Does Nazareth Hospital have an emergency room?

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

Where is Nazareth Hospital?

2601 Holme Ave, Philadelphia, PA 19152, in Philadelphia County, Pennsylvania.

What is the phone number of Nazareth Hospital?

(215) 335-6000, as listed by Medicare (CMS).

What is the Medicare star rating of Nazareth Hospital?

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

Nazareth Hospital — Philadelphia, PA

Quick answers

Does Nazareth Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Nazareth Hospital. In a medical emergency, call 911.
Where is Nazareth Hospital?: 2601 Holme Ave, Philadelphia, PA 19152, in Philadelphia County, Pennsylvania.
What is the phone number of Nazareth Hospital?: (215) 335-6000, as listed by Medicare (CMS).
What is the Medicare star rating of Nazareth Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5]

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

Programs and centers^[6][7]

Primary Stroke Center
24/7 emergency cardiac catheterization lab

Emergency care (hospital website)^[4][5][6][7]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center certified by The Joint Commission

Visiting and practical information

Interpreters and languages	Language assistance notice is available on the site^[4]
Patient portal	MyChart

Recognition^[7]

Primary Stroke Center certification (The Joint Commission)

Doctors and clinicians (340)

340 doctors and other clinicians list Nazareth 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

And 316 more: the button below opens the full list.

Other emergency rooms nearby

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

Jefferson Health- Northeast2.4 mi · Philadelphia, PA · Acute Care Hospital
Holy Redeemer Hospital and Medical Center4.0 mi · Meadowbrook, PA · Acute Care Hospital
Jefferson Einstein Philadelphia Hospital5.6 mi · Philadelphia, PA · Acute Care Hospital
Jefferson Abington Hospital5.8 mi · Abington, PA · Acute Care Hospital
St Christopher's Hospital for Children5.8 mi · Philadelphia, PA · Children's Hospital

Other hospitals nearby

Kindred Hospital Philadelphia3.0 mi · Lawncrest, PA · Long-Term Acute Care Hospital
Friends Hospital3.7 mi · Philadelphia, PA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Transitional Care Unit at Nazareth Hospital0.0 mi · Philadelphia, PA · 5 of 5 stars
Deer Meadows Rehabilitation Center0.2 mi · Philadelphia, PA · 2 of 5 stars
Wesley Enhanced Living Pennypack Park0.3 mi · Philadelphia, PA · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Holy Redeemer Hospice - PA4.1 mi · Philadelphia, PA · 4 of 5 stars
Ennoble Care4.5 mi · Jenkintown, PA
Humanitas Health Services Inc4.9 mi · Huntingdon Valley, PA

All hospice providers in the state →

Home health agencies

Deer Meadows Home Health and Support Services, LLC0.3 mi · Philadelphia, PA · 4 of 5 stars
Kindest Care Healthcare LLC0.3 mi · Philadelphia, PA
Divine Health Care Services1.9 mi · Philadelphia, PA

All home health agencies in the state →

Dialysis facilities

FKC Nazareth0.3 mi · Philadelphia, PA · 1 of 5 stars
Lexington Renal Care Roosevelt0.3 mi · Philadelphia, PA
FKC Bridesburg1.8 mi · Philadelphia, PA · 2 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.

Azura Surgery Center Northeast Philadelphia0.3 mi · Philadelphia, PA
Nazareth Health Endoscopy Center2.0 mi · Philadelphia, PA
PGC Endoscopy Center for Excellence2.0 mi · Philadelphia, PA

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Philadelphia District Health Center #101.2 mi · Philadelphia, PA · Community health center
Cottman Community Health Center1.4 mi · Philadelphia, PA · Community health center
Spectrum Health Services Inc1.8 mi · Philadelphia, PA · Community health center

Clinics and urgent care

On Demand Urgent Care Group PC0.3 mi · Philadelphia, PA · Urgent care center
Occupational Health Centers of the Southwest P.A.1.9 mi · Philadelphia, PA · Urgent care center
Urgent Care at Northeast Philadelphia LLC1.9 mi · Philadelphia, PA · Urgent care center

Pharmacies

Acme Markets Inc0.3 mi · Philadelphia, PA · Community/retail pharmacy
Medivance Equipment LLC0.3 mi · Philadelphia, PA · Community/retail pharmacy
Medplus Pharmacy Inc0.3 mi · Philadelphia, PA · Community/retail pharmacy

Assisted living nearby

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

Deer Meadows Residences0.3 mi · Philadelphia, PA
Wesley Enhanced Living Pennypack Park0.3 mi · Philadelphia, PA
Philadelphia Protestant Home2.0 mi · Philadelphia, PA
Tabor Manor2.0 mi · Philadelphia, PA

