $7,265.94 $162.30 – $10,097.01
Shoulder arthroscopy: shaving of shoulder bone: 10 of 96 insurance plan rates
  • 1199 — 1199: $769
  • Aetna — Commercial: $789.69
  • Aetna — Commercial Midlevels: $671.24
  • Aetna — Medicare: $200.37
  • Aetna — Medicare Midlevels: $170.31
  • Affinity — Essential Plan 3 & 4: $242.45
  • Affinity — Health Exchange Plan: $282.76
  • Affinity — Medicaid - Specialists: $778.24
  • Amida Care — Amida Care: $940.24
  • BCBC Empre Healthplus — Medicaid & HARP: $200.37
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $200.37 – $17,559
Shoulder arthroscopy: shaving of shoulder bone: 10 of 27 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $8,010
  • Anthem — Connection LG: $8,010
  • Anthem — Connection SG: $7,120
  • Anthem — EPO PPO: $8,900
  • Anthem — Exchange: $4,461
  • Anthem — HMO: $9,140
  • Anthem — Indemnity: $9,059
  • Anthem — SG EPO/PPO: $7,565
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: CPT 29826 Not listed in the file Not listed in the file $200.37 – $17,559
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG $9,895 $6,471.33 $308.07 – $8,991.57
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 96 insurance plan rates
  • 1199 — 1199: $686
  • Aetna — Commercial: $2,461.87
  • Aetna — Commercial Midlevels: $2,092.61
  • Aetna — Medicare: $647.16
  • Aetna — Medicare Midlevels: $550.09
  • Affinity — Essential Plan 3 & 4: $783.06
  • Affinity — Health Exchange Plan: $896.17
  • Affinity — Medicaid - Specialists: $725.33
  • Amida Care — Amida Care: $877.75
  • BCBC Empre Healthplus — Medicaid & HARP: $647.16
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 $647.16 – $25,839
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 64 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Anthem — Blue Access: $8,010
  • Anthem — Child Health Plus: $3,929
  • Anthem — Connection LG: $8,010
  • Anthem — Connection SG: $7,120
  • Anthem — EPO PPO: $8,900
  • Anthem — Essential 1, 2, 3, 4: $4,420.13
  • Anthem — Exchange: $4,461
  • Anthem — HARP: $1,964.50
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthrs kne srg mnisectmy m l Not listed in the file Not listed in the file $647.16 – $25,839
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 28 insurance plan rates
  • Aetna — Medicare: $4,043.55
  • Agewell — Medicare: $4,288.61
  • Anthem — Medicare: $4,084.39
  • Centerlight — Medicare: $4,206.92
  • Centerlight — PACE: $4,206.92
  • CentersPlan — Medicare Advan I SNP: $4,492.83
  • Emblem — HIP HMO: $16,786.84
  • Emblem — Medicare: $4,084.39
  • Emblem — Select Care: $4,901.27
  • Hamaspik — Medicare: $4,411.14
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 $4,195 $2,743.53 $141.04 – $3,809.82
Removal of tonsils and adenoids (under age 12): 10 of 96 insurance plan rates
  • 1199 — 1199: $363
  • Aetna — Commercial: $1,277.97
  • Aetna — Commercial Midlevels: $1,086.28
  • Aetna — Medicare: $340.67
  • Aetna — Medicare Midlevels: $289.57
  • Affinity — Essential Plan 3 & 4: $412.21
  • Affinity — Health Exchange Plan: $479.89
  • Affinity — Medicaid - Specialists: $321.35
  • Amida Care — Amida Care: $392.79
  • BCBC Empre Healthplus — Medicaid & HARP: $340.67
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $272.25 – $30,371.38
Removal of tonsils and adenoids (under age 12): 10 of 51 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Aetna — Medicare: $7,315.73
  • Agewell — Medicare: $7,759.11
  • Anthem — Blue Access: $11,308
  • Anthem — Connection LG: $11,308
  • Anthem — Connection SG: $10,051
  • Anthem — EPO PPO: $12,564
  • Anthem — Exchange: $6,298
  • Anthem — HMO: $12,906
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: CPT 42820 Not listed in the file Not listed in the file $272.25 – $30,371.38
Removal of tonsils and adenoids (under age 12): rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $1,705 $1,115.07 $80.80 – $1,549.59
Upper GI endoscopy (diagnostic): 10 of 96 insurance plan rates
  • 1199 — 1199: $147
  • Aetna — Commercial: $525.80
  • Aetna — Commercial Midlevels: $446.93
  • Aetna — Medicare: $138.76
  • Aetna — Medicare Midlevels: $117.95
  • Affinity — Essential Plan 3 & 4: $167.90
  • Affinity — Health Exchange Plan: $236.60
  • Affinity — Medicaid - Specialists: $152.33
  • Amida Care — Amida Care: $430.82
  • BCBC Empre Healthplus — Medicaid & HARP: $138.76
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $110.25 – $12,465
Upper GI endoscopy (diagnostic): 10 of 92 insurance plan rates
  • Aetna — ASA: $5,520
  • Aetna — Commercial: $4,935
  • Aetna — Medicare: $1,120.86
  • Agewell — Medicare: $1,188.79
  • Anthem — Blue Access: $3,056
  • Anthem — Child Health Plus: $1,735.54
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Essential 1, 2, 3, 4: $1,952.48
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: CPT 43235 Not listed in the file Not listed in the file $110.25 – $12,465
Upper GI endoscopy (diagnostic): rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $2,030 $1,327.62 $101 – $1,845.69
Upper GI endoscopy with biopsy: 10 of 96 insurance plan rates
  • 1199 — 1199: $174
  • Aetna — Commercial: $588.92
  • Aetna — Commercial Midlevels: $500.59
  • Aetna — Medicare: $155.38
  • Aetna — Medicare Midlevels: $132.07
  • Affinity — Essential Plan 3 & 4: $188.01
  • Affinity — Health Exchange Plan: $278.46
  • Affinity — Medicaid - Specialists: $180.22
  • Amida Care — Amida Care: $490.10
  • BCBC Empre Healthplus — Medicaid & HARP: $155.38
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: HC EGD BIOPSY SINGLE MULTIPLE $1,985 Not listed in the file $130.50 – $13,815.60
Upper GI endoscopy with biopsy: 10 of 74 insurance plan rates
  • Aetna — Medicare: $1,120.86
  • Agewell — Medicare: $1,188.79
  • Anthem — Child Health Plus: $1,735.54
  • Anthem — Essential 1, 2, 3, 4: $1,952.48
  • Anthem — Exchange: $1,588
  • Anthem — HARP: $867.77
  • Anthem — Medicaid: $867.77
  • Anthem — Medicare: $1,132.18
  • Anthem — WPH Employees: $794
  • Centerlight — Medicare: $1,166.15
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single multiple Not listed in the file Not listed in the file $130.50 – $13,815.60
Upper GI endoscopy with biopsy: 10 of 24 insurance plan rates
  • Aetna — ASA: $5,520
  • Aetna — Commercial: $4,935
  • Anthem — Blue Access: $3,056
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Exchange: $1,704
  • Anthem — HMO: $3,489
  • Anthem — Indemnity: $3,563
  • Anthem — SG EPO/PPO: $2,887
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $2,585 $1,690.59 $103.24 – $2,349.06
Colonoscopy (diagnostic): 10 of 96 insurance plan rates
  • 1199 — 1199: $232
  • Aetna — Commercial: $792.70
  • Aetna — Commercial Midlevels: $673.80
  • Aetna — Medicare: $208.36
  • Aetna — Medicare Midlevels: $177.11
  • Affinity — Essential Plan 3 & 4: $252.12
  • Affinity — Health Exchange Plan: $351.88
  • Affinity — Medicaid - Specialists: $228.66
  • Amida Care — Amida Care: $556.66
  • BCBC Empre Healthplus — Medicaid & HARP: $208.36
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: HC DIAGNOSTIC COLONOSCOPY $1,688 Not listed in the file $174 – $12,465
Colonoscopy (diagnostic): 10 of 75 insurance plan rates
  • Aetna — Medicare: $1,149.24
  • Agewell — Medicare: $1,218.89
  • Anthem — Child Health Plus: $1,667.20
  • Anthem — Essential 1, 2, 3, 4: $1,875.60
  • Anthem — Exchange: $1,350.40
  • Anthem — HARP: $833.60
  • Anthem — Medicaid: $833.60
  • Anthem — Medicare: $1,160.85
  • Anthem — WPH Employees: $675.20
  • Centerlight — Medicare: $1,195.68
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $174 – $12,465
Colonoscopy (diagnostic): 10 of 24 insurance plan rates
  • Aetna — ASA: $5,520
  • Aetna — Commercial: $4,935
  • Anthem — Blue Access: $3,056
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Exchange: $1,704
  • Anthem — HMO: $3,489
  • Anthem — Indemnity: $3,563
  • Anthem — SG EPO/PPO: $2,887
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $3,085 $2,017.59 $161.60 – $2,803.08
Colonoscopy with biopsy: 10 of 96 insurance plan rates
  • 1199 — 1199: $274
  • Aetna — Commercial: $855.48
  • Aetna — Commercial Midlevels: $727.16
  • Aetna — Medicare: $226.61
  • Aetna — Medicare Midlevels: $192.62
  • Affinity — Essential Plan 3 & 4: $274.20
  • Affinity — Health Exchange Plan: $419.17
  • Affinity — Medicaid - Specialists: $272.89
  • Amida Care — Amida Care: $660.50
  • BCBC Empre Healthplus — Medicaid & HARP: $226.61
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: HC COLONOSCOPY AND BIOPSY $1,835 Not listed in the file $205.50 – $12,771.60
Colonoscopy with biopsy: 10 of 74 insurance plan rates
  • Aetna — Medicare: $1,478.81
  • Agewell — Medicare: $1,568.44
  • Anthem — Child Health Plus: $1,667.20
  • Anthem — Essential 1, 2, 3, 4: $1,875.60
  • Anthem — Exchange: $1,468
  • Anthem — HARP: $833.60
  • Anthem — Medicaid: $833.60
  • Anthem — Medicare: $1,493.75
  • Anthem — WPH Employees: $734
  • Centerlight — Medicare: $1,538.56
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $205.50 – $12,771.60
Colonoscopy with biopsy: 10 of 24 insurance plan rates
  • Aetna — ASA: $5,520
  • Aetna — Commercial: $4,935
  • Anthem — Blue Access: $7,137
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Exchange: $3,976
  • Anthem — HMO: $8,149
  • Anthem — Indemnity: $8,088
  • Anthem — SG EPO/PPO: $6,741
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $3,670 $2,400.18 $146.87 – $3,336.06
Colonoscopy with removal of polyps (snare): 10 of 96 insurance plan rates
  • 1199 — 1199: $325
  • Aetna — Commercial: $1,090.01
  • Aetna — Commercial Midlevels: $926.52
  • Aetna — Medicare: $284.43
  • Aetna — Medicare Midlevels: $241.77
  • Affinity — Essential Plan 3 & 4: $344.16
  • Affinity — Health Exchange Plan: $496.96
  • Affinity — Medicaid - Specialists: $324.12
  • Amida Care — Amida Care: $740.86
  • BCBC Empre Healthplus — Medicaid & HARP: $284.43
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy w lesion removal Not listed in the file Not listed in the file $243.75 – $12,465
Colonoscopy with removal of polyps (snare): 10 of 92 insurance plan rates
  • Aetna — ASA: $5,520
  • Aetna — Commercial: $4,935
  • Aetna — Medicare: $1,478.81
  • Agewell — Medicare: $1,568.44
  • Anthem — Blue Access: $7,137
  • Anthem — Child Health Plus: $1,667.20
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Essential 1, 2, 3, 4: $1,875.60
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: CPT 45385 Not listed in the file Not listed in the file $243.75 – $12,465
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX $3,550 $2,321.70 $142.75 – $3,227.49
Ultrasound of the lower bowel by endoscope: 10 of 96 insurance plan rates
  • 1199 — 1199: $311.94
  • Aetna — Commercial: $1,096.38
  • Aetna — Commercial Midlevels: $931.93
  • Aetna — Medicare: $287.55
  • Aetna — Medicare Midlevels: $244.42
  • Affinity — Essential Plan 3 & 4: $347.94
  • Affinity — Health Exchange Plan: $477.05
  • Affinity — Medicaid - Specialists: $314.11
  • Amida Care — Amida Care: $382.29
  • BCBC Empre Healthplus — Medicaid & HARP: $287.55
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy w endoscope us Not listed in the file Not listed in the file $233.96 – $12,920
Ultrasound of the lower bowel by endoscope: 10 of 92 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Aetna — Medicare: $1,478.81
  • Agewell — Medicare: $1,568.44
  • Anthem — Blue Access: $7,137
  • Anthem — Child Health Plus: $1,667.20
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Essential 1, 2, 3, 4: $1,875.60
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: CPT 45391 Not listed in the file Not listed in the file $233.96 – $12,920
Ultrasound of the lower bowel by endoscope: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: PR COLON CA SCRN NOT HI RSK IND $2,585 $1,690.59 $169.27 – $2,349.06
Screening colonoscopy (not high risk): 10 of 94 insurance plan rates
  • 1199 — 1199: $365
  • Aetna — Commercial: $795.95
  • Aetna — Commercial Midlevels: $676.56
  • Aetna — Medicare: $208.98
  • Aetna — Medicare Midlevels: $177.63
  • Affinity — Essential Plan 3 & 4: $252.87
  • Affinity — Health Exchange Plan: $351.88
  • Affinity — Medicaid - Specialists: $228.66
  • Amida Care — Amida Care: $556.66
  • BCBC Empre Healthplus — Medicaid & HARP: $208.98
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $208.98 – $17,559
Screening colonoscopy (not high risk): 10 of 51 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Aetna — Medicare: $1,149.24
  • Agewell — Medicare: $1,218.89
  • Anthem — Blue Access: $3,056
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Exchange: $1,704
  • Anthem — HMO: $3,489
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY $8,310 $5,434.74 $333.58 – $7,550.55
Gallbladder removal by laparoscope: 10 of 96 insurance plan rates
  • 1199 — 1199: $719
  • Aetna — Commercial: $3,134.65
  • Aetna — Commercial Midlevels: $2,664.47
  • Aetna — Medicare: $793.18
  • Aetna — Medicare Midlevels: $674.20
  • Affinity — Essential Plan 3 & 4: $959.75
  • Affinity — Health Exchange Plan: $1,067.98
  • Affinity — Medicaid - Specialists: $760.21
  • Amida Care — Amida Care: $919.09
  • BCBC Empre Healthplus — Medicaid & HARP: $793.18
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 $539.25 – $31,016.24
Gallbladder removal by laparoscope: 10 of 50 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Aetna — Medicare: $7,471.06
  • Agewell — Medicare: $7,923.86
  • Anthem — Blue Access: $11,308
  • Anthem — Connection LG: $11,308
  • Anthem — Connection SG: $10,051
  • Anthem — EPO PPO: $12,564
  • Anthem — Exchange: $6,298
  • Anthem — HMO: $12,906
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: CPT 47562 Not listed in the file Not listed in the file $539.25 – $31,016.24
Gallbladder removal by laparoscope: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (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: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $5,920 $3,871.68 $233.75 – $5,379.15
Groin (inguinal) hernia repair, age 5 or older: 10 of 96 insurance plan rates
  • 1199 — 1199: $513
  • Aetna — Commercial: $2,475.75
  • Aetna — Commercial Midlevels: $2,104.40
  • Aetna — Medicare: $629.73
  • Aetna — Medicare Midlevels: $535.27
  • Affinity — Essential Plan 3 & 4: $761.97
  • Affinity — Health Exchange Plan: $848.23
  • Affinity — Medicaid - Specialists: $535
  • Amida Care — Amida Care: $646.80
  • BCBC Empre Healthplus — Medicaid & HARP: $629.73
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 $629.73 – $25,839
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Aetna — Medicare: $4,424.67
  • Agewell — Medicare: $4,692.83
  • Anthem — Blue Access: $8,010
  • Anthem — Connection LG: $8,010
  • Anthem — Connection SG: $7,120
  • Anthem — EPO PPO: $8,900
  • Anthem — Exchange: $4,461
  • Anthem — HMO: $9,140
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: CPT 49505 Not listed in the file Not listed in the file $629.73 – $25,839
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH $1,715 $1,121.61 $66.66 – $1,559.46
Prostate biopsy: 10 of 96 insurance plan rates
  • 1199 — 1199: $99
  • Aetna — Commercial: $552.03
  • Aetna — Commercial Midlevels: $469.23
  • Aetna — Medicare: $145.58
  • Aetna — Medicare Midlevels: $123.74
  • Affinity — Essential Plan 3 & 4: $176.15
  • Affinity — Health Exchange Plan: $215.46
  • Affinity — Medicaid - Specialists: $139.68
  • Amida Care — Amida Care: $367
  • BCBC Empre Healthplus — Medicaid & HARP: $145.58
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: HC BIOPSY OF PROSTATE $5,852 Not listed in the file $74.25 – $40,729.92
Prostate biopsy: 10 of 51 insurance plan rates
  • Anthem — Child Health Plus: $4,572.44
  • Anthem — Essential 1, 2, 3, 4: $5,144
  • Anthem — Exchange: $4,681.60
  • Anthem — HARP: $2,286.22
  • Anthem — Medicaid: $2,286.22
  • Anthem — WPH Employees: $2,340.80
  • Emblem — Essential Plan 1 & 2: $2,743.46
  • Emblem — Essential Plan 3 & 4: $2,286.22
  • Emblem — GHI Commercial: $4,681.60
  • Emblem — HIP Commerical EPO PPO: $40,729.92
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy of prostate Not listed in the file Not listed in the file $74.25 – $40,729.92
Prostate biopsy: 10 of 23 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $7,137
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Exchange: $3,976
  • Anthem — HMO: $8,149
  • Anthem — Indemnity: $8,088
  • Anthem — SG EPO/PPO: $6,741
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT $21,335 $13,953.09 $881.41 – $19,394.55
Prostate removal by laparoscope (radical prostatectomy): 10 of 96 insurance plan rates
  • 1199 — 1199: $1,793
  • Aetna — Commercial: $6,159.95
  • Aetna — Commercial Midlevels: $5,235.99
  • Aetna — Medicare: $1,352.99
  • Aetna — Medicare Midlevels: $1,150.04
  • Affinity — Essential Plan 3 & 4: $1,637.12
  • Affinity — Health Exchange Plan: $2,679.21
  • Affinity — Medicaid - Specialists: $1,926.76
  • Amida Care — Amida Care: $2,350.50
  • BCBC Empre Healthplus — Medicaid & HARP: $1,352.99
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $1,344.75 – $58,734
Prostate removal by laparoscope (radical prostatectomy): 10 of 49 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Aetna — Medicare: $13,136.36
  • Agewell — Medicare: $13,932.50
  • Anthem — Blue Access: $11,308
  • Anthem — Connection LG: $11,308
  • Anthem — Connection SG: $10,051
  • Anthem — EPO PPO: $12,564
  • Anthem — Exchange: $6,298
  • Anthem — HMO: $12,906
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: CPT 55866 Not listed in the file Not listed in the file $1,344.75 – $58,734
Prostate removal by laparoscope (radical prostatectomy): rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $5,620 $3,675.48 $113.35 – $5,181.75
Hysteroscopy with biopsy of the uterus lining: 10 of 96 insurance plan rates
  • 1199 — 1199: $272.89
  • Aetna — Commercial: $1,026.30
  • Aetna — Commercial Midlevels: $872.36
  • Aetna — Medicare: $267.50
  • Aetna — Medicare Midlevels: $227.38
  • Affinity — Essential Plan 3 & 4: $323.68
  • Affinity — Health Exchange Plan: $432.04
  • Affinity — Medicaid - Specialists: $307.45
  • Amida Care — Amida Care: $400.23
  • BCBC Empre Healthplus — Medicaid & HARP: $267.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: HC HYSTEROSCOPY BIOPSY $6,125 Not listed in the file $267.50 – $42,630
Hysteroscopy with biopsy of the uterus lining: 10 of 75 insurance plan rates
  • Aetna — Medicare: $4,000.44
  • Agewell — Medicare: $4,242.89
  • Anthem — Child Health Plus: $3,009.32
  • Anthem — Essential 1, 2, 3, 4: $3,385.49
  • Anthem — Exchange: $4,900
  • Anthem — HARP: $1,504.66
  • Anthem — Medicaid: $1,504.66
  • Anthem — Medicare: $4,040.85
  • Anthem — WPH Employees: $2,450
  • Centerlight — Medicare: $4,162.08
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 $267.50 – $42,630
Hysteroscopy with biopsy of the uterus lining: 10 of 24 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $7,137
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Exchange: $3,976
  • Anthem — HMO: $8,149
  • Anthem — Indemnity: $8,088
  • Anthem — SG EPO/PPO: $6,741
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $910 $595.14 $55.41 – $848.92
Spinal injection, lower back (epidural), with imaging guidance: 10 of 93 insurance plan rates
  • 1199 — 1199: $118
  • Aetna — Commercial: $421.73
  • Aetna — Commercial Midlevels: $358.48
  • Aetna — Medicare: $111.33
  • Aetna — Medicare Midlevels: $94.63
  • Affinity — Essential Plan 3 & 4: $134.71
  • Affinity — Health Exchange Plan: $170.32
  • Affinity — Medicaid - Specialists: $121.66
  • Amida Care — Amida Care: $345.37
  • BCBC Empre Healthplus — Medicaid & HARP: $111.33
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HC NJX S INTERLAMINAR LMBR SAC W IMGING $1,961 Not listed in the file $111.33 – $17,559
Spinal injection, lower back (epidural), with imaging guidance: 10 of 75 insurance plan rates
  • Aetna — Medicare: $872.33
  • Agewell — Medicare: $925.20
  • Anthem — Child Health Plus: $1,194.12
  • Anthem — Essential 1, 2, 3, 4: $1,343.39
  • Anthem — Exchange: $1,568.80
  • Anthem — HARP: $597.06
  • Anthem — Medicaid: $597.06
  • Anthem — Medicare: $881.14
  • Anthem — WPH Employees: $784.40
  • Centerlight — Medicare: $907.57
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Njx interlaminar lmbr sac Not listed in the file Not listed in the file $111.33 – $17,559
Spinal injection, lower back (epidural), with imaging guidance: 10 of 24 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $3,056
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Exchange: $1,704
  • Anthem — HMO: $3,489
  • Anthem — Indemnity: $3,563
  • Anthem — SG EPO/PPO: $2,887
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $1,140 $745.56 $51.02 – $1,036.35
Nerve root injection, lower back, with imaging guidance: 10 of 96 insurance plan rates
  • 1199 — 1199: $110
  • Aetna — Commercial: $470.88
  • Aetna — Commercial Midlevels: $400.25
  • Aetna — Medicare: $124.64
  • Aetna — Medicare Midlevels: $105.94
  • Affinity — Essential Plan 3 & 4: $150.81
  • Affinity — Health Exchange Plan: $182.70
  • Affinity — Medicaid - Specialists: $114.88
  • Amida Care — Amida Care: $504.06
  • BCBC Empre Healthplus — Medicaid & HARP: $124.64
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HC INJ FORAMEN EPIDURAL LUMBAR SACRAL SINGL LVL $2,688 Not listed in the file $123.75 – $18,708.48
Nerve root injection, lower back, with imaging guidance: 10 of 74 insurance plan rates
  • Aetna — Medicare: $1,093.03
  • Agewell — Medicare: $1,159.27
  • Anthem — Child Health Plus: $1,194.12
  • Anthem — Essential 1, 2, 3, 4: $1,343.39
  • Anthem — Exchange: $2,150.40
  • Anthem — HARP: $597.06
  • Anthem — Medicaid: $597.06
  • Anthem — Medicare: $1,104.07
  • Anthem — WPH Employees: $1,075.20
  • Centerlight — Medicare: $1,137.19
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Njx aa strd tfrm epi l s 1 Not listed in the file Not listed in the file $123.75 – $18,708.48
Nerve root injection, lower back, with imaging guidance: 10 of 24 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $3,056
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Exchange: $1,704
  • Anthem — HMO: $3,489
  • Anthem — Indemnity: $3,563
  • Anthem — SG EPO/PPO: $2,887
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE $13,030 $8,521.62 $200.67 – $11,844
Carpal tunnel release: 10 of 96 insurance plan rates
  • 1199 — 1199: $460
  • Aetna — Commercial: $1,969.75
  • Aetna — Commercial Midlevels: $1,674.30
  • Aetna — Medicare: $524.69
  • Aetna — Medicare Midlevels: $445.99
  • Affinity — Essential Plan 3 & 4: $634.87
  • Affinity — Health Exchange Plan: $707.59
  • Affinity — Medicaid - Specialists: $474.36
  • Amida Care — Amida Care: $577.29
  • BCBC Empre Healthplus — Medicaid & HARP: $524.69
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: HC NEUROPLASTY TRANSPOS MEDIAN NRV CARPAL TUNNE $8,619 Not listed in the file $517.50 – $17,559
Carpal tunnel release: 10 of 34 insurance plan rates
  • Aetna — Medicare: $2,413.18
  • Agewell — Medicare: $2,559.44
  • Anthem — Exchange: $6,895.20
  • Anthem — Medicare: $2,437.56
  • Anthem — WPH Employees: $3,447.60
  • Centerlight — Medicare: $2,510.69
  • Centerlight — PACE: $2,510.69
  • CentersPlan — Medicare Advan I SNP: $2,681.32
  • Emblem — GHI Commercial: $6,895.20
  • Emblem — HIP Commerical EPO PPO: $4,309.50
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 $517.50 – $17,559
Carpal tunnel release: 10 of 24 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $7,137
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Exchange: $3,976
  • Anthem — HMO: $8,149
  • Anthem — Indemnity: $8,088
  • Anthem — SG EPO/PPO: $6,741
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: PR POST-CATARACT LASER SURGERY $2,925 $1,912.95 $131.95 – $2,655.03
Laser treatment of clouding after cataract surgery: 10 of 96 insurance plan rates
  • 1199 — 1199: $251
  • Aetna — Commercial: $1,295.90
  • Aetna — Commercial Midlevels: $1,101.52
  • Aetna — Medicare: $349.47
  • Aetna — Medicare Midlevels: $297.05
  • Affinity — Essential Plan 3 & 4: $422.86
  • Affinity — Health Exchange Plan: $531.13
  • Affinity — Medicaid - Specialists: $301.57
  • Amida Care — Amida Care: $398.18
  • BCBC Empre Healthplus — Medicaid & HARP: $349.47
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: HC AFTER CATARACT LASER SURGERY $1,693 Not listed in the file $282.38 – $17,559
Laser treatment of clouding after cataract surgery: 10 of 74 insurance plan rates
  • Aetna — Medicare: $679.68
  • Agewell — Medicare: $720.88
  • Anthem — Child Health Plus: $3,471
  • Anthem — Essential 1, 2, 3, 4: $3,904.88
  • Anthem — Exchange: $1,354.40
  • Anthem — HARP: $1,735.50
  • Anthem — Medicaid: $1,735.50
  • Anthem — Medicare: $686.55
  • Anthem — WPH Employees: $677.20
  • Centerlight — Medicare: $707.15
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: After cataract laser surgery Not listed in the file Not listed in the file $282.38 – $17,559
Laser treatment of clouding after cataract surgery: 10 of 24 insurance plan rates
  • Aetna — ASA: $12,920
  • Aetna — Commercial: $11,550
  • Anthem — Blue Access: $3,056
  • Anthem — Connection LG: $3,056
  • Anthem — Connection SG: $2,717
  • Anthem — EPO PPO: $3,396
  • Anthem — Exchange: $1,704
  • Anthem — HMO: $3,489
  • Anthem — Indemnity: $3,563
  • Anthem — SG EPO/PPO: $2,887
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $8,870 $5,800.98 $444.40 – $8,063.79
Cataract removal with lens implant: 10 of 96 insurance plan rates
  • 1199 — 1199: $766
  • Aetna — Commercial: $2,248.86
  • Aetna — Commercial Midlevels: $1,911.55
  • Aetna — Medicare: $606.65
  • Aetna — Medicare Midlevels: $515.65
  • Affinity — Essential Plan 3 & 4: $734.05
  • Affinity — Health Exchange Plan: $1,081.71
  • Affinity — Medicaid - Specialists: $749.55
  • Amida Care — Amida Care: $920.77
  • BCBC Empre Healthplus — Medicaid & HARP: $606.65
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Xcapsl ctrc rmvl w o ecp Not listed in the file Not listed in the file $606.65 – $25,839
Cataract removal with lens implant: 10 of 91 insurance plan rates
  • Aetna — ASA: $25,839
  • Aetna — Commercial: $23,100
  • Aetna — Medicare: $2,852.01
  • Agewell — Medicare: $3,024.86
  • Anthem — Blue Access: $7,137
  • Anthem — Child Health Plus: $4,391.28
  • Anthem — Connection LG: $7,137
  • Anthem — Connection SG: $6,344
  • Anthem — EPO PPO: $7,930
  • Anthem — Essential 1, 2, 3, 4: $4,940.19
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: CPT 66984 Not listed in the file Not listed in the file $606.65 – $25,839
Cataract removal with lens implant: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM $38,790 $25,368.66 $1,737.96 – $35,263.78
Vaginal delivery, with care before and after: 10 of 96 insurance plan rates
  • 1199 — 1199: $3,000
  • Aetna — Commercial: $12,875.90
  • Aetna — Commercial Midlevels: $10,944.51
  • Aetna — Medicare: $2,896.36
  • Aetna — Medicare Midlevels: $2,461.91
  • Affinity — Essential Plan 3 & 4: $3,504.60
  • Affinity — Health Exchange Plan: $3,497.17
  • Affinity — Medicaid - Specialists: $2,059.09
  • Amida Care — Amida Care: $2,468.23
  • BCBC Empre Healthplus — Medicaid & HARP: $3,675
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: HC DELIVERY ROOM PACU CHARGE $19,397 Not listed in the file $695 – $135,003.12
Vaginal delivery, with care before and after: 10 of 56 insurance plan rates
  • Anthem — Child Health Plus: $4,307.34
  • Anthem — Essential 1, 2, 3, 4: $4,845.76
  • Anthem — Exchange: $15,517.60
  • Anthem — HARP: $2,153.67
  • Anthem — Medicaid: $2,153.67
  • Anthem — WPH Employees: $7,758.80
  • Cigna — Commercial: $9,093.31
  • Cigna — LocalPlus: $11,213.41
  • Emblem — Essential Plan 1 & 2: $2,584.40
  • Emblem — Essential Plan 3 & 4: $2,153.67
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: CPT 59400 Not listed in the file Not listed in the file $695 – $135,003.12
Vaginal delivery, with care before and after: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM $38,790 $25,368.66 $1,967.57 – $35,263.78
Cesarean delivery (C-section), with care before and after: 10 of 96 insurance plan rates
  • 1199 — 1199: $3,000
  • Aetna — Commercial: $14,412.72
  • Aetna — Commercial Midlevels: $12,250.81
  • Aetna — Medicare: $3,243.43
  • Aetna — Medicare Midlevels: $2,756.92
  • Affinity — Essential Plan 3 & 4: $3,924.55
  • Affinity — Health Exchange Plan: $3,867.61
  • Affinity — Medicaid - Specialists: $2,326.62
  • Amida Care — Amida Care: $2,788.42
  • BCBC Empre Healthplus — Medicaid & HARP: $3,675
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Cesarean delivery Not listed in the file Not listed in the file $2,250 – $17,559
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans
  • Emblem — GHI Commercial: $17,559
  • Emblem — HIP Commerical EPO PPO: $12,211
  • MetroPlus — Default Duals: $3,243.43
  • MetroPlus — Exchange Products: $4,216.46
  • MetroPlus — Medicaid Advantage Plus: $3,243.43
  • MetroPlus — Medicare: $3,243.43
  • Oscar — Commercial: $6,602
  • SEIU1199 — Local 1199: $2,250
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: CPT 59510 Not listed in the file Not listed in the file $2,250 – $17,559
Cesarean delivery (C-section), with care before and after: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB $38,790 $25,368.66 $1,829.32 – $35,263.78
Vaginal delivery after a previous C-section, with care before and after: 10 of 96 insurance plan rates
  • 1199 — 1199: $3,000
  • Aetna — Commercial: $13,671.91
  • Aetna — Commercial Midlevels: $11,621.12
  • Aetna — Medicare: $3,061.83
  • Aetna — Medicare Midlevels: $2,602.56
  • Affinity — Essential Plan 3 & 4: $3,704.81
  • Affinity — Health Exchange Plan: $3,668.01
  • Affinity — Medicaid - Specialists: $2,156.71
  • Amida Care — Amida Care: $2,583.73
  • BCBC Empre Healthplus — Medicaid & HARP: $3,675
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Vbac delivery Not listed in the file Not listed in the file $2,250 – $17,559
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans
  • Emblem — GHI Commercial: $17,559
  • Emblem — HIP Commerical EPO PPO: $12,211
  • MetroPlus — Default Duals: $3,061.83
  • MetroPlus — Exchange Products: $3,980.38
  • MetroPlus — Medicaid Advantage Plus: $3,061.83
  • MetroPlus — Medicare: $3,061.83
  • Oscar — Commercial: $6,602
  • SEIU1199 — Local 1199: $2,250
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: CPT 59610 Not listed in the file Not listed in the file $2,250 – $17,559
Vaginal delivery after a previous C-section, with care before and after: rates for 6 insurance plans
  • Centivo — Centivo Network: 55% (a percentage in the contract, not a dollar amount)
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: Cardiac valve oth maj cardiothoracic proc w cardiac cath w MCC Not listed in the file Not listed in the file $32,396.53 – $106,445.73
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 27 insurance plan rates
  • Aetna — Medicare: $76,363.24
  • Agewell — Medicare: $84,848.05
  • Anthem — Medicare: $77,134.59
  • Centerlight — Medicare: $79,448.63
  • Centerlight — PACE: $79,448.63
  • CentersPlan — Medicare Advan I SNP: $84,848.05
  • Emblem — Medicare: $80,991.32
  • Emblem — Select Care: $94,875.55
  • Fidelis — Medicare: $77,134.59
  • Hamaspik — Medicare: $84,848.05
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: MS-DRG 216 Not listed in the file Not listed in the file $32,396.53 – $106,445.73
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 5 insurance plans
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: Major hip knee joint replace or reattach lower extremity w o MCC Not listed in the file Not listed in the file $6,329.65 – $20,797.41
Hip or knee replacement (major joint of the leg), without major complications: 10 of 27 insurance plan rates
  • Aetna — Medicare: $14,919.88
  • Agewell — Medicare: $16,577.65
  • Anthem — Medicare: $15,070.59
  • Centerlight — Medicare: $15,522.71
  • Centerlight — PACE: $15,522.71
  • CentersPlan — Medicare Advan I SNP: $16,577.65
  • Emblem — Medicare: $15,824.12
  • Emblem — Select Care: $18,536.83
  • Fidelis — Medicare: $15,070.59
  • Hamaspik — Medicare: $16,577.65
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MS-DRG 470 Not listed in the file Not listed in the file $6,329.65 – $20,797.41
Hip or knee replacement (major joint of the leg), without major complications: rates for 5 insurance plans
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: Cervical spinal fusion without CC MCC Not listed in the file Not listed in the file $7,946.72 – $26,110.66
Neck (cervical) spinal fusion, without complications: 10 of 27 insurance plan rates
  • Aetna — Medicare: $18,731.56
  • Agewell — Medicare: $20,812.85
  • Anthem — Medicare: $18,920.77
  • Centerlight — Medicare: $19,488.39
  • Centerlight — PACE: $19,488.39
  • CentersPlan — Medicare Advan I SNP: $20,812.85
  • Emblem — Medicare: $19,866.81
  • Emblem — Select Care: $23,272.55
  • Fidelis — Medicare: $18,920.77
  • Hamaspik — Medicare: $20,812.85
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: MS-DRG 473 Not listed in the file Not listed in the file $7,946.72 – $26,110.66
Neck (cervical) spinal fusion, without complications: rates for 5 insurance plans
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (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 Not listed in the file Not listed in the file $4,023.72 – $13,220.79
Uterus and ovary surgery (not for cancer), without complications: 10 of 27 insurance plan rates
  • Aetna — Medicare: $9,484.48
  • Agewell — Medicare: $10,538.31
  • Anthem — Medicare: $9,580.28
  • Centerlight — Medicare: $9,867.69
  • Centerlight — PACE: $9,867.69
  • CentersPlan — Medicare Advan I SNP: $10,538.31
  • Emblem — Medicare: $10,059.29
  • Emblem — Select Care: $11,783.74
  • Fidelis — Medicare: $9,580.28
  • Hamaspik — Medicare: $10,538.31
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: MS-DRG 743 Not listed in the file Not listed in the file $4,023.72 – $13,220.79
Uterus and ovary surgery (not for cancer), without complications: rates for 5 insurance plans
  • Emblem — GHI Access Network: 60% (a percentage in the contract, not a dollar amount)
  • Magnacare — JIB: 73% (a percentage in the contract, not a dollar amount)
  • Magnacare — Preferred: 75.5% (a percentage in the contract, not a dollar amount)
  • Magnacare — Standard: 82% (a percentage in the contract, not a dollar amount)
  • Multiplan — Multiplan: 83% (a percentage in the contract, not a dollar amount)

Source: Montefiore Medical Center’s standard charges file (assets.montefioreeinstein.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 28, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address111 East 210th Street, Bronx, NY 10467
CountyBronx County
StateNew York
Phone(718) 920‑4321
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number330059
Name in Medicare recordsMONTEFIORE MEDICAL CENTER
Profile levelMedicare data + hospital website
Name on the hospital’s websiteMontefiore Einstein Hospital—Moses Campus
Official websitemontefioreeinstein.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Facilities | Emergency Medicine | Patient Care | Montefiore Einstein — montefioreeinstein.org
  2. Emergency Services | Patient Care | Montefiore Einstein — montefioreeinstein.org
  3. Emergency Psychiatry — montefioreeinstein.org
  4. Emergency Medicine Residency — montefioreeinstein.org
  5. For Visitors | Patient Care | Montefiore Einstein — montefioreeinstein.org