Does Mount Desert Island Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mount Desert Island Hospital. In a medical emergency, call 911.

Where is Mount Desert Island Hospital?

10 Wayman Lane, Bar Harbor, ME 04609, in Hancock County, Maine.

What is the phone number of Mount Desert Island Hospital?

(207) 288-5081, as listed by Medicare (CMS).

What is the Medicare star rating of Mount Desert Island Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Mount Desert Island Hospital — Bar Harbor, ME

Quick answers

Does Mount Desert Island Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mount Desert Island Hospital. In a medical emergency, call 911.
Where is Mount Desert Island Hospital?: 10 Wayman Lane, Bar Harbor, ME 04609, in Hancock County, Maine.
What is the phone number of Mount Desert Island Hospital?: (207) 288-5081, as listed by Medicare (CMS).
What is the Medicare star rating of Mount Desert Island Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[5][6]

Emergency Medicine
Orthopedics
Surgery
Urology
Cardiology
Pulmonology
Oncology & Hematology
Pediatrics
Women's Health
Behavioral Health
Palliative Care
Critical Care/ICU
Medical Imaging
Physical Medicine
Occupational Medicine
Dental/Oral Health
Family Medicine

Treatments^[4][5]

Physical therapy
Speech therapy
Cardiac rehabilitation
Short-term skilled rehabilitation
Platelet-rich plasma therapy
Pain management
Infusion/oncology care
Nutrition counseling
Music therapy
Anticoagulation clinic

Programs and centers^[5][6]

Cancer Patient Navigator Program
Diabetes Prevention Program
Health Coaching
Wellness Programs
Childbirth education classes
Tobacco avoidance education
Penn Medicine emergency medicine collaboration
Prescription Assistance

Emergency care (hospital website)^[6]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Parking	Visitor parking lot is at the new Main Street entrance (opened Oct 19, 2026); Wayman Lane entrance is employee-only; ED entrance unchanged^[4]
Interpreters and languages	Interpretation services available by calling the hospital at 207-288-5081^[9]
Patient portal	My MDIH Patient Portal

Recognition^[4][7]

Critical Access Hospital
AHA Get With The Guidelines-Stroke Rural Recognition Bronze (2026)
CMS 5-star rating for patient experience and nurse communication (2026)
Gold Star Standards of Excellence Platinum (tobacco-free campus)

Doctors and clinicians (117)

117 doctors and other clinicians list Mount Desert Island Hospital 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 (117)

Alan Jansujwicz, MDCardiovascular Disease (Cardiology)
Alexander Kulczycki, MDHospitalist
Alexander M. Schin, MDEmergency Medicine
Alexandra Lekson, MDEmergency Medicine
Alisa M. Vroman, CNACertified Registered Nurse Anesthetist (CRNA)
Allison TsomidesPhysician Assistant
Angela S. Delvecchio, NPNurse Practitioner
Anita D. Kolisch, MDInternal Medicine
Audrey L. FarleyNurse Practitioner
Audrey M. Garrett, MDHematology/Oncology
Auria M. MaurasMental Health Counselor
Ayodele T. Isaacs, MDFamily Practice
Bakhtier Nurmukhamedov, MDNeurology
Barbara Mercado-Stallard, MDObstetrics/Gynecology
Bartholomew R. Clayton, MDHospitalist
Bartlett H. Hayes, MDOphthalmology
Bettina I. HerrickNurse Practitioner
Billy W. Mahaney, MDDiagnostic Radiology
Bruce BosingerMental Health Counselor
Casey S. Hanson, MDFamily Practice
Cecily J. Swinburne, MDEmergency Medicine
Charles D. Radis, DORheumatology
Charles E. Hendricks, MDGeneral Surgery
Chris P. Schleif, NPNurse Practitioner

And 93 more: the button below opens the full list.

Other emergency rooms nearby

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

Northern Light Maine Coast Hospital15 mi · Ellsworth, ME · Acute Care Hospital
Northern Light Blue Hill Memorial Hospital19 mi · Blue Hill, ME · Critical Access Hospital
Northern Light Eastern Maine Medical Center40 mi · Bangor, ME · Acute Care Hospital
Down East Community Hospital41 mi · Machias, ME · Critical Access Hospital
St Joseph Hospital41 mi · Bangor, ME · Acute Care Hospital

Other hospitals nearby

Dorothea Dix Psychiatric Center40 mi · Bangor, ME · Psychiatric Hospital
Northern Light Acadia Hospital41 mi · Bangor, ME · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Home health agencies

Mount Desert Nursing Assoc6.8 mi · Northeast Harbor, ME

All home health agencies in the state →

Dialysis facilities

DaVita Eastern Maine Dialysis23 mi · Ellsworth, ME · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Coastal Eye Surgery Center, LLC23 mi · Ellsworth, ME

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

Ellsworth High School16 mi · Ellsworth, ME · Community health center
Bucksport Regional Health Center- Ellsworth Site17 mi · Ellsworth, ME · Community health center
Blueberry Harvest School19 mi · Milbridge, ME · Community health center

Clinics and urgent care

Milbridge Medical Center18 mi · Milbridge, ME · Rural health clinic
Convenientmd - FFS UC LLC23 mi · Ellsworth, ME · Urgent care center
Convenientmd LLC23 mi · Ellsworth, ME · Urgent care center

Pharmacies

Hannaford Bros Co LLC3.2 mi · Bar Harbor, ME · Community/retail pharmacy
Walgreen Eastern Co Inc3.2 mi · Bar Harbor, ME · Pharmacy

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 Mount Desert Island Hospital 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)	5 of 5 stars
Overall rating of the hospital	5 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	5 of 5 stars
Doctors communicated well	5 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	5 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	86%National average: 72%
Would definitely recommend the hospital	90%National average: 71%
Nurses “always” communicated well	93%National average: 80%
Doctors “always” communicated well	94%National average: 80%
Staff “always” explained medicines before giving them	68%National average: 62%
Were given information about recovery at home	94%National average: 86%
Room and bathroom “always” clean	75%National average: 74%
Area around the room “always” quiet at night	67%National average: 60%
Completed surveys	106Response rate: 25%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

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

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	14.8%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.3%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	130 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	81%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Maine

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 70 common services exactly as Mount Desert Island Hospital 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 →

$ 2 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: 99203 CLINIC FEE-NEW PT LEVEL 3 EXPANDED CHARGE	$101	$90.90	$45.45 – $101
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $92.42 Aetna — MCR Advantage: $45.45 Anthem — Commercial: $78.58 Anthem — MCR Advantage: $45.45 Cigna — Commercial: $93.93 Cigna — MCR Advantage: $45.45 Community Health Options — Commercial: $85.85 First Health — Commercial: $95.95 Harvard Pilgrim — Commercial: $91.41 HealthNet — Commercial: $65.65
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: 99203 CLINIC FEE-NEW PT LEVEL 3 EXPANDED CHARGE Pro Fee	$348	$313.20	$156.60 – $348
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $318.42 Aetna — MCR Advantage: $156.60 Anthem — Commercial: $270.74 Anthem — MCR Advantage: $156.60 Cigna — Commercial: $323.64 Cigna — MCR Advantage: $156.60 Community Health Options — Commercial: $295.80 First Health — Commercial: $330.60 Harvard Pilgrim — Commercial: $314.94 HealthNet — Commercial: $226.20
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: 99203 Office/Outpatient Visit - New Patient, Level 3 (30-44 min)	$265	$238.50	$119.25 – $265
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $242.47 Aetna — MCR Advantage: $119.25 Anthem — Commercial: $206.17 Anthem — MCR Advantage: $119.25 Cigna — Commercial: $246.45 Cigna — MCR Advantage: $119.25 Community Health Options — Commercial: $225.25 First Health — Commercial: $251.75 Harvard Pilgrim — Commercial: $239.82 HealthNet — Commercial: $172.25
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: 99204 CLINIC FEE-NEW PT LEVEL 4 EXPANDED CHARGE	$278	$250.20	$125.10 – $278
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $254.37 Aetna — MCR Advantage: $125.10 Anthem — Commercial: $216.28 Anthem — MCR Advantage: $125.10 Cigna — Commercial: $258.54 Cigna — MCR Advantage: $125.10 Community Health Options — Commercial: $236.30 First Health — Commercial: $264.10 Harvard Pilgrim — Commercial: $251.59 HealthNet — Commercial: $180.70
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: 99204 CLINIC FEE-NEW PT LEVEL 4 EXPANDED CHARGE Pro Fee	$191	$171.90	$85.95 – $191
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $174.76 Aetna — MCR Advantage: $85.95 Anthem — Commercial: $148.60 Anthem — MCR Advantage: $85.95 Cigna — Commercial: $177.63 Cigna — MCR Advantage: $85.95 Community Health Options — Commercial: $162.35 First Health — Commercial: $181.45 Harvard Pilgrim — Commercial: $172.85 HealthNet — Commercial: $124.15
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: 99204 Office/Outpatient Visit - New Patient, Level 4 (45-59 min)	$191	$171.90	$85.95 – $191
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $174.76 Aetna — MCR Advantage: $85.95 Anthem — Commercial: $148.60 Anthem — MCR Advantage: $85.95 Cigna — Commercial: $177.63 Cigna — MCR Advantage: $85.95 Community Health Options — Commercial: $162.35 First Health — Commercial: $181.45 Harvard Pilgrim — Commercial: $172.85 HealthNet — Commercial: $124.15
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: 99205 CLINIC FEE-NEW PT LEVEL 5 EXPANDED CHARGE	$368	$331.20	$165.60 – $368
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $336.72 Aetna — MCR Advantage: $165.60 Anthem — Commercial: $286.30 Anthem — MCR Advantage: $165.60 Cigna — Commercial: $342.24 Cigna — MCR Advantage: $165.60 Community Health Options — Commercial: $312.80 First Health — Commercial: $349.60 Harvard Pilgrim — Commercial: $333.04 HealthNet — Commercial: $239.20
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: 99205 CLINIC FEE-NEW PT LEVEL 5 EXPANDED CHARGE Pro Fee	$275	$247.50	$123.75 – $275
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $251.62 Aetna — MCR Advantage: $123.75 Anthem — Commercial: $213.95 Anthem — MCR Advantage: $123.75 Cigna — Commercial: $255.75 Cigna — MCR Advantage: $123.75 Community Health Options — Commercial: $233.75 First Health — Commercial: $261.25 Harvard Pilgrim — Commercial: $248.88 HealthNet — Commercial: $178.75
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: 99205 Office/Outpatient Visit - New Patient, Level 5 (60 Min)	$399	$359.10	$179.55 – $399
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $365.08 Aetna — MCR Advantage: $179.55 Anthem — Commercial: $310.42 Anthem — MCR Advantage: $179.55 Cigna — Commercial: $371.07 Cigna — MCR Advantage: $179.55 Community Health Options — Commercial: $339.15 First Health — Commercial: $379.05 Harvard Pilgrim — Commercial: $361.10 HealthNet — Commercial: $259.35
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: 99213 Office/Outpatient Visit - Established Patient, Level 3	$220	$198	$99 – $220
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $201.30 Aetna — MCR Advantage: $99 Anthem — Commercial: $171.16 Anthem — MCR Advantage: $99 Cigna — Commercial: $204.60 Cigna — MCR Advantage: $99 Community Health Options — Commercial: $187 First Health — Commercial: $209 Harvard Pilgrim — Commercial: $199.10 HealthNet — Commercial: $143
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Telehealth OFFICE/ O/P VISIT EST - LEVEL 3	$22	$19.80	$9.90 – $22
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $20.13 Aetna — MCR Advantage: $9.90 Anthem — Commercial: $17.12 Anthem — MCR Advantage: $9.90 Cigna — Commercial: $20.46 Cigna — MCR Advantage: $9.90 Community Health Options — Commercial: $18.70 First Health — Commercial: $20.90 Harvard Pilgrim — Commercial: $19.91 HealthNet — Commercial: $14.30
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: 99213 CLINIC FEE-EST PT LEVEL 3 EXPANDED CHARGE	$41	$36.90	$18.45 – $41
Established patient office visit (about 20–29 minutes): rates for 8 insurance plans Aetna — Commercial: $37.52 Anthem — Commercial: $31.90 Cigna — Commercial: $38.13 Community Health Options — Commercial: $34.85 First Health — Commercial: $38.95 Harvard Pilgrim — Commercial: $37.10 HealthNet — Commercial: $26.65 United Healthcare — Commercial: $24.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: 99214 CLINIC FEE-EST PT LEVEL 4 EXPANDED CHARGE	$226	$203.40	$101.70 – $226
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $206.79 Aetna — MCR Advantage: $101.70 Anthem — Commercial: $175.83 Anthem — MCR Advantage: $101.70 Cigna — Commercial: $210.18 Cigna — MCR Advantage: $101.70 Community Health Options — Commercial: $192.10 First Health — Commercial: $214.70 Harvard Pilgrim — Commercial: $204.53 HealthNet — Commercial: $146.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: 99214 CLINIC FEE-EST PT LEVEL 4 EXPANDED CHARGE Pro Fee	$220	$198	$99 – $220
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $201.30 Aetna — MCR Advantage: $99 Anthem — Commercial: $171.16 Anthem — MCR Advantage: $99 Cigna — Commercial: $204.60 Cigna — MCR Advantage: $99 Community Health Options — Commercial: $187 First Health — Commercial: $209 Harvard Pilgrim — Commercial: $199.10 HealthNet — Commercial: $143
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: 99214 Office/Outpatient Visit - Established Patient,Level 4 (30-39 min)	$282	$253.80	$126.90 – $282
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $258.03 Aetna — MCR Advantage: $126.90 Anthem — Commercial: $219.40 Anthem — MCR Advantage: $126.90 Cigna — Commercial: $262.26 Cigna — MCR Advantage: $126.90 Community Health Options — Commercial: $239.70 First Health — Commercial: $267.90 Harvard Pilgrim — Commercial: $255.21 HealthNet — Commercial: $183.30
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: 99243 LEVEL 3 OUTPT CONSULT ProFee - HUMB	$180	$162	$81 – $180
Office consultation with a specialist (moderate): 10 of 14 insurance plan rates Aetna — Commercial: $164.70 Aetna — MCR Advantage: $81 Anthem — Commercial: $140.04 Anthem — MCR Advantage: $81 Cigna — Commercial: $167.40 Cigna — MCR Advantage: $81 Community Health Options — Commercial: $153 First Health — Commercial: $171 Harvard Pilgrim — Commercial: $162.90 HealthNet — Commercial: $117
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: 99243 Office Consultation, Level 3	$209	$188.10	$94.05 – $209
Office consultation with a specialist (moderate): rates for 8 insurance plans Aetna — Commercial: $191.24 Anthem — Commercial: $162.60 Cigna — Commercial: $194.37 Community Health Options — Commercial: $177.65 First Health — Commercial: $198.55 Harvard Pilgrim — Commercial: $189.15 HealthNet — Commercial: $135.85 United Healthcare — Commercial: $125.40
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: 99243 LEVEL 3 OUTPT CONSULT ProFee	$19	$17.10	$8.55 – $19
Office consultation with a specialist (moderate): rates for 8 insurance plans Aetna — Commercial: $17.39 Anthem — Commercial: $14.78 Cigna — Commercial: $17.67 Community Health Options — Commercial: $16.15 First Health — Commercial: $18.05 Harvard Pilgrim — Commercial: $17.20 HealthNet — Commercial: $12.35 United Healthcare — Commercial: $11.40
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: 99244 LEVEL 4 OUTPT CONSULT ProFee - HUMB	$261	$234.90	$117.45 – $261
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates Aetna — Commercial: $238.81 Aetna — MCR Advantage: $117.45 Anthem — Commercial: $203.06 Anthem — MCR Advantage: $117.45 Cigna — Commercial: $242.73 Cigna — MCR Advantage: $117.45 Community Health Options — Commercial: $221.85 First Health — Commercial: $247.95 Harvard Pilgrim — Commercial: $236.21 HealthNet — Commercial: $169.65
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: 99244 LEVEL 4 OUTPT CONSULT ProFee	$134	$120.60	$60.30 – $134
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates Aetna — Commercial: $122.61 Aetna — MCR Advantage: $60.30 Anthem — Commercial: $104.25 Anthem — MCR Advantage: $60.30 Cigna — Commercial: $124.62 Cigna — MCR Advantage: $60.30 Community Health Options — Commercial: $113.90 First Health — Commercial: $127.30 Harvard Pilgrim — Commercial: $121.27 HealthNet — Commercial: $87.10
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee · modifier 95 In the file: 99244 Office Consultation, Level 4	$218	$196.20	$98.10 – $218
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates Aetna — Commercial: $199.47 Aetna — MCR Advantage: $98.10 Anthem — Commercial: $169.60 Anthem — MCR Advantage: $98.10 Cigna — Commercial: $202.74 Cigna — MCR Advantage: $98.10 Community Health Options — Commercial: $185.30 First Health — Commercial: $207.10 Harvard Pilgrim — Commercial: $197.29 HealthNet — Commercial: $141.70
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: 99385 Preventive Evaluation, New Pt; 18-39 Yrs	$644	$579.60	$289.80 – $644
Preventive checkup, new patient, age 18–39: 10 of 14 insurance plan rates Aetna — Commercial: $589.26 Aetna — MCR Advantage: $289.80 Anthem — Commercial: $501.03 Anthem — MCR Advantage: $289.80 Cigna — Commercial: $598.92 Cigna — MCR Advantage: $289.80 Community Health Options — Commercial: $547.40 First Health — Commercial: $611.80 Harvard Pilgrim — Commercial: $582.82 HealthNet — Commercial: $418.60
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: 99386 Preventive Evaluation, New Pt; 40-64 Yrs	$828	$745.20	$372.60 – $828
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans Aetna — Commercial: $757.62 Anthem — Commercial: $644.18 Cigna — Commercial: $770.04 Community Health Options — Commercial: $703.80 First Health — Commercial: $786.60 Harvard Pilgrim — Commercial: $749.34 HealthNet — Commercial: $538.20 United Healthcare — Commercial: $496.80
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 99386 Preventive Evaluation, New Pt; 40-64 Yrs	$828	$745.20	$372.60 – $828
Preventive checkup, new patient, age 40–64: rates for 6 insurance plans Aetna — MCR Advantage: $372.60 Anthem — MCR Advantage: $372.60 Cigna — MCR Advantage: $372.60 Martins Point — MCR Advantage: $372.60 United Healthcare — MCR Advantage: $372.60 Wellcare — MCR Advantage: $372.60
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: 99283 Level 3 ED TechFee	$237	$213.30	$106.65 – $237
Emergency room visit (moderate): 10 of 14 insurance plan rates Aetna — Commercial: $216.85 Aetna — MCR Advantage: $106.65 Anthem — Commercial: $184.39 Anthem — MCR Advantage: $106.65 Cigna — Commercial: $220.41 Cigna — MCR Advantage: $106.65 Community Health Options — Commercial: $201.45 First Health — Commercial: $225.15 Harvard Pilgrim — Commercial: $214.49 HealthNet — Commercial: $154.05
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: 99283 EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY ProFee	$375	$337.50	$168.75 – $375
Emergency room visit (moderate): rates for 8 insurance plans Aetna — Commercial: $343.12 Anthem — Commercial: $291.75 Cigna — Commercial: $348.75 Community Health Options — Commercial: $318.75 First Health — Commercial: $356.25 Harvard Pilgrim — Commercial: $339.38 HealthNet — Commercial: $243.75 United Healthcare — Commercial: $225
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: 99283-E&M req. a medically appropriate hx and/or exam and low level medical decision making	$258	$232.20	$116.10 – $258
Emergency room visit (moderate): rates for 8 insurance plans Aetna — Commercial: $236.07 Anthem — Commercial: $200.72 Cigna — Commercial: $239.94 Community Health Options — Commercial: $219.30 First Health — Commercial: $245.10 Harvard Pilgrim — Commercial: $233.49 HealthNet — Commercial: $167.70 United Healthcare — Commercial: $154.80
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: 99284 Level 4 ED TechFee	$897	$807.30	$403.65 – $897
Emergency room visit (moderately high): 10 of 14 insurance plan rates Aetna — Commercial: $820.75 Aetna — MCR Advantage: $403.65 Anthem — Commercial: $697.87 Anthem — MCR Advantage: $403.65 Cigna — Commercial: $834.21 Cigna — MCR Advantage: $403.65 Community Health Options — Commercial: $762.45 First Health — Commercial: $852.15 Harvard Pilgrim — Commercial: $811.78 HealthNet — Commercial: $583.05
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: 99284 ED VISIT E&M PATIENT, LEV 4, REQ MED APPROP HSTRY/EXAM/MODERATE MDM, CC	$93	$83.70	$41.85 – $93
Emergency room visit (moderately high): rates for 8 insurance plans Aetna — Commercial: $85.09 Anthem — Commercial: $72.35 Cigna — Commercial: $86.49 Community Health Options — Commercial: $79.05 First Health — Commercial: $88.35 Harvard Pilgrim — Commercial: $84.17 HealthNet — Commercial: $60.45 United Healthcare — Commercial: $55.80
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: 99284 EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY ProFee	$401	$360.90	$180.45 – $401
Emergency room visit (moderately high): rates for 8 insurance plans Aetna — Commercial: $366.92 Anthem — Commercial: $311.98 Cigna — Commercial: $372.93 Community Health Options — Commercial: $340.85 First Health — Commercial: $380.95 Harvard Pilgrim — Commercial: $362.90 HealthNet — Commercial: $260.65 United Healthcare — Commercial: $240.60
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: 99285 ED VISIT E M PATIENT, LEV 5, REQ MED APPROP HSTRY/EXAM/HIGH MDM, CC	$300	$270	$135 – $300
Emergency room visit (high): 10 of 14 insurance plan rates Aetna — Commercial: $274.50 Aetna — MCR Advantage: $135 Anthem — Commercial: $233.40 Anthem — MCR Advantage: $135 Cigna — Commercial: $279 Cigna — MCR Advantage: $135 Community Health Options — Commercial: $255 First Health — Commercial: $285 Harvard Pilgrim — Commercial: $271.50 HealthNet — Commercial: $195
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: 99285 EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ ProFee	$104	$93.60	$46.80 – $104
Emergency room visit (high): rates for 8 insurance plans Aetna — Commercial: $95.16 Anthem — Commercial: $80.91 Cigna — Commercial: $96.72 Community Health Options — Commercial: $88.40 First Health — Commercial: $98.80 Harvard Pilgrim — Commercial: $94.12 HealthNet — Commercial: $67.60 United Healthcare — Commercial: $62.40
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: 99285-E&M req. a medically appropriate hx and/or exam and high level of medical decision making	$593	$533.70	$266.85 – $593
Emergency room visit (high): rates for 8 insurance plans Aetna — Commercial: $542.60 Anthem — Commercial: $461.35 Cigna — Commercial: $551.49 Community Health Options — Commercial: $504.05 First Health — Commercial: $563.35 Harvard Pilgrim — Commercial: $536.66 HealthNet — Commercial: $385.45 United Healthcare — Commercial: $355.80

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Basic Metabolic Panel	$393.75	$354.38	$177.19 – $393.75
Basic metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — Commercial: $360.28 Aetna — MCR Advantage: $177.19 Anthem — Commercial: $306.34 Anthem — MCR Advantage: $177.19 Cigna — Commercial: $366.19 Cigna — MCR Advantage: $177.19 Community Health Options — Commercial: $334.69 First Health — Commercial: $374.06 Harvard Pilgrim — Commercial: $356.34 HealthNet — Commercial: $255.94
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: iSTAT BMP	$24	$21.60	$10.80 – $24
Basic metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — Commercial: $21.96 Aetna — MCR Advantage: $10.80 Anthem — Commercial: $18.67 Anthem — MCR Advantage: $10.80 Cigna — Commercial: $22.32 Cigna — MCR Advantage: $10.80 Community Health Options — Commercial: $20.40 First Health — Commercial: $22.80 Harvard Pilgrim — Commercial: $21.72 HealthNet — Commercial: $15.60
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lipid Panel	$84	$75.60	$37.80 – $84
Cholesterol panel (lipid panel): 10 of 14 insurance plan rates Aetna — Commercial: $76.86 Aetna — MCR Advantage: $37.80 Anthem — Commercial: $65.35 Anthem — MCR Advantage: $37.80 Cigna — Commercial: $78.12 Cigna — MCR Advantage: $37.80 Community Health Options — Commercial: $71.40 First Health — Commercial: $79.80 Harvard Pilgrim — Commercial: $76.02 HealthNet — Commercial: $54.60
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Renal Pnl	$312	$280.80	$140.40 – $312
Kidney function panel: 10 of 14 insurance plan rates Aetna — Commercial: $285.48 Aetna — MCR Advantage: $140.40 Anthem — Commercial: $242.74 Anthem — MCR Advantage: $140.40 Cigna — Commercial: $290.16 Cigna — MCR Advantage: $140.40 Community Health Options — Commercial: $265.20 First Health — Commercial: $296.40 Harvard Pilgrim — Commercial: $282.36 HealthNet — Commercial: $202.80
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: .Urinalysis POCT	$175	$157.50	$78.75 – $175
Urine test (manual, without microscope): 10 of 14 insurance plan rates Aetna — Commercial: $160.12 Aetna — MCR Advantage: $78.75 Anthem — Commercial: $136.15 Anthem — MCR Advantage: $78.75 Cigna — Commercial: $162.75 Cigna — MCR Advantage: $78.75 Community Health Options — Commercial: $148.75 First Health — Commercial: $166.25 Harvard Pilgrim — Commercial: $158.38 HealthNet — Commercial: $113.75
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee · modifier QW In the file: Urine Dipstick Clinic POC (RE)	$1,974 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$1,776.60	$888.30 – $1,974 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (manual, without microscope): 10 of 14 insurance plan rates Aetna — Commercial: $1,806.21 Aetna — MCR Advantage: $888.30 Anthem — Commercial: $1,535.77 Anthem — MCR Advantage: $888.30 Cigna — Commercial: $1,835.82 Cigna — MCR Advantage: $888.30 Community Health Options — Commercial: $1,677.90 First Health — Commercial: $1,875.30 Harvard Pilgrim — Commercial: $1,786.47 HealthNet — Commercial: $1,283.10
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: Specific Gravity Urine	$24	$21.60	$10.80 – $24
Urine test (automated, without microscope): 10 of 14 insurance plan rates Aetna — Commercial: $21.96 Aetna — MCR Advantage: $10.80 Anthem — Commercial: $18.67 Anthem — MCR Advantage: $10.80 Cigna — Commercial: $22.32 Cigna — MCR Advantage: $10.80 Community Health Options — Commercial: $20.40 First Health — Commercial: $22.80 Harvard Pilgrim — Commercial: $21.72 HealthNet — Commercial: $15.60
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA Diagnostic	$39	$35.10	$17.55 – $39
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — Commercial: $35.69 Aetna — MCR Advantage: $17.55 Anthem — Commercial: $30.34 Anthem — MCR Advantage: $17.55 Cigna — Commercial: $36.27 Cigna — MCR Advantage: $17.55 Community Health Options — Commercial: $33.15 First Health — Commercial: $37.05 Harvard Pilgrim — Commercial: $35.30 HealthNet — Commercial: $25.35
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA, Post Prostatectomy with HAMA Treatment QST	$109	$98.10	$49.05 – $109
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — Commercial: $99.73 Aetna — MCR Advantage: $49.05 Anthem — Commercial: $84.80 Anthem — MCR Advantage: $49.05 Cigna — Commercial: $101.37 Cigna — MCR Advantage: $49.05 Community Health Options — Commercial: $92.65 First Health — Commercial: $103.55 Harvard Pilgrim — Commercial: $98.64 HealthNet — Commercial: $70.85
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PSA, Post-Prostatectomy QST	$75	$67.50	$33.75 – $75
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — Commercial: $68.62 Aetna — MCR Advantage: $33.75 Anthem — Commercial: $58.35 Anthem — MCR Advantage: $33.75 Cigna — Commercial: $69.75 Cigna — MCR Advantage: $33.75 Community Health Options — Commercial: $63.75 First Health — Commercial: $71.25 Harvard Pilgrim — Commercial: $67.88 HealthNet — Commercial: $48.75
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Thyroid Cascading Reflex QST	$67	$60.30	$30.15 – $67
Thyroid stimulating hormone (TSH) test: 10 of 14 insurance plan rates Aetna — Commercial: $61.30 Aetna — MCR Advantage: $30.15 Anthem — Commercial: $52.13 Anthem — MCR Advantage: $30.15 Cigna — Commercial: $62.31 Cigna — MCR Advantage: $30.15 Community Health Options — Commercial: $56.95 First Health — Commercial: $63.65 Harvard Pilgrim — Commercial: $60.63 HealthNet — Commercial: $43.55
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: Thyroid Stimulating Hormone	$27	$24.30	$12.15 – $27
Thyroid stimulating hormone (TSH) test: 10 of 14 insurance plan rates Aetna — Commercial: $24.70 Aetna — MCR Advantage: $12.15 Anthem — Commercial: $21.01 Anthem — MCR Advantage: $12.15 Cigna — Commercial: $25.11 Cigna — MCR Advantage: $12.15 Community Health Options — Commercial: $22.95 First Health — Commercial: $25.65 Harvard Pilgrim — Commercial: $24.43 HealthNet — Commercial: $17.55
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: Anemia Pnl	$22	$19.80	$9.90 – $22
Complete blood count (CBC) with differential: 10 of 14 insurance plan rates Aetna — Commercial: $20.13 Aetna — MCR Advantage: $9.90 Anthem — Commercial: $17.12 Anthem — MCR Advantage: $9.90 Cigna — Commercial: $20.46 Cigna — MCR Advantage: $9.90 Community Health Options — Commercial: $18.70 First Health — Commercial: $20.90 Harvard Pilgrim — Commercial: $19.91 HealthNet — Commercial: $14.30
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC w/ Differential	$35	$31.50	$15.75 – $35
Complete blood count (CBC) with differential: 10 of 14 insurance plan rates Aetna — Commercial: $32.02 Aetna — MCR Advantage: $15.75 Anthem — Commercial: $27.23 Anthem — MCR Advantage: $15.75 Cigna — Commercial: $32.55 Cigna — MCR Advantage: $15.75 Community Health Options — Commercial: $29.75 First Health — Commercial: $33.25 Harvard Pilgrim — Commercial: $31.68 HealthNet — Commercial: $22.75
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Anemia Panel DC	$36	$32.40	$16.20 – $36
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — Commercial: $32.94 Aetna — MCR Advantage: $16.20 Anthem — Commercial: $28.01 Anthem — MCR Advantage: $16.20 Cigna — Commercial: $33.48 Cigna — MCR Advantage: $16.20 Community Health Options — Commercial: $30.60 First Health — Commercial: $34.20 Harvard Pilgrim — Commercial: $32.58 HealthNet — Commercial: $23.40
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC w/ Manual Differential	$82	$73.80	$36.90 – $82
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — Commercial: $75.03 Aetna — MCR Advantage: $36.90 Anthem — Commercial: $63.80 Anthem — MCR Advantage: $36.90 Cigna — Commercial: $76.26 Cigna — MCR Advantage: $36.90 Community Health Options — Commercial: $69.70 First Health — Commercial: $77.90 Harvard Pilgrim — Commercial: $74.21 HealthNet — Commercial: $53.30
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC without Differential	$54	$48.60	$24.30 – $54
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — Commercial: $49.41 Aetna — MCR Advantage: $24.30 Anthem — Commercial: $42.01 Anthem — MCR Advantage: $24.30 Cigna — Commercial: $50.22 Cigna — MCR Advantage: $24.30 Community Health Options — Commercial: $45.90 First Health — Commercial: $51.30 Harvard Pilgrim — Commercial: $48.87 HealthNet — Commercial: $35.10
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PT/INR Clinic POC (RE)	$64	$57.60	$28.80 – $64
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — Commercial: $58.56 Aetna — MCR Advantage: $28.80 Anthem — Commercial: $49.79 Anthem — MCR Advantage: $28.80 Cigna — Commercial: $59.52 Cigna — MCR Advantage: $28.80 Community Health Options — Commercial: $54.40 First Health — Commercial: $60.80 Harvard Pilgrim — Commercial: $57.92 HealthNet — Commercial: $41.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: Instr PT	$23.43	$21.09	$10.54 – $23.43
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — Commercial: $21.44 Aetna — MCR Advantage: $10.54 Anthem — Commercial: $18.23 Anthem — MCR Advantage: $10.54 Cigna — Commercial: $21.79 Cigna — MCR Advantage: $10.54 Community Health Options — Commercial: $19.92 First Health — Commercial: $22.26 Harvard Pilgrim — Commercial: $21.20 HealthNet — Commercial: $15.23
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PT (INR)	$22	$19.80	$9.90 – $22
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — Commercial: $20.13 Aetna — MCR Advantage: $9.90 Anthem — Commercial: $17.12 Anthem — MCR Advantage: $9.90 Cigna — Commercial: $20.46 Cigna — MCR Advantage: $9.90 Community Health Options — Commercial: $18.70 First Health — Commercial: $20.90 Harvard Pilgrim — Commercial: $19.91 HealthNet — Commercial: $14.30
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: 85730 - PTT-LA w/Reflex to Hexagonal Phase Confirmation	$14	$12.60	$6.30 – $14
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — Commercial: $12.81 Aetna — MCR Advantage: $6.30 Anthem — Commercial: $10.89 Anthem — MCR Advantage: $6.30 Cigna — Commercial: $13.02 Cigna — MCR Advantage: $6.30 Community Health Options — Commercial: $11.90 First Health — Commercial: $13.30 Harvard Pilgrim — Commercial: $12.67 HealthNet — Commercial: $9.10
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: PTT LA QST	$285	$256.50	$128.25 – $285
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — Commercial: $260.77 Aetna — MCR Advantage: $128.25 Anthem — Commercial: $221.73 Anthem — MCR Advantage: $128.25 Cigna — Commercial: $265.05 Cigna — MCR Advantage: $128.25 Community Health Options — Commercial: $242.25 First Health — Commercial: $270.75 Harvard Pilgrim — Commercial: $257.93 HealthNet — Commercial: $185.25
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: PTT LA Screen QST	$285	$256.50	$128.25 – $285
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — Commercial: $260.77 Aetna — MCR Advantage: $128.25 Anthem — Commercial: $221.73 Anthem — MCR Advantage: $128.25 Cigna — Commercial: $265.05 Cigna — MCR Advantage: $128.25 Community Health Options — Commercial: $242.25 First Health — Commercial: $270.75 Harvard Pilgrim — Commercial: $257.93 HealthNet — Commercial: $185.25

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Head w/o Contrast	$314	$282.60	$141.30 – $314
CT scan of the head or brain, without contrast: rates for 8 insurance plans Aetna — Commercial: $287.31 Anthem — Commercial: $244.29 Cigna — Commercial: $292.02 Community Health Options — Commercial: $266.90 First Health — Commercial: $298.30 Harvard Pilgrim — Commercial: $284.17 HealthNet — Commercial: $204.10 United Healthcare — Commercial: $188.40
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: CT Head w/o Contrast	$314	$282.60	$141.30 – $314
CT scan of the head or brain, without contrast: rates for 6 insurance plans Aetna — MCR Advantage: $141.30 Anthem — MCR Advantage: $141.30 Cigna — MCR Advantage: $141.30 Martins Point — MCR Advantage: $141.30 United Healthcare — MCR Advantage: $141.30 Wellcare — MCR Advantage: $141.30
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee · modifier 95 In the file: MRI Brain w/ + w/o Contrast	$302	$271.80	$135.90 – $302
MRI of the brain, before and after contrast: rates for 8 insurance plans Aetna — Commercial: $276.33 Anthem — Commercial: $234.96 Cigna — Commercial: $280.86 Community Health Options — Commercial: $256.70 First Health — Commercial: $286.90 Harvard Pilgrim — Commercial: $273.31 HealthNet — Commercial: $196.30 United Healthcare — Commercial: $181.20
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: MRI Brain w/ + w/o Contrast	$302	$271.80	$135.90 – $302
MRI of the brain, before and after contrast: rates for 6 insurance plans Aetna — MCR Advantage: $135.90 Anthem — MCR Advantage: $135.90 Cigna — MCR Advantage: $135.90 Martins Point — MCR Advantage: $135.90 United Healthcare — MCR Advantage: $135.90 Wellcare — MCR Advantage: $135.90
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: XR Chest 2 Views	$48	$43.20	$21.60 – $48
Chest X-ray, 2 views: rates for 8 insurance plans Aetna — Commercial: $43.92 Anthem — Commercial: $37.34 Cigna — Commercial: $44.64 Community Health Options — Commercial: $40.80 First Health — Commercial: $45.60 Harvard Pilgrim — Commercial: $43.44 HealthNet — Commercial: $31.20 United Healthcare — Commercial: $28.80
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: XR Chest 2 Views	$48	$43.20	$7.65 – $48
Chest X-ray, 2 views: rates for 6 insurance plans Aetna — MCR Advantage: $21.60 Anthem — MCR Advantage: $21.60 Cigna — MCR Advantage: $21.60 Martins Point — MCR Advantage: $21.60 United Healthcare — MCR Advantage: $21.60 Wellcare — MCR Advantage: $21.60
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: XR Spine Lumbosacral 4plus Views - Report	$65	$58.50	$29.25 – $65
X-ray of the lower spine, at least 4 views: rates for 8 insurance plans Aetna — Commercial: $59.48 Anthem — Commercial: $50.57 Cigna — Commercial: $60.45 Community Health Options — Commercial: $55.25 First Health — Commercial: $61.75 Harvard Pilgrim — Commercial: $58.83 HealthNet — Commercial: $42.25 United Healthcare — Commercial: $39
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: XR Spine Lumbosacral 4plus Views - Report	$65	$58.50	$29.25 – $65
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans Aetna — MCR Advantage: $29.25 Anthem — MCR Advantage: $29.25 Cigna — MCR Advantage: $29.25 Martins Point — MCR Advantage: $29.25 United Healthcare — MCR Advantage: $29.25 Wellcare — MCR Advantage: $29.25
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MR LUMBAR SPINE SURVEY	$2,336	$2,102.40	$1,051.20 – $2,336
MRI of the lower back (lumbar spine), without contrast: 10 of 14 insurance plan rates Aetna — Commercial: $2,137.44 Aetna — MCR Advantage: $1,051.20 Anthem — Commercial: $1,817.41 Anthem — MCR Advantage: $1,051.20 Cigna — Commercial: $2,172.48 Cigna — MCR Advantage: $1,051.20 Community Health Options — Commercial: $1,985.60 First Health — Commercial: $2,219.20 Harvard Pilgrim — Commercial: $2,114.08 HealthNet — Commercial: $1,518.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI Spine Lumbar Limited	$599	$539.10	$269.55 – $599
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans Aetna — Commercial: $548.09 Anthem — Commercial: $466.02 Cigna — Commercial: $557.07 Community Health Options — Commercial: $509.15 First Health — Commercial: $569.05 Harvard Pilgrim — Commercial: $542.10 HealthNet — Commercial: $389.35 United Healthcare — Commercial: $359.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI Spine Lumbar w/o Contrast	$447	$402.30	$201.15 – $447
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans Aetna — Commercial: $409 Anthem — Commercial: $347.77 Cigna — Commercial: $415.71 Community Health Options — Commercial: $379.95 First Health — Commercial: $424.65 Harvard Pilgrim — Commercial: $404.54 HealthNet — Commercial: $290.55 United Healthcare — Commercial: $268.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI LE Joint w/o Contrast Lt	$438	$394.20	$197.10 – $438
MRI of a leg joint (such as the knee), without contrast: rates for 8 insurance plans Aetna — Commercial: $400.77 Anthem — Commercial: $340.76 Cigna — Commercial: $407.34 Community Health Options — Commercial: $372.30 First Health — Commercial: $416.10 Harvard Pilgrim — Commercial: $396.39 HealthNet — Commercial: $284.70 United Healthcare — Commercial: $262.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI LE Joint w/o Contrast Rt	$336	$302.40	$151.20 – $336
MRI of a leg joint (such as the knee), without contrast: rates for 8 insurance plans Aetna — Commercial: $307.44 Anthem — Commercial: $261.41 Cigna — Commercial: $312.48 Community Health Options — Commercial: $285.60 First Health — Commercial: $319.20 Harvard Pilgrim — Commercial: $304.08 HealthNet — Commercial: $218.40 United Healthcare — Commercial: $201.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: MRI LE Joint w/o Contrast Lt	$438	$394.20	$197.10 – $438
MRI of a leg joint (such as the knee), without contrast: rates for 6 insurance plans Aetna — MCR Advantage: $197.10 Anthem — MCR Advantage: $197.10 Cigna — MCR Advantage: $197.10 Martins Point — MCR Advantage: $197.10 United Healthcare — MCR Advantage: $197.10 Wellcare — MCR Advantage: $197.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Abdomen and Pelvis w/ Contrast	$422	$379.80	$189.90 – $422
CT scan of the abdomen and pelvis, with contrast: 10 of 14 insurance plan rates Aetna — Commercial: $386.13 Aetna — MCR Advantage: $189.90 Anthem — Commercial: $328.32 Anthem — MCR Advantage: $189.90 Cigna — Commercial: $392.46 Cigna — MCR Advantage: $189.90 Community Health Options — Commercial: $358.70 First Health — Commercial: $400.90 Harvard Pilgrim — Commercial: $381.91 HealthNet — Commercial: $274.30
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee · modifier 95 In the file: US Abdomen Complete - Report	$1,119	$1,007.10	$503.55 – $1,119
Ultrasound of the abdomen, complete: 10 of 14 insurance plan rates Aetna — Commercial: $1,023.88 Aetna — MCR Advantage: $503.55 Anthem — Commercial: $870.58 Anthem — MCR Advantage: $503.55 Cigna — Commercial: $1,040.67 Cigna — MCR Advantage: $503.55 Community Health Options — Commercial: $951.15 First Health — Commercial: $1,063.05 Harvard Pilgrim — Commercial: $1,012.70 HealthNet — Commercial: $727.35
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee · modifier 95 In the file: US OB Comp 2nd Trimester Survey	$721	$648.90	$324.45 – $721
Pregnancy ultrasound (after the first trimester): 10 of 14 insurance plan rates Aetna — Commercial: $659.72 Aetna — MCR Advantage: $324.45 Anthem — Commercial: $560.94 Anthem — MCR Advantage: $324.45 Cigna — Commercial: $670.53 Cigna — MCR Advantage: $324.45 Community Health Options — Commercial: $612.85 First Health — Commercial: $684.95 Harvard Pilgrim — Commercial: $652.50 HealthNet — Commercial: $468.65
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: US Transvaginal Non-OB	$384	$345.60	$172.80 – $384
Transvaginal ultrasound: rates for 8 insurance plans Aetna — Commercial: $351.36 Anthem — Commercial: $298.75 Cigna — Commercial: $357.12 Community Health Options — Commercial: $326.40 First Health — Commercial: $364.80 Harvard Pilgrim — Commercial: $347.52 HealthNet — Commercial: $249.60 United Healthcare — Commercial: $230.40
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: US Transvaginal Non-OB	$384	$345.60	$172.80 – $384
Transvaginal ultrasound: rates for 6 insurance plans Aetna — MCR Advantage: $172.80 Anthem — MCR Advantage: $172.80 Cigna — MCR Advantage: $172.80 Martins Point — MCR Advantage: $172.80 United Healthcare — MCR Advantage: $172.80 Wellcare — MCR Advantage: $172.80
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MA 3D LT UNI DIAGNOSTIC MAMMO W/CAD	$175	$157.50	$78.75 – $175
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — Commercial: $160.12 Aetna — MCR Advantage: $78.75 Anthem — Commercial: $136.15 Anthem — MCR Advantage: $78.75 Cigna — Commercial: $162.75 Cigna — MCR Advantage: $78.75 Community Health Options — Commercial: $148.75 First Health — Commercial: $166.25 Harvard Pilgrim — Commercial: $158.38 HealthNet — Commercial: $113.75
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MA 3D RT UNI DIAGNOSTIC MAMMO W/CAD	$175	$157.50	$78.75 – $175
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — Commercial: $160.12 Aetna — MCR Advantage: $78.75 Anthem — Commercial: $136.15 Anthem — MCR Advantage: $78.75 Cigna — Commercial: $162.75 Cigna — MCR Advantage: $78.75 Community Health Options — Commercial: $148.75 First Health — Commercial: $166.25 Harvard Pilgrim — Commercial: $158.38 HealthNet — Commercial: $113.75
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MG Mammo Diagnostic Left	$286	$257.40	$128.70 – $286
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates Aetna — Commercial: $261.69 Aetna — MCR Advantage: $128.70 Anthem — Commercial: $222.51 Anthem — MCR Advantage: $128.70 Cigna — Commercial: $265.98 Cigna — MCR Advantage: $128.70 Community Health Options — Commercial: $243.10 First Health — Commercial: $271.70 Harvard Pilgrim — Commercial: $258.83 HealthNet — Commercial: $185.90
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: MA 3D BILAT DIAGNOSTIC MAMMO W/CAD	$254	$228.60	$114.30 – $254
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Commercial: $232.41 Aetna — MCR Advantage: $114.30 Anthem — Commercial: $197.61 Anthem — MCR Advantage: $114.30 Cigna — Commercial: $236.22 Cigna — MCR Advantage: $114.30 Community Health Options — Commercial: $215.90 First Health — Commercial: $241.30 Harvard Pilgrim — Commercial: $229.87 HealthNet — Commercial: $165.10
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: MG Mammo Diagnostic Bilateral	$2,611	$2,349.90	$1,174.95 – $2,611
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Commercial: $2,389.07 Aetna — MCR Advantage: $1,174.95 Anthem — Commercial: $2,031.36 Anthem — MCR Advantage: $1,174.95 Cigna — Commercial: $2,428.23 Cigna — MCR Advantage: $1,174.95 Community Health Options — Commercial: $2,219.35 First Health — Commercial: $2,480.45 Harvard Pilgrim — Commercial: $2,362.95 HealthNet — Commercial: $1,697.15
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: MG Mammo Diagnostic Bilateral w/ Tomo	$162	$145.80	$72.90 – $162
Diagnostic mammogram, both breasts: rates for 8 insurance plans Aetna — Commercial: $148.23 Anthem — Commercial: $126.04 Cigna — Commercial: $150.66 Community Health Options — Commercial: $137.70 First Health — Commercial: $153.90 Harvard Pilgrim — Commercial: $146.61 HealthNet — Commercial: $105.30 United Healthcare — Commercial: $97.20
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MA 3D Bilat ImplantScreening Mammo	$254	$228.60	$114.30 – $254
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Commercial: $232.41 Aetna — MCR Advantage: $114.30 Anthem — Commercial: $197.61 Anthem — MCR Advantage: $114.30 Cigna — Commercial: $236.22 Cigna — MCR Advantage: $114.30 Community Health Options — Commercial: $215.90 First Health — Commercial: $241.30 Harvard Pilgrim — Commercial: $229.87 HealthNet — Commercial: $165.10
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MA 3D Bilat Screening Mammo	$793	$713.70	$356.85 – $793
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Commercial: $725.60 Aetna — MCR Advantage: $356.85 Anthem — Commercial: $616.95 Anthem — MCR Advantage: $356.85 Cigna — Commercial: $737.49 Cigna — MCR Advantage: $356.85 Community Health Options — Commercial: $674.05 First Health — Commercial: $753.35 Harvard Pilgrim — Commercial: $717.66 HealthNet — Commercial: $515.45
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MA 3D LT UNI Screening Mammo W/CAD	$254	$228.60	$114.30 – $254
Screening mammogram, both breasts: 10 of 14 insurance plan rates Aetna — Commercial: $232.41 Aetna — MCR Advantage: $114.30 Anthem — Commercial: $197.61 Anthem — MCR Advantage: $114.30 Cigna — Commercial: $236.22 Cigna — MCR Advantage: $114.30 Community Health Options — Commercial: $215.90 First Health — Commercial: $241.30 Harvard Pilgrim — Commercial: $229.87 HealthNet — Commercial: $165.10

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee · modifier SL In the file: 93000 EKG w/ 12+ leads; tracing/interp/report	$103	$92.70	$46.35 – $103
Electrocardiogram (ECG/EKG) with reading: 10 of 14 insurance plan rates Aetna — Commercial: $94.25 Aetna — MCR Advantage: $46.35 Anthem — Commercial: $80.13 Anthem — MCR Advantage: $46.35 Cigna — Commercial: $95.79 Cigna — MCR Advantage: $46.35 Community Health Options — Commercial: $87.55 First Health — Commercial: $97.85 Harvard Pilgrim — Commercial: $93.22 HealthNet — Commercial: $66.95

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: OT Therapeutic Exercise Assistant units	$80	$72	$36 – $80
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $73.20 Aetna — MCR Advantage: $36 Anthem — Commercial: $62.24 Anthem — MCR Advantage: $36 Cigna — Commercial: $74.40 Cigna — MCR Advantage: $36 Community Health Options — Commercial: $68 First Health — Commercial: $76 Harvard Pilgrim — Commercial: $72.40 HealthNet — Commercial: $52
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: PT Therapeutic Exercise Assit Units	$94	$84.60	$42.30 – $94
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates Aetna — Commercial: $86.01 Aetna — MCR Advantage: $42.30 Anthem — Commercial: $73.13 Anthem — MCR Advantage: $42.30 Cigna — Commercial: $87.42 Cigna — MCR Advantage: $42.30 Community Health Options — Commercial: $79.90 First Health — Commercial: $89.30 Harvard Pilgrim — Commercial: $85.07 HealthNet — Commercial: $61.10
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee · modifier GO In the file: PT Low Complex Units	$131	$117.90	$58.95 – $131
Physical therapy evaluation (low complexity): 10 of 14 insurance plan rates Aetna — Commercial: $119.86 Aetna — MCR Advantage: $58.95 Anthem — Commercial: $101.92 Anthem — MCR Advantage: $58.95 Cigna — Commercial: $121.83 Cigna — MCR Advantage: $58.95 Community Health Options — Commercial: $111.35 First Health — Commercial: $124.45 Harvard Pilgrim — Commercial: $118.56 HealthNet — Commercial: $85.15
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee · modifier GO In the file: PT Moderate Complex Units	$175	$157.50	$78.75 – $175
Physical therapy evaluation (moderate complexity): 10 of 14 insurance plan rates Aetna — Commercial: $160.12 Aetna — MCR Advantage: $78.75 Anthem — Commercial: $136.15 Anthem — MCR Advantage: $78.75 Cigna — Commercial: $162.75 Cigna — MCR Advantage: $78.75 Community Health Options — Commercial: $148.75 First Health — Commercial: $166.25 Harvard Pilgrim — Commercial: $158.38 HealthNet — Commercial: $113.75
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: PT High Complex Units	$110	$99	$49.50 – $110
Physical therapy evaluation (high complexity): 10 of 14 insurance plan rates Aetna — Commercial: $100.65 Aetna — MCR Advantage: $49.50 Anthem — Commercial: $85.58 Anthem — MCR Advantage: $49.50 Cigna — Commercial: $102.30 Cigna — MCR Advantage: $49.50 Community Health Options — Commercial: $93.50 First Health — Commercial: $104.50 Harvard Pilgrim — Commercial: $99.55 HealthNet — Commercial: $71.50
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: 90832 Psychotherapy, 30 min with patient	$315	$283.50	$141.75 – $315
Psychotherapy, 30 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $288.23 Aetna — MCR Advantage: $141.75 Anthem — Commercial: $245.07 Anthem — MCR Advantage: $141.75 Cigna — Commercial: $292.95 Cigna — MCR Advantage: $141.75 Community Health Options — Commercial: $267.75 First Health — Commercial: $299.25 Harvard Pilgrim — Commercial: $285.07 HealthNet — Commercial: $204.75
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: 90832 Psychotherapy, 30 minutes with patient and/or family member	$440	$396	$198 – $440
Psychotherapy, 30 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $402.60 Aetna — MCR Advantage: $198 Anthem — Commercial: $342.32 Anthem — MCR Advantage: $198 Cigna — Commercial: $409.20 Cigna — MCR Advantage: $198 Community Health Options — Commercial: $374 First Health — Commercial: $418 Harvard Pilgrim — Commercial: $398.20 HealthNet — Commercial: $286
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: 90832 Telehealth PSYCHOTHERAPY 30 MIS W/PATIENT AND/OR F	$359	$323.10	$161.55 – $359
Psychotherapy, 30 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $328.49 Aetna — MCR Advantage: $161.55 Anthem — Commercial: $279.30 Anthem — MCR Advantage: $161.55 Cigna — Commercial: $333.87 Cigna — MCR Advantage: $161.55 Community Health Options — Commercial: $305.15 First Health — Commercial: $341.05 Harvard Pilgrim — Commercial: $324.89 HealthNet — Commercial: $233.35
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: 90834 Psychotherapy, 45 minutes with patient and/or family member	$204	$183.60	$91.80 – $204
Psychotherapy, 45 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $186.66 Aetna — MCR Advantage: $91.80 Anthem — Commercial: $158.71 Anthem — MCR Advantage: $91.80 Cigna — Commercial: $189.72 Cigna — MCR Advantage: $91.80 Community Health Options — Commercial: $173.40 First Health — Commercial: $193.80 Harvard Pilgrim — Commercial: $184.62 HealthNet — Commercial: $132.60
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: 90834 Telehealth PSYCHOTHERAPY 45 MIN W/PT /OR FAM	$336	$302.40	$151.20 – $336
Psychotherapy, 45 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $307.44 Aetna — MCR Advantage: $151.20 Anthem — Commercial: $261.41 Anthem — MCR Advantage: $151.20 Cigna — Commercial: $312.48 Cigna — MCR Advantage: $151.20 Community Health Options — Commercial: $285.60 First Health — Commercial: $319.20 Harvard Pilgrim — Commercial: $304.08 HealthNet — Commercial: $218.40
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: 90834 IND PSYCHTHRPY 45 MI CHARGE	$218	$196.20	$98.10 – $218
Psychotherapy, 45 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $199.47 Aetna — MCR Advantage: $98.10 Anthem — Commercial: $169.60 Anthem — MCR Advantage: $98.10 Cigna — Commercial: $202.74 Cigna — MCR Advantage: $98.10 Community Health Options — Commercial: $185.30 First Health — Commercial: $207.10 Harvard Pilgrim — Commercial: $197.29 HealthNet — Commercial: $141.70
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: 90837 Psychotherapy, 60 minutes with patient and/or family member	$103	$92.70	$46.35 – $103
Psychotherapy, 60 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $94.25 Aetna — MCR Advantage: $46.35 Anthem — Commercial: $80.13 Anthem — MCR Advantage: $46.35 Cigna — Commercial: $95.79 Cigna — MCR Advantage: $46.35 Community Health Options — Commercial: $87.55 First Health — Commercial: $97.85 Harvard Pilgrim — Commercial: $93.22 HealthNet — Commercial: $66.95
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: 90837 Telehealth Psychotherapy, 60 minutes with patient and/or family m	$166	$149.40	$74.70 – $166
Psychotherapy, 60 minutes: 10 of 14 insurance plan rates Aetna — Commercial: $151.89 Aetna — MCR Advantage: $74.70 Anthem — Commercial: $129.15 Anthem — MCR Advantage: $74.70 Cigna — Commercial: $154.38 Cigna — MCR Advantage: $74.70 Community Health Options — Commercial: $141.10 First Health — Commercial: $157.70 Harvard Pilgrim — Commercial: $150.23 HealthNet — Commercial: $107.90
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: 90837 INDIVIDUAL PSYCHOTHERAPY- 60 MINUTES	$300	$270	$135 – $300
Psychotherapy, 60 minutes: rates for 8 insurance plans Aetna — Commercial: $274.50 Anthem — Commercial: $233.40 Cigna — Commercial: $279 Community Health Options — Commercial: $255 First Health — Commercial: $285 Harvard Pilgrim — Commercial: $271.50 HealthNet — Commercial: $195 United Healthcare — Commercial: $180
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: 90846 Family psychotherapy without the patient present	$552	$496.80	$248.40 – $552
Family psychotherapy, without the patient: 10 of 14 insurance plan rates Aetna — Commercial: $505.08 Aetna — MCR Advantage: $248.40 Anthem — Commercial: $429.46 Anthem — MCR Advantage: $248.40 Cigna — Commercial: $513.36 Cigna — MCR Advantage: $248.40 Community Health Options — Commercial: $469.20 First Health — Commercial: $524.40 Harvard Pilgrim — Commercial: $499.56 HealthNet — Commercial: $358.80
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: Telehealth FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT	$54	$48.60	$24.30 – $54
Family psychotherapy, without the patient: 10 of 14 insurance plan rates Aetna — Commercial: $49.41 Aetna — MCR Advantage: $24.30 Anthem — Commercial: $42.01 Anthem — MCR Advantage: $24.30 Cigna — Commercial: $50.22 Cigna — MCR Advantage: $24.30 Community Health Options — Commercial: $45.90 First Health — Commercial: $51.30 Harvard Pilgrim — Commercial: $48.87 HealthNet — Commercial: $35.10
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: 90847 Family psychotherapy, conjoint psychotherapy, with patient present	$984	$885.60	$442.80 – $984
Family psychotherapy, with the patient: 10 of 14 insurance plan rates Aetna — Commercial: $900.36 Aetna — MCR Advantage: $442.80 Anthem — Commercial: $765.55 Anthem — MCR Advantage: $442.80 Cigna — Commercial: $915.12 Cigna — MCR Advantage: $442.80 Community Health Options — Commercial: $836.40 First Health — Commercial: $934.80 Harvard Pilgrim — Commercial: $890.52 HealthNet — Commercial: $639.60
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: Telehealth FAMILY WITH PATIENT PRESENT	$455	$409.50	$204.75 – $455
Family psychotherapy, with the patient: 10 of 14 insurance plan rates Aetna — Commercial: $416.32 Aetna — MCR Advantage: $204.75 Anthem — Commercial: $353.99 Anthem — MCR Advantage: $204.75 Cigna — Commercial: $423.15 Cigna — MCR Advantage: $204.75 Community Health Options — Commercial: $386.75 First Health — Commercial: $432.25 Harvard Pilgrim — Commercial: $411.77 HealthNet — Commercial: $295.75
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: 90853 Group psychotherapy (other than of a multiple-family group)	$790	$711	$355.50 – $790
Group psychotherapy: 10 of 14 insurance plan rates Aetna — Commercial: $722.85 Aetna — MCR Advantage: $355.50 Anthem — Commercial: $614.62 Anthem — MCR Advantage: $355.50 Cigna — Commercial: $734.70 Cigna — MCR Advantage: $355.50 Community Health Options — Commercial: $671.50 First Health — Commercial: $750.50 Harvard Pilgrim — Commercial: $714.95 HealthNet — Commercial: $513.50

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: 19120 BREAST BIOPSY,EXCISIONAL	$3,539	$3,185.10	$1,592.55 – $3,539
Removal of breast growth (open surgery): 10 of 14 insurance plan rates Aetna — Commercial: $3,238.18 Aetna — MCR Advantage: $1,592.55 Anthem — Commercial: $2,753.34 Anthem — MCR Advantage: $1,592.55 Cigna — Commercial: $3,291.27 Cigna — MCR Advantage: $1,592.55 Community Health Options — Commercial: $3,008.15 First Health — Commercial: $3,362.05 Harvard Pilgrim — Commercial: $3,202.80 HealthNet — Commercial: $2,300.35
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: 19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TI ProFee	$588	$529.20	$264.60 – $588
Removal of breast growth (open surgery): rates for 8 insurance plans Aetna — Commercial: $538.02 Anthem — Commercial: $457.46 Cigna — Commercial: $546.84 Community Health Options — Commercial: $499.80 First Health — Commercial: $558.60 Harvard Pilgrim — Commercial: $532.14 HealthNet — Commercial: $382.20 United Healthcare — Commercial: $352.80
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TI ProFee	$588	$529.20	$264.60 – $588
Removal of breast growth (open surgery): rates for 6 insurance plans Aetna — MCR Advantage: $264.60 Anthem — MCR Advantage: $264.60 Cigna — MCR Advantage: $264.60 Martins Point — MCR Advantage: $264.60 United Healthcare — MCR Advantage: $264.60 Wellcare — MCR Advantage: $264.60
Total hip replacement CPT 27130 · Inpatient or outpatient · Hospital (facility) fee In the file: 27130 ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHRO ProFee	$1,559	$1,403.10	$701.55 – $1,559
Total hip replacement: rates for 8 insurance plans Aetna — Commercial: $1,426.48 Anthem — Commercial: $1,212.90 Cigna — Commercial: $1,449.87 Community Health Options — Commercial: $1,325.15 First Health — Commercial: $1,481.05 Harvard Pilgrim — Commercial: $1,410.89 HealthNet — Commercial: $1,013.35 United Healthcare — Commercial: $935.40
Total hip replacement CPT 27130 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 27130 ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHRO ProFee	$1,559	$1,403.10	$701.55 – $1,559
Total hip replacement: rates for 6 insurance plans Aetna — MCR Advantage: $701.55 Anthem — MCR Advantage: $701.55 Cigna — MCR Advantage: $701.55 Martins Point — MCR Advantage: $701.55 United Healthcare — MCR Advantage: $701.55 Wellcare — MCR Advantage: $701.55
Total knee replacement CPT 27447 · Inpatient or outpatient · Hospital (facility) fee In the file: 27447 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHO ProFee	$3,550	$3,195	$1,597.50 – $3,550
Total knee replacement: rates for 8 insurance plans Aetna — Commercial: $3,248.25 Anthem — Commercial: $2,761.90 Cigna — Commercial: $3,301.50 Community Health Options — Commercial: $3,017.50 First Health — Commercial: $3,372.50 Harvard Pilgrim — Commercial: $3,212.75 HealthNet — Commercial: $2,307.50 United Healthcare — Commercial: $2,130
Total knee replacement CPT 27447 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 27447 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHO ProFee	$3,550	$3,195	$1,597.50 – $3,550
Total knee replacement: rates for 6 insurance plans Aetna — MCR Advantage: $1,597.50 Anthem — MCR Advantage: $1,597.50 Cigna — MCR Advantage: $1,597.50 Martins Point — MCR Advantage: $1,597.50 United Healthcare — MCR Advantage: $1,597.50 Wellcare — MCR Advantage: $1,597.50
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Hospital (facility) fee In the file: 29826 ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROM ProFee	$2,049	$1,844.10	$922.05 – $2,049
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans Aetna — Commercial: $1,874.84 Anthem — Commercial: $1,594.12 Cigna — Commercial: $1,905.57 Community Health Options — Commercial: $1,741.65 First Health — Commercial: $1,946.55 Harvard Pilgrim — Commercial: $1,854.35 HealthNet — Commercial: $1,331.85 United Healthcare — Commercial: $1,229.40
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 29826 ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROM ProFee	$2,049	$1,844.10	$922.05 – $2,049
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans Aetna — MCR Advantage: $922.05 Anthem — MCR Advantage: $922.05 Cigna — MCR Advantage: $922.05 Martins Point — MCR Advantage: $922.05 United Healthcare — MCR Advantage: $922.05 Wellcare — MCR Advantage: $922.05
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Hospital (facility) fee In the file: 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENIS ProFee	$141	$126.90	$63.45 – $141
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans Aetna — Commercial: $129.01 Anthem — Commercial: $109.70 Cigna — Commercial: $131.13 Community Health Options — Commercial: $119.85 First Health — Commercial: $133.95 Harvard Pilgrim — Commercial: $127.61 HealthNet — Commercial: $91.65 United Healthcare — Commercial: $84.60
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENIS ProFee	$141	$126.90	$63.45 – $141
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans Aetna — MCR Advantage: $63.45 Anthem — MCR Advantage: $63.45 Cigna — MCR Advantage: $63.45 Martins Point — MCR Advantage: $63.45 United Healthcare — MCR Advantage: $63.45 Wellcare — MCR Advantage: $63.45
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: 43235 ESOPHAGOGASTRODUODENOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC INCLUDING COLLECTION OF S ProFee	$585	$526.50	$263.25 – $585
Upper GI endoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial: $535.27 Anthem — Commercial: $455.13 Cigna — Commercial: $544.05 Community Health Options — Commercial: $497.25 First Health — Commercial: $555.75 Harvard Pilgrim — Commercial: $529.42 HealthNet — Commercial: $380.25 United Healthcare — Commercial: $351
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 43235 ESOPHAGOGASTRODUODENOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC INCLUDING COLLECTION OF S ProFee	$585	$526.50	$263.25 – $585
Upper GI endoscopy (diagnostic): rates for 6 insurance plans Aetna — MCR Advantage: $263.25 Anthem — MCR Advantage: $263.25 Cigna — MCR Advantage: $263.25 Martins Point — MCR Advantage: $263.25 United Healthcare — MCR Advantage: $263.25 Wellcare — MCR Advantage: $263.25
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: 43239 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE ProFee	$633	$569.70	$284.85 – $633
Upper GI endoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial: $579.20 Anthem — Commercial: $492.47 Cigna — Commercial: $588.69 Community Health Options — Commercial: $538.05 First Health — Commercial: $601.35 Harvard Pilgrim — Commercial: $572.87 HealthNet — Commercial: $411.45 United Healthcare — Commercial: $379.80
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 43239 ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE ProFee	$633	$569.70	$92.75 – $633
Upper GI endoscopy with biopsy: rates for 6 insurance plans Aetna — MCR Advantage: $284.85 Anthem — MCR Advantage: $284.85 Cigna — MCR Advantage: $284.85 Martins Point — MCR Advantage: $284.85 United Healthcare — MCR Advantage: $284.85 Wellcare — MCR Advantage: $284.85
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: 45378 COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR ProFee	$4,916	$4,424.40	$2,212.20 – $4,916
Colonoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial: $4,498.14 Anthem — Commercial: $3,824.65 Cigna — Commercial: $4,571.88 Community Health Options — Commercial: $4,178.60 First Health — Commercial: $4,670.20 Harvard Pilgrim — Commercial: $4,448.98 HealthNet — Commercial: $3,195.40 United Healthcare — Commercial: $2,949.60
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 45378 COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR ProFee	$4,916	$4,424.40	$2,212.20 – $4,916
Colonoscopy (diagnostic): rates for 6 insurance plans Aetna — MCR Advantage: $2,212.20 Anthem — MCR Advantage: $2,212.20 Cigna — MCR Advantage: $2,212.20 Martins Point — MCR Advantage: $2,212.20 United Healthcare — MCR Advantage: $2,212.20 Wellcare — MCR Advantage: $2,212.20
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee In the file: 45380 COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE ProFee	$2,927	$2,634.30	$1,317.15 – $2,927
Colonoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial: $2,678.20 Anthem — Commercial: $2,277.21 Cigna — Commercial: $2,722.11 Community Health Options — Commercial: $2,487.95 First Health — Commercial: $2,780.65 Harvard Pilgrim — Commercial: $2,648.93 HealthNet — Commercial: $1,902.55 United Healthcare — Commercial: $1,756.20
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 45380 COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE ProFee	$2,927	$2,634.30	$1,317.15 – $2,927
Colonoscopy with biopsy: rates for 6 insurance plans Aetna — MCR Advantage: $1,317.15 Anthem — MCR Advantage: $1,317.15 Cigna — MCR Advantage: $1,317.15 Martins Point — MCR Advantage: $1,317.15 United Healthcare — MCR Advantage: $1,317.15 Wellcare — MCR Advantage: $1,317.15
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq	$2,156	$1,940.40	$970.20 – $2,156
Colonoscopy with removal of polyps (snare): 10 of 14 insurance plan rates Aetna — Commercial: $1,972.74 Aetna — MCR Advantage: $970.20 Anthem — Commercial: $1,677.37 Anthem — MCR Advantage: $970.20 Cigna — Commercial: $2,005.08 Cigna — MCR Advantage: $970.20 Community Health Options — Commercial: $1,832.60 First Health — Commercial: $2,048.20 Harvard Pilgrim — Commercial: $1,951.18 HealthNet — Commercial: $1,401.40
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: 45385 COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE ProFee	$3,165	$2,848.50	$1,424.25 – $3,165
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans Aetna — Commercial: $2,895.97 Anthem — Commercial: $2,462.37 Cigna — Commercial: $2,943.45 Community Health Options — Commercial: $2,690.25 First Health — Commercial: $3,006.75 Harvard Pilgrim — Commercial: $2,864.32 HealthNet — Commercial: $2,057.25 United Healthcare — Commercial: $1,899
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 45385 COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE ProFee	$3,165	$2,848.50	$1,424.25 – $3,165
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans Aetna — MCR Advantage: $1,424.25 Anthem — MCR Advantage: $1,424.25 Cigna — MCR Advantage: $1,424.25 Martins Point — MCR Advantage: $1,424.25 United Healthcare — MCR Advantage: $1,424.25 Wellcare — MCR Advantage: $1,424.25
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	$113	$101.70	$50.85 – $113
Screening colonoscopy (not high risk): 10 of 14 insurance plan rates Aetna — Commercial: $103.39 Aetna — MCR Advantage: $50.85 Anthem — Commercial: $87.91 Anthem — MCR Advantage: $50.85 Cigna — Commercial: $105.09 Cigna — MCR Advantage: $50.85 Community Health Options — Commercial: $96.05 First Health — Commercial: $107.35 Harvard Pilgrim — Commercial: $102.27 HealthNet — Commercial: $73.45
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: G0121 SCRN COLONOSCOPY PT NOT H ProFee	$392	$352.80	$176.40 – $392
Screening colonoscopy (not high risk): rates for 8 insurance plans Aetna — Commercial: $358.68 Anthem — Commercial: $304.98 Cigna — Commercial: $364.56 Community Health Options — Commercial: $333.20 First Health — Commercial: $372.40 Harvard Pilgrim — Commercial: $354.76 HealthNet — Commercial: $254.80 United Healthcare — Commercial: $235.20
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: G0121 SCRN COLONOSCOPY PT NOT H ProFee	$392	$352.80	$176.40 – $392
Screening colonoscopy (not high risk): rates for 6 insurance plans Aetna — MCR Advantage: $176.40 Anthem — MCR Advantage: $176.40 Cigna — MCR Advantage: $176.40 Martins Point — MCR Advantage: $176.40 United Healthcare — MCR Advantage: $176.40 Wellcare — MCR Advantage: $176.40
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Hospital (facility) fee In the file: 47562 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY ProFee	$446	$401.40	$200.70 – $446
Gallbladder removal by laparoscope: rates for 8 insurance plans Aetna — Commercial: $408.09 Anthem — Commercial: $346.99 Cigna — Commercial: $414.78 Community Health Options — Commercial: $379.10 First Health — Commercial: $423.70 Harvard Pilgrim — Commercial: $403.63 HealthNet — Commercial: $289.90 United Healthcare — Commercial: $267.60
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 47562 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY ProFee	$446	$401.40	$200.70 – $446
Gallbladder removal by laparoscope: rates for 6 insurance plans Aetna — MCR Advantage: $200.70 Anthem — MCR Advantage: $200.70 Cigna — MCR Advantage: $200.70 Martins Point — MCR Advantage: $200.70 United Healthcare — MCR Advantage: $200.70 Wellcare — MCR Advantage: $200.70
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Hospital (facility) fee In the file: 49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ProFee	$1,401	$1,260.90	$630.45 – $1,401
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans Aetna — Commercial: $1,281.91 Anthem — Commercial: $1,089.98 Cigna — Commercial: $1,302.93 Community Health Options — Commercial: $1,190.85 First Health — Commercial: $1,330.95 Harvard Pilgrim — Commercial: $1,267.90 HealthNet — Commercial: $910.65 United Healthcare — Commercial: $840.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ProFee	$1,401	$1,260.90	$630.45 – $1,401
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans Aetna — MCR Advantage: $630.45 Anthem — MCR Advantage: $630.45 Cigna — MCR Advantage: $630.45 Martins Point — MCR Advantage: $630.45 United Healthcare — MCR Advantage: $630.45 Wellcare — MCR Advantage: $630.45
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH ProFee	$981	$882.90	$441.45 – $981
Prostate biopsy: rates for 8 insurance plans Aetna — Commercial: $897.62 Anthem — Commercial: $763.22 Cigna — Commercial: $912.33 Community Health Options — Commercial: $833.85 First Health — Commercial: $931.95 Harvard Pilgrim — Commercial: $887.80 HealthNet — Commercial: $637.65 United Healthcare — Commercial: $588.60
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: US Biopsy Prostate	$816	$734.40	$367.20 – $816
Prostate biopsy: rates for 8 insurance plans Aetna — Commercial: $746.64 Anthem — Commercial: $634.85 Cigna — Commercial: $758.88 Community Health Options — Commercial: $693.60 First Health — Commercial: $775.20 Harvard Pilgrim — Commercial: $738.48 HealthNet — Commercial: $530.40 United Healthcare — Commercial: $489.60
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH ProFee	$981	$882.90	$441.45 – $981
Prostate biopsy: rates for 6 insurance plans Aetna — MCR Advantage: $441.45 Anthem — MCR Advantage: $441.45 Cigna — MCR Advantage: $441.45 Martins Point — MCR Advantage: $441.45 United Healthcare — MCR Advantage: $441.45 Wellcare — MCR Advantage: $441.45
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: 58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C	$901	$810.90	$405.45 – $901
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans Aetna — Commercial: $824.41 Anthem — Commercial: $700.98 Cigna — Commercial: $837.93 Community Health Options — Commercial: $765.85 First Health — Commercial: $855.95 Harvard Pilgrim — Commercial: $815.40 HealthNet — Commercial: $585.65 United Healthcare — Commercial: $540.60
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: 58558 HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH ProFee	$3,424	$3,081.60	$1,540.80 – $3,424
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans Aetna — Commercial: $3,132.96 Anthem — Commercial: $2,663.87 Cigna — Commercial: $3,184.32 Community Health Options — Commercial: $2,910.40 First Health — Commercial: $3,252.80 Harvard Pilgrim — Commercial: $3,098.72 HealthNet — Commercial: $2,225.60 United Healthcare — Commercial: $2,054.40
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C	$901	$810.90	$405.45 – $901
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans Aetna — MCR Advantage: $405.45 Anthem — MCR Advantage: $405.45 Cigna — MCR Advantage: $405.45 Martins Point — MCR Advantage: $405.45 United Healthcare — MCR Advantage: $405.45 Wellcare — MCR Advantage: $405.45
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: 62323 ESI lumbar or sacral with fluoroscopy	$1,345	$1,210.50	$605.25 – $1,345
Spinal injection, lower back (epidural), with imaging guidance: 10 of 14 insurance plan rates Aetna — Commercial: $1,230.67 Aetna — MCR Advantage: $605.25 Anthem — Commercial: $1,046.41 Anthem — MCR Advantage: $605.25 Cigna — Commercial: $1,250.85 Cigna — MCR Advantage: $605.25 Community Health Options — Commercial: $1,143.25 First Health — Commercial: $1,277.75 Harvard Pilgrim — Commercial: $1,217.22 HealthNet — Commercial: $874.25
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: 62323 INJECTION(S), DIAGNOSTIC/THERAPEUTIC INTERLAMINAR EPIDURAL, LUMBAR OR SACRAL, W/ IMAGING (PRO)	$5,746	$5,171.40	$2,585.70 – $5,746
Spinal injection, lower back (epidural), with imaging guidance: rates for 8 insurance plans Aetna — Commercial: $5,257.59 Anthem — Commercial: $4,470.39 Cigna — Commercial: $5,343.78 Community Health Options — Commercial: $4,884.10 First Health — Commercial: $5,458.70 Harvard Pilgrim — Commercial: $5,200.13 HealthNet — Commercial: $3,734.90 United Healthcare — Commercial: $3,447.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 62323 INJECTION(S), DIAGNOSTIC/THERAPEUTIC INTERLAMINAR EPIDURAL, LUMBAR OR SACRAL, W/ IMAGING (PRO)	$5,746	$5,171.40	$2,585.70 – $5,746
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans Aetna — MCR Advantage: $2,585.70 Anthem — MCR Advantage: $2,585.70 Cigna — MCR Advantage: $2,585.70 Martins Point — MCR Advantage: $2,585.70 United Healthcare — MCR Advantage: $2,585.70 Wellcare — MCR Advantage: $2,585.70
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: 64483 Injection Transforaminal Epidural - single level	$1,409	$1,268.10	$634.05 – $1,409
Nerve root injection, lower back, with imaging guidance: 10 of 14 insurance plan rates Aetna — Commercial: $1,289.23 Aetna — MCR Advantage: $634.05 Anthem — Commercial: $1,096.20 Anthem — MCR Advantage: $634.05 Cigna — Commercial: $1,310.37 Cigna — MCR Advantage: $634.05 Community Health Options — Commercial: $1,197.65 First Health — Commercial: $1,338.55 Harvard Pilgrim — Commercial: $1,275.14 HealthNet — Commercial: $915.85
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: 64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL ProFee	$3,620	$3,258	$1,629 – $3,620
Carpal tunnel release: rates for 8 insurance plans Aetna — Commercial: $3,312.30 Anthem — Commercial: $2,816.36 Cigna — Commercial: $3,366.60 Community Health Options — Commercial: $3,077 First Health — Commercial: $3,439 Harvard Pilgrim — Commercial: $3,276.10 HealthNet — Commercial: $2,353 United Healthcare — Commercial: $2,172
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL ProFee	$3,620	$3,258	$1,629 – $3,620
Carpal tunnel release: rates for 6 insurance plans Aetna — MCR Advantage: $1,629 Anthem — MCR Advantage: $1,629 Cigna — MCR Advantage: $1,629 Martins Point — MCR Advantage: $1,629 United Healthcare — MCR Advantage: $1,629 Wellcare — MCR Advantage: $1,629
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: 66821 Discission of secondary membranous cataract; laser surgery (1 or more stages)	$979	$881.10	$440.55 – $979
Laser treatment of clouding after cataract surgery: 10 of 14 insurance plan rates Aetna — Commercial: $895.78 Aetna — MCR Advantage: $440.55 Anthem — Commercial: $761.66 Anthem — MCR Advantage: $440.55 Cigna — Commercial: $910.47 Cigna — MCR Advantage: $440.55 Community Health Options — Commercial: $832.15 First Health — Commercial: $930.05 Harvard Pilgrim — Commercial: $886 HealthNet — Commercial: $636.35
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: 66821 DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR A ProFee	$986	$887.40	$443.70 – $986
Laser treatment of clouding after cataract surgery: rates for 8 insurance plans Aetna — Commercial: $902.19 Anthem — Commercial: $767.11 Cigna — Commercial: $916.98 Community Health Options — Commercial: $838.10 First Health — Commercial: $936.70 Harvard Pilgrim — Commercial: $892.33 HealthNet — Commercial: $640.90 United Healthcare — Commercial: $591.60
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 66821 DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR A ProFee	$986	$887.40	$443.70 – $986
Laser treatment of clouding after cataract surgery: rates for 6 insurance plans Aetna — MCR Advantage: $443.70 Anthem — MCR Advantage: $443.70 Cigna — MCR Advantage: $443.70 Martins Point — MCR Advantage: $443.70 United Healthcare — MCR Advantage: $443.70 Wellcare — MCR Advantage: $443.70
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee In the file: 66984 EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE ProFee	$1,403	$1,262.70	$631.35 – $1,403
Cataract removal with lens implant: rates for 8 insurance plans Aetna — Commercial: $1,283.74 Anthem — Commercial: $1,091.53 Cigna — Commercial: $1,304.79 Community Health Options — Commercial: $1,192.55 First Health — Commercial: $1,332.85 Harvard Pilgrim — Commercial: $1,269.71 HealthNet — Commercial: $911.95 United Healthcare — Commercial: $841.80
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 66984 EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE ProFee	$1,403	$1,262.70	$631.35 – $1,403
Cataract removal with lens implant: rates for 6 insurance plans Aetna — MCR Advantage: $631.35 Anthem — MCR Advantage: $631.35 Cigna — MCR Advantage: $631.35 Martins Point — MCR Advantage: $631.35 United Healthcare — MCR Advantage: $631.35 Wellcare — MCR Advantage: $631.35

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Hospital (facility) fee In the file: 59400 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH OR WITHOUT EP ProFee	$3,374	$3,036.60	$1,518.30 – $3,374
Vaginal delivery, with care before and after: rates for 8 insurance plans Aetna — Commercial: $3,087.21 Anthem — Commercial: $2,624.97 Cigna — Commercial: $3,137.82 Community Health Options — Commercial: $2,867.90 First Health — Commercial: $3,205.30 Harvard Pilgrim — Commercial: $3,053.47 HealthNet — Commercial: $2,193.10 United Healthcare — Commercial: $2,024.40
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 59400 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH OR WITHOUT EP ProFee	$3,374	$3,036.60	$1,518.30 – $3,374
Vaginal delivery, with care before and after: rates for 6 insurance plans Aetna — MCR Advantage: $1,518.30 Anthem — MCR Advantage: $1,518.30 Cigna — MCR Advantage: $1,518.30 Martins Point — MCR Advantage: $1,518.30 United Healthcare — MCR Advantage: $1,518.30 Wellcare — MCR Advantage: $1,518.30
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Hospital (facility) fee In the file: 59510 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, CESAREAN DELIVERY, AND POSTPARTUM CA ProFee	$3,938	$3,544.20	$1,772.10 – $3,938
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans Aetna — Commercial: $3,603.27 Anthem — Commercial: $3,063.76 Cigna — Commercial: $3,662.34 Community Health Options — Commercial: $3,347.30 First Health — Commercial: $3,741.10 Harvard Pilgrim — Commercial: $3,563.89 HealthNet — Commercial: $2,559.70 United Healthcare — Commercial: $2,362.80
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 59510 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, CESAREAN DELIVERY, AND POSTPARTUM CA ProFee	$3,938	$3,544.20	$1,772.10 – $3,938
Cesarean delivery (C-section), with care before and after: rates for 6 insurance plans Aetna — MCR Advantage: $1,772.10 Anthem — MCR Advantage: $1,772.10 Cigna — MCR Advantage: $1,772.10 Martins Point — MCR Advantage: $1,772.10 United Healthcare — MCR Advantage: $1,772.10 Wellcare — MCR Advantage: $1,772.10
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Hospital (facility) fee In the file: 59610 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH OR WITHOUT EP ProFee	$6,856	$6,170.40	$3,085.20 – $6,856
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans Aetna — Commercial: $6,273.24 Anthem — Commercial: $5,333.97 Cigna — Commercial: $6,376.08 Community Health Options — Commercial: $5,827.60 First Health — Commercial: $6,513.20 Harvard Pilgrim — Commercial: $6,204.68 HealthNet — Commercial: $4,456.40 United Healthcare — Commercial: $4,113.60
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Hospital (facility) fee · modifier 26 In the file: 59610 ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH OR WITHOUT EP ProFee	$6,856	$6,170.40	$3,085.20 – $6,856
Vaginal delivery after a previous C-section, with care before and after: rates for 6 insurance plans Aetna — MCR Advantage: $3,085.20 Anthem — MCR Advantage: $3,085.20 Cigna — MCR Advantage: $3,085.20 Martins Point — MCR Advantage: $3,085.20 United Healthcare — MCR Advantage: $3,085.20 Wellcare — MCR Advantage: $3,085.20

Source: Mount Desert Island Hospital’s standard charges file (mdihospital.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 8, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	10 Wayman Lane, Bar Harbor, ME 04609
County	Hancock County
State	Maine
Phone	(207) 288‑5081
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	201304
Name in Medicare records	MOUNT DESERT ISLAND HOSPITAL
Profile level	Medicare data + hospital website
Name on the hospital’s website	Mount Desert Island Hospital (MDI Hospital)
Official website	mdihospital.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

MDI Hospital: Quality Healthcare for Bar Harbor & MDI — mdihospital.org
Healthcare Services at MDI Hospital - MDI Hospital — mdihospital.org
Emergency Department - MDI Hospital — mdihospital.org
Awards and Honors — mdihospital.org
Interpretation Services - MDI Hospital — mdihospital.org

Mount Desert Island Hospital

Summary

Profile from official sources

At a glance