About the Medicare star rating

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

Medicare quality data

What Nazareth 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)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	1 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	1 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	57%National average: 72%
Would definitely recommend the hospital	52%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	73%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	56%National average: 74%
Area around the room “always” quiet at night	47%National average: 60%
Completed surveys	403Response rate: 11%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	1.462No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.55No different from the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	1.105No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.633No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	13.3%
Deaths within 30 days: heart failure patients	10.5%
Deaths within 30 days: pneumonia patients	13.4%
Deaths within 30 days: COPD patients	9.1%
Deaths within 30 days: stroke patients	12.5%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.88No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	15.3%
Readmitted within 30 days: heart failure	22.2%
Readmitted within 30 days: pneumonia	18.2%
Readmitted within 30 days: COPD	20.7%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	222 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	4%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	83%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 Philadelphia Best hospitals in Philadelphia

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 54 common services exactly as Nazareth 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 →

$ 4 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 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$175	$175	$54.25 – $166.48
New patient office visit (about 30–44 minutes): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $72.51 AETNA — AETNA: $145.96 AETNA DOMESTIC — AETNA: $145.96 AETNA MEDICAID — AETNA MEDICAID: $78.66 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.25 ALIGN SENIOR CARE — MEDICARE: $72.51 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.38 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $79.91 ALLY ALIGN CARE ADV — MEDICARE: $72.51 AMBETTER — AMBETTER: $105.66
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$205	$205	$52.19 – $194.75
New patient office visit (about 30–44 minutes): 10 of 752 insurance plan rates AETNA — AETNA: $145.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $79.76 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.25 ALIGN SENIOR CARE — MEDICARE: $72.51 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $72.51 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.38 ALLY ALIGN CARE ADV — MEDICARE: $72.51 AMBETTER — AMBETTER: $105.66 AMERIGROUP MEDICAID — MEDICAID: $54.25 AMERIHEALTH — AMERIHEALTH: $92.96
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$360	$360	$84.99 – $342
New patient office visit (about 45–59 minutes): 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $118.50 AETNA — AETNA: $236.03 AETNA MEDICAID — AETNA MEDICAID: $131.04 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $118.50 AETNA MEDICARE TRANSPLANT — MEDICARE: $118.50 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.37 ALIGN SENIOR CARE — MEDICARE: $118.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $118.50 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.56 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $130.59
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$285	$285	$90.37 – $272.07
New patient office visit (about 45–59 minutes): 10 of 756 insurance plan rates AETNA — AETNA: $236.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.35 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $118.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.37 ALIGN SENIOR CARE — MEDICARE: $118.50 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.56 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $130.59 ALLY ALIGN CARE ADV — MEDICARE: $118.50 AMBETTER — AMBETTER: $172.67 AMERIGROUP MEDICAID — MEDICAID: $90.37
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$390	$390	$113.59 – $373.59
New patient office visit (about 60–74 minutes): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.72 AETNA — AETNA: $320.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $178.99 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $117.54 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $117.54 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $179.32 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $176.31 ALLY ALIGN CARE ADV — MEDICARE: $162.72 AMBETTER — AMBETTER: $237.11 AMERIGROUP MEDICAID — MEDICAID: $117.54
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$388	$388	$113.59 – $373.59
New patient office visit (about 60–74 minutes): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.72 AETNA — AETNA: $320.33 AETNA MEDICAID — AETNA MEDICAID: $170.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $178.99 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $117.54 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $117.54 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $176.31 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $179.32 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $179.32 ALLY ALIGN CARE ADV — MEDICARE: $162.72
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$140	$140	$3.23 – $133.34
Established patient office visit (about 20–29 minutes): 10 of 675 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $58.07 AETNA — AETNA: $116.33 AETNA DOMESTIC — AETNA: $116.33 AETNA MEDICAID — AETNA MEDICAID: $50.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $63.88 AETNA MEDICARE TRANSPLANT — MEDICARE: $58.07 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $35 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $52.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $64 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $64
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$140	$140	$40.02 – $74.03
Established patient office visit (about 20–29 minutes): 10 of 77 insurance plan rates AMERIHEALTH — AMERIHEALTH: $74.03 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $74.03 BCN DOMESTIC — INDEPENDENCE BLUE CROSS: $74.03 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — INDEPENDENCE BLUE CROSS: $74.03 BLUE CARE NETWORK — INDEPENDENCE BLUE CROSS: $74.03 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS: $74.03 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS: $74.03 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS: $74.03 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS: $74.03 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS: $74.03
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$140	$140	$41.96 – $68.69
Established patient office visit (about 20–29 minutes): 10 of 77 insurance plan rates AMERIHEALTH — AMERIHEALTH: $68.69 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $68.69 BCN DOMESTIC — INDEPENDENCE BLUE CROSS: $68.69 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — INDEPENDENCE BLUE CROSS: $68.69 BLUE CARE NETWORK — INDEPENDENCE BLUE CROSS: $68.69 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS: $68.69 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS: $68.69 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS: $68.69 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS: $68.69 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS: $68.69
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$205	$205	$54.42 – $196.20
Established patient office visit (about 30–39 minutes): 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $85.46 AETNA — AETNA: $170.40 AETNA DOMESTIC — AETNA: $170.40 AETNA MEDICAID — AETNA MEDICAID: $78.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $94 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $85.46 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.42 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $94.18 AMBETTER — AMBETTER: $124.52
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$207	$207	$54.42 – $196.65
Established patient office visit (about 30–39 minutes): 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $85.46 AETNA — AETNA: $170.40 AETNA DOMESTIC — AETNA: $170.40 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $85.46 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $85.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $94.18 ALLY ALIGN CARE ADV — MEDICARE: $85.46 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $85.46
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee · modifier AS In the file: PR Visit Office Outpatient Established Moderate Level\|ASSISTANT AT SURGERY SERVICE	$33.12	$33.12	$4.77 – $33.12
Established patient office visit (about 30–39 minutes): 10 of 756 insurance plan rates AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $13.67 AETNA MEDICARE TRANSPLANT — MEDICARE: $13.67 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $10.88 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $10.88 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $15.07 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $13.67 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $10.88 AMERIHEALTH MEDICARE — MEDICARE: $13.67 ANDRIE INC — WORKERS COMP: $15.77 ANTHEM MYCARE OHIO — MEDICARE: $13.67
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$148	$148	$44.94 – $148
Emergency room visit (moderate): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $70.67 AETNA — AETNA: $125.68 AETNA MEDICAID — AETNA MEDICAID: $82.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.73 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $56.65 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $56.65 ALIGN SENIOR CARE — MEDICARE: $70.67 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $77.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$250	$250	$41.98 – $239.32
Emergency room visit (moderate): 10 of 752 insurance plan rates AETNA — AETNA: $125.68 AETNA DOMESTIC — AETNA: $125.68 AETNA MEDICAID — AETNA MEDICAID: $82.14 AETNA MEDICARE TRANSPLANT — MEDICARE: $70.67 ALIGN SENIOR CARE — MEDICARE: $70.67 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $77.88 AMBETTER — AMBETTER: $102.97 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $70.67
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 Sane_Safe	$900	$585	$52.50 – $1,873
Emergency room visit (moderate): 10 of 97 insurance plan rates AETNA — AETNA: $1,873 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $311.47 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $300.17 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $52.50 AMBETTER — AMBETTER MARKETPLACE: $525.30 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $821
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$250	$250	$63.52 – $250
Emergency room visit (moderately high): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.30 AETNA — AETNA: $211.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.34 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $95.33 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 AMBETTER — AMBETTER: $175.30 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $120.30 AMERICAN HEALTH PLAN — MEDICARE: $120.30 AMERIHEALTH — AMERIHEALTH: $239.32 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $95.33
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$253	$253	$63.52 – $253
Emergency room visit (moderately high): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.30 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $120.30 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $95.33 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 AMBETTER — AMBETTER: $175.30 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $120.30 AMERICAN HEALTH PLAN — MEDICARE: $120.30 AMERIGROUP MEDICAID — MEDICAID: $95.33 AMERIHEALTH — AMERIHEALTH: $145.39
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4 Sane_Safe	$1,161	$754.65	$75 – $1,873
Emergency room visit (moderately high): 10 of 97 insurance plan rates AETNA — AETNA: $1,873 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $476.10 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $458.83 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 AMBETTER — AMBETTER MARKETPLACE: $802.95 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $821
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$367	$367	$65.07 – $367
Emergency room visit (high): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $174.19 AETNA — AETNA: $307.53 AETNA DOMESTIC — AETNA: $307.53 AETNA MEDICAID — AETNA MEDICAID: $201.17 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $174.19 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $138.74 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $138.74 ALIGN SENIOR CARE — MEDICARE: $174.19 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $208.11 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $191.96
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$360	$360	$65.07 – $360
Emergency room visit (high): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $174.19 AETNA — AETNA: $307.53 AETNA DOMESTIC — AETNA: $307.53 AETNA MEDICAID — AETNA MEDICAID: $201.17 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $191.60 AETNA MEDICARE TRANSPLANT — MEDICARE: $174.19 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $138.74 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $138.74 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $174.19 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $208.11
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Partial Trauma W/O Pre Notification Critical Care - Downgrade	$3,423	$2,224.95	$75 – $3,354.54
Emergency room visit (high): 10 of 97 insurance plan rates AETNA — AETNA: $1,873 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $679.51 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $654.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 AMBETTER — AMBETTER MARKETPLACE: $1,146 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $821 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $821

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Basic Metabolic Panel (Calcium Total)	$508	$330.20	$8.46 – $497.84
Basic metabolic panel (blood test): 10 of 96 insurance plan rates AETNA — AETNA: $472.44 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $8.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.04 AMBETTER — AMBETTER MARKETPLACE: $15.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	$508	$330.20	$8.46 – $497.84
Basic metabolic panel (blood test): 10 of 96 insurance plan rates AETNA — AETNA: $472.44 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $8.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.04 AMBETTER — AMBETTER MARKETPLACE: $15.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	Not listed in the file	$672.10	$8.46 – $473.55
Basic metabolic panel (blood test): 10 of 85 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $8.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.04 AMBETTER — AMBETTER MARKETPLACE: $15.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $43.67
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$755	$490.75	$10.56 – $739.90
Comprehensive metabolic panel (blood test): 10 of 96 insurance plan rates AETNA — AETNA: $702.15 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $16.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $10.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $17.54 AMBETTER — AMBETTER MARKETPLACE: $18.85 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	Not listed in the file	$1,131.65	$10.56 – $473.55
Comprehensive metabolic panel (blood test): 10 of 85 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $16.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $10.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $17.54 AMBETTER — AMBETTER MARKETPLACE: $18.85 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $54.49
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Lipid Panel W Ldl:Hdl Ratio	$263	$170.95	$13.39 – $473.55
Cholesterol panel (lipid panel): 10 of 96 insurance plan rates AETNA — AETNA: $244.59 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $13.66 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$263	$170.95	$13.39 – $473.55
Cholesterol panel (lipid panel): 10 of 96 insurance plan rates AETNA — AETNA: $244.59 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $13.66 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 92145 Lipid Panel	$263	$170.95	$13.39 – $473.55
Cholesterol panel (lipid panel): 10 of 96 insurance plan rates AETNA — AETNA: $244.59 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $13.66 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $70.91
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$57	$37.05	$8.68 – $473.55
Kidney function panel: 10 of 96 insurance plan rates AETNA — AETNA: $53.01 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9.19 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $8.85 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.40 AMBETTER — AMBETTER MARKETPLACE: $15.49 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $44.79 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $44.79 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $44.79 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $44.79
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$405	$263.25	$8.17 – $473.55
Liver function panel: 10 of 96 insurance plan rates AETNA — AETNA: $376.65 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.65 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $8.33 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $13.55 AMBETTER — AMBETTER MARKETPLACE: $14.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $42.17 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $42.17 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $42.17 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $42.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$111	$72.15	$3.17 – $473.55
Urine test (automated, with microscope): 10 of 96 insurance plan rates AETNA — AETNA: $103.23 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $3.23 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Urinalysis With Microscopy Automated	$111	$72.15	$3.17 – $473.55
Urine test (automated, with microscope): 10 of 96 insurance plan rates AETNA — AETNA: $103.23 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $3.23 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	Not listed in the file	$1,101.75	$3.17 – $473.55
Urine test (automated, with microscope): 10 of 85 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $3.23 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $16.42
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$68	$44.20	$2.25 – $473.55
Urine test (automated, without microscope): 10 of 96 insurance plan rates AETNA — AETNA: $63.24 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $2.30 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 AMBETTER — AMBETTER MARKETPLACE: $4.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	Not listed in the file	$1,348.10	$2.25 – $473.55
Urine test (automated, without microscope): 10 of 85 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $2.30 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 AMBETTER — AMBETTER MARKETPLACE: $4.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $12.69
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 31348 Prostate Specific Antigen Total	$322	$209.30	$18.39 – $473.55
PSA (prostate specific antigen) blood test: 10 of 96 insurance plan rates AETNA — AETNA: $299.46 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $35.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $18.76 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$322	$209.30	$18.39 – $473.55
PSA (prostate specific antigen) blood test: 10 of 96 insurance plan rates AETNA — AETNA: $299.46 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $35.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $18.76 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $97.41
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Thyroid Stimulating Hormone	$322	$209.30	$16.80 – $473.55
Thyroid stimulating hormone (TSH) test: 10 of 96 insurance plan rates AETNA — AETNA: $299.46 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $33.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $17.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $34.82 AMBETTER — AMBETTER MARKETPLACE: $29.99 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$322	$209.30	$16.80 – $473.55
Thyroid stimulating hormone (TSH) test: 10 of 96 insurance plan rates AETNA — AETNA: $299.46 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $33.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $17.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $34.82 AMBETTER — AMBETTER MARKETPLACE: $29.99 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $97.78
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Cbc Automated/Differential Wbc Automated	$129	$83.85	$7.77 – $473.55
Complete blood count (CBC) with differential: 10 of 96 insurance plan rates AETNA — AETNA: $119.97 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $7.93 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$129	$83.85	$7.77 – $473.55
Complete blood count (CBC) with differential: 10 of 96 insurance plan rates AETNA — AETNA: $119.97 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $7.93 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	Not listed in the file	$1,068.60	$7.77 – $473.55
Complete blood count (CBC) with differential: 10 of 85 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $7.93 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $41.05
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated Intrauterine	$131	$85.15	$6.47 – $473.55
Complete blood count (CBC), automated: 10 of 96 insurance plan rates AETNA — AETNA: $121.83 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $6.60 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$131	$85.15	$6.47 – $473.55
Complete blood count (CBC), automated: 10 of 96 insurance plan rates AETNA — AETNA: $121.83 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $6.60 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $37.32
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3514930 Prothrombin Time	$116	$75.40	$4.29 – $473.55
Blood clotting time test (prothrombin time, PT): 10 of 96 insurance plan rates AETNA — AETNA: $107.88 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.54 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $4.38 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $6 AMBETTER — AMBETTER MARKETPLACE: $7.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prothrombin Time	$116	$75.40	$4.29 – $473.55
Blood clotting time test (prothrombin time, PT): 10 of 96 insurance plan rates AETNA — AETNA: $107.88 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.54 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $4.38 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $6 AMBETTER — AMBETTER MARKETPLACE: $7.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $20.90
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 7079 Thromboplastin Time Partial (Ptt)	$118	$76.70	$6.01 – $473.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 96 insurance plan rates AETNA — AETNA: $109.74 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $6.13 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 19790 Thromboplastin Time Partial (Ptt)	$118	$76.70	$6.01 – $473.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 96 insurance plan rates AETNA — AETNA: $109.74 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $6.13 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3514930 Thromboplastin Time Partial (Ptt)	$118	$76.70	$6.01 – $473.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 96 insurance plan rates AETNA — AETNA: $109.74 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $6.13 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $35.08

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	$2,245	$1,459.25	$90.16 – $2,200.10
CT scan of the head or brain, without contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,087.85 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $169.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $175.13 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76 CIGNA — CIGNA: $254.71 CIGNA — CIGNA EXCHANGE: $473.55
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	Not listed in the file	$1,459.25	$90.16 – $473.55
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $112.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $175.13 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76 CIGNA — CIGNA: $254.71 CIGNA — CIGNA EXCHANGE: $473.55 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $113.77
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Head/Brain W/O Contrast\|TECHNICAL COMPONENT	$2,245	$1,459.25	$90.16 – $2,200.10
CT scan of the head or brain, without contrast: 10 of 20 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $112.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $116.25 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $113.77 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $135.25 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $115.52 HEALTH AMERICA ADVANTRA — HEALTH AMERICA MEDICARE ADVANTAGE: $135.25 HEALTH PARTNERS MEDICARE ADVANTAGE — HEALTH PARTNERS MEDICARE ADVANTAGE: $119.47
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	$8,697	$5,653.05	$300.88 – $8,523.06
MRI of the brain, before and after contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,181 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $491.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $398.07 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $383.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $508.50 AMBETTER — AMBETTER MARKETPLACE: $671.35 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $376.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $1,016.99 CIGNA — CIGNA: $849.98 CIGNA — CIGNA EXCHANGE: $473.55
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$607	$394.55	$21.53 – $594.86
Chest X-ray, 2 views: 10 of 97 insurance plan rates AETNA — AETNA: $564.51 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $34.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.30 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $95.69 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $35.46 AMBETTER — AMBETTER MARKETPLACE: $167.46 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Chest 2 Views	Not listed in the file	$394.55	$21.53 – $473.55
Chest X-ray, 2 views: 10 of 86 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $21.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.30 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $95.69 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $35.46 AMBETTER — AMBETTER MARKETPLACE: $167.46 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $126.89
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC Xr Chest 2 Views\|TECHNICAL COMPONENT	$607	$394.55	$21.53 – $594.86
Chest X-ray, 2 views: rates for 6 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $21.53 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $22.28 KEYSTONE FIRST — KEYSTONE MEDICAID: $39.06 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $39.06 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $39.06 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $22.28
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	$844	$548.60	$42.92 – $827.12
X-ray of the lower spine, at least 4 views: 10 of 97 insurance plan rates AETNA — AETNA: $784.92 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $53.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $54.93 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $186.61 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $186.61 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $186.61 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $186.61
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$4,425	$2,876.25	$205.78 – $4,336.50
MRI of the lower back (lumbar spine), without contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,181 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $371.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $262.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $384.23 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54 CIGNA — CIGNA: $581.32 CIGNA — CIGNA EXCHANGE: $473.55
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$3,113	$2,023.45	$151.27 – $3,050.74
CT scan of the pelvis, with contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,895.09 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $203.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $200.13 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $192.87 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $210.14 AMBETTER — AMBETTER MARKETPLACE: $337.53 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $189.09 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $511.30 CIGNA — CIGNA: $427.35 CIGNA — CIGNA EXCHANGE: $473.55
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Rt	$6,941	$4,511.65	$205.78 – $6,802.18
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,181 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $480.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $262.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54 CIGNA — CIGNA: $581.32 CIGNA — CIGNA EXCHANGE: $473.55
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Lt	$6,941	$4,511.65	$205.78 – $6,802.18
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,181 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $480.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $262.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54 CIGNA — CIGNA: $581.32 CIGNA — CIGNA EXCHANGE: $473.55
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Bl	$10,412	$6,767.80	$205.78 – $10,203.76
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates AETNA — AETNA: $2,181 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $480.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $262.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54 CIGNA — CIGNA: $581.32 CIGNA — CIGNA EXCHANGE: $473.55
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	$6,524	$4,240.60	$279.46 – $6,393.52
CT scan of the abdomen and pelvis, with contrast: 10 of 43 insurance plan rates AETNA — AETNA: $6,067.32 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $381.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $398.07 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $383.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $394.74 AMBETTER — AMBETTER MARKETPLACE: $671.35 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $376.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $1,016.99 CIGNA — CIGNA: $849.98 CIGNA — CIGNA EXCHANGE: $473.55
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Abdomen & Pelvis W/Contrast\|TECHNICAL COMPONENT	$6,524	$4,240.60	$279.46 – $6,393.52
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $279.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $289.10 KEYSTONE FIRST — KEYSTONE MEDICAID: $506.88 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $506.88 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $506.88 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $289.10
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR US Abdomen Complete	$110	$110	$24.28 – $110
Ultrasound of the abdomen, complete: 10 of 751 insurance plan rates AETNA DOMESTIC — AETNA: $110 AETNA MEDICAID — AETNA MEDICAID: $110 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $110 AETNA MEDICARE TRANSPLANT — MEDICARE: $110 ALIGN SENIOR CARE — MEDICARE: $110 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $110 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $110 ALLY ALIGN CARE ADV — MEDICARE: $110 AMBETTER — AMBETTER: $110 AMERICAN HEALTH PLAN — MEDICARE: $110
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$1,260	$819	$90.16 – $1,234.80
Ultrasound of the abdomen, complete: 10 of 43 insurance plan rates AETNA — AETNA: $1,171.80 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $138.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $142.91 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76 CIGNA — CIGNA: $254.71 CIGNA — CIGNA EXCHANGE: $473.55
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR US Abdomen Complete	Not listed in the file	$329.82	$24.28 – $329.82
Ultrasound of the abdomen, complete: 10 of 751 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $138.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $127.86 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $95.27 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $95.27 ALIGN SENIOR CARE — MEDICARE: $116.24 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $142.91 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $142.91 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $128.10 ALLY ALIGN CARE ADV — MEDICARE: $116.24 AMBETTER — AMBETTER: $169.38
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$1,350	$877.50	$88.69 – $1,323
Pregnancy ultrasound (after the first trimester): 10 of 97 insurance plan rates AETNA — AETNA: $1,255.50 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $112.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $116.25 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $373.22 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $373.22 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $373.22 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $373.22
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$1,190	$773.50	$88.69 – $1,166.20
Transvaginal ultrasound: 10 of 97 insurance plan rates AETNA — AETNA: $1,106.70 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $110.93 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $114.75 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	Not listed in the file	$1,664	$67.43 – $733.15
Transvaginal ultrasound: 10 of 86 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $67.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $114.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $114.75 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $347.09
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$468	$304.20	$71.81 – $488.76
Diagnostic mammogram, one breast: 10 of 97 insurance plan rates AETNA — AETNA: $435.24 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $148.49 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $91.56 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$468	$304.20	$71.81 – $488.76
Diagnostic mammogram, one breast: 10 of 97 insurance plan rates AETNA — AETNA: $435.24 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $148.49 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $91.56 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $231.40
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$736	$478.40	$92.15 – $721.28
Diagnostic mammogram, both breasts: 10 of 97 insurance plan rates AETNA — AETNA: $684.48 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $188.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.92 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $117.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $194.78 AMBETTER — AMBETTER MARKETPLACE: $205.61 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $294.84 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $294.84 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $294.84 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $294.84
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$502	$326.30	$75.98 – $491.96
Screening mammogram, both breasts: 10 of 97 insurance plan rates AETNA — AETNA: $466.86 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $151.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $96.87 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $157.05 AMBETTER — AMBETTER MARKETPLACE: $169.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$502	$326.30	$75.98 – $491.96
Screening mammogram, both breasts: 10 of 97 insurance plan rates AETNA — AETNA: $466.86 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $151.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $96.87 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $157.05 AMBETTER — AMBETTER MARKETPLACE: $169.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $223.93

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$9,763	$6,345.95	$473.55 – $9,963
Left heart catheterization (diagnostic): 10 of 95 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,699.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $3,564.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 AMBETTER — AMBETTER MARKETPLACE: $6,238.54 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $7,464.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $7,464.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $7,464.40 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $7,464.40 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $7,464.40
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Comprehensive Rt Atrial/Ventricular Pacing/Record W/O Arrhythmia	$24,333	$15,816.45	$473.55 – $23,846.34
Heart rhythm study (electrophysiology evaluation): 10 of 95 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8,899.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $8,576.64 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 AMBETTER — AMBETTER MARKETPLACE: $15,009.11 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $11,397 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $11,397 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $11,397 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $11,397 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $11,397

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$106	$68.90	$23.97 – $184
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 94 insurance plan rates AETNA — AETNA: $98.58 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $37.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $30.70 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$106	$68.90	$23.97 – $184
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 94 insurance plan rates AETNA — AETNA: $98.58 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $37.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $30.70 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $101.12
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier CQ In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes\|CQ	$106	$68.90	$23.97 – $184
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $30.70 AMBETTER — AMBETTER MARKETPLACE: $53.73 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $30.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $81.39 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $30.38 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $36.12 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $30.85 GROUP PENSION ADMINISTRATORS — REEDMAN TOLL MANAGEMENT GROUP: $67.73 HEALTH AMERICA ADVANTRA — HEALTH AMERICA MEDICARE ADVANTAGE: $36.12
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$331	$215.15	$80.59 – $324.38
Physical therapy evaluation (low complexity): 10 of 95 insurance plan rates AETNA — AETNA: $307.83 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $115.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $103.28 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $134.83 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $134.83 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $134.83 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $134.83 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $134.83
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$424	$275.60	$48.31 – $415.52
Physical therapy evaluation (moderate complexity): 10 of 95 insurance plan rates AETNA — AETNA: $394.32 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $148.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $103.28 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $168.54 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $168.54 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $168.54 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $168.54 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $168.54
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$562	$365.30	$80.59 – $550.76
Physical therapy evaluation (high complexity): 10 of 95 insurance plan rates AETNA — AETNA: $522.66 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $196.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $103.28 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $202.25 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $202.25 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $202.25 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $202.25 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $202.25

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$920	$920	$86.50 – $883.50
Removal of breast growth (open surgery): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $209.46 AETNA — AETNA: $434.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $230.41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $86.50 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $86.50 ALIGN SENIOR CARE — MEDICARE: $209.46 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $209.46 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $129.75 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $230.84 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $129.75
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$930	$930	$86.50 – $1,767
Removal of breast growth (open surgery): 10 of 752 insurance plan rates AETNA DOMESTIC — AETNA: $434.40 AETNA MEDICAID — AETNA MEDICAID: $125.43 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $209.46 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $86.50 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $129.75 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $209.46 AMERICAN HEALTH PLAN — MEDICARE: $209.46 AMERIGROUP MEDICAID — MEDICAID: $86.50 AMERIHEALTH — AMERIHEALTH: $235.18 AMERIHEALTH MEDICARE — MEDICARE: $209.46
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt	Not listed in the file	$11,607.09	$386.42 – $11,413.73
Removal of breast growth (open surgery): 10 of 88 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,207.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,467.56 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $4,305.47 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,249.50 AMBETTER — AMBETTER MARKETPLACE: $7,534.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$285	$285	$38.88 – $270.75
Upper GI endoscopy (diagnostic): 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $56.23 AETNA — AETNA: $143.29 AETNA DOMESTIC — AETNA: $143.29 AETNA MEDICAID — AETNA MEDICAID: $90.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $61.85 AETNA MEDICARE TRANSPLANT — MEDICARE: $56.23 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $62.61 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $56.23 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $61.96
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$267	$267	$38.88 – $253.65
Upper GI endoscopy (diagnostic): 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $56.23 AETNA — AETNA: $143.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $61.85 AETNA MEDICARE TRANSPLANT — MEDICARE: $56.23 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $62.61 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $62.61 ALIGN SENIOR CARE — MEDICARE: $56.23 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $56.23 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $61.96
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	Not listed in the file	$3,912.19	$414.70 – $2,785
Upper GI endoscopy (diagnostic): rates for 9 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $414.70 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $429 CIGNA — CIGNA EXCHANGE: $473.55 JEFFERSON HEALTH PLANS MEDICAID — HEALTH PARTNERS MEDICAID: $782.22 KEYSTONE FIRST — KEYSTONE MEDICAID: $2,785 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $2,785 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $2,785 UNITED HEALTHCARE MEDICAID — UHC COMMUNITY PLAN MEDICAID: $1,958.40 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $429
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$350	$350	$43.67 – $332.50
Upper GI endoscopy with biopsy: 10 of 756 insurance plan rates AETNA DOMESTIC — AETNA: $161.11 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $62.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $74.29 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $62.84 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $62.84 AMERICAN HEALTH PLAN — MEDICARE: $62.84 AMERIGROUP MEDICAID — MEDICAID: $74.29 AMERIHEALTH — AMERIHEALTH: $90.98 AMERIHEALTH MEDICARE — MEDICARE: $62.84 AMISH MENNONITE — MEDICAID: $74.29
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$301	$301	$43.67 – $285.95
Upper GI endoscopy with biopsy: 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $62.84 AETNA — AETNA: $161.11 AETNA MEDICAID — AETNA MEDICAID: $107.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $62.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $74.29 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $74.29 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $62.84 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $111.44 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $69.25 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $111.44
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	Not listed in the file	$8,608.34	$183.67 – $5,593.73
Upper GI endoscopy with biopsy: 10 of 86 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,189.50 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $2,110.06 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $206.04 AMBETTER — AMBETTER MARKETPLACE: $3,692.61 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$475	$475	$58.36 – $451.25
Colonoscopy (diagnostic): 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $83.82 AETNA — AETNA: $215.36 AETNA MEDICAID — AETNA MEDICAID: $130.87 AETNA MEDICARE TRANSPLANT — MEDICARE: $83.82 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.25 ALIGN SENIOR CARE — MEDICARE: $83.82 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $83.82 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.38 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	Not listed in the file	$475	$58.36 – $451.25
Colonoscopy (diagnostic): 10 of 756 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.25 AMERICAN HEALTH PLAN — MEDICARE: $83.82 AMERIGROUP MEDICAID — MEDICAID: $90.25 AMERIHEALTH — AMERIHEALTH: $122.30 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $90.25 AMISH MENNONITE — MEDICAID: $90.25 ANDRIE INC — WORKERS COMP: $96.65 ANTHEM MYCARE OHIO — MEDICARE: $83.82 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $90.25
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	Not listed in the file	$4,270.99	$473.55 – $4,104.05
Colonoscopy (diagnostic): 10 of 83 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,061.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $1,022.60 AMBETTER — AMBETTER MARKETPLACE: $1,789.54 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$560	$560	$63.48 – $532
Colonoscopy with biopsy: 10 of 756 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $90.38 AETNA — AETNA: $233.55 AETNA MEDICAID — AETNA MEDICAID: $163.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.42 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $112.71 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $112.71 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $90.38 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $99.60 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLY ALIGN CARE ADV — MEDICARE: $90.38
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	Not listed in the file	$560	$63.48 – $532
Colonoscopy with biopsy: 10 of 756 insurance plan rates AETNA DOMESTIC — AETNA: $233.55 AETNA MEDICAID — AETNA MEDICAID: $163.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.42 ALIGN SENIOR CARE — MEDICARE: $90.38 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $99.60 AMBETTER — AMBETTER: $131.69 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $90.38 AMERICAN HEALTH PLAN — MEDICARE: $90.38 AMERIGROUP MEDICAID — MEDICAID: $112.71
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	Not listed in the file	$7,299.82	$56.18 – $4,104.05
Colonoscopy with biopsy: 10 of 86 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,365.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $1,315.85 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $255 AMBETTER — AMBETTER MARKETPLACE: $2,302.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$551	$551	$79.98 – $523.45
Colonoscopy with removal of polyps (snare): 10 of 756 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $194.36 AETNA MEDICARE TRANSPLANT — MEDICARE: $113.57 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $134.04 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $134.04 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $113.57 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $125.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06 ALLY ALIGN CARE ADV — MEDICARE: $113.57 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $113.57
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$660	$660	$79.98 – $627
Colonoscopy with removal of polyps (snare): 10 of 756 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $194.36 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $113.57 AETNA MEDICARE TRANSPLANT — MEDICARE: $113.57 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $134.04 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $134.04 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $113.57 ALLY ALIGN CARE ADV — MEDICARE: $113.57 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $113.57 AMERIGROUP MEDICAID — MEDICAID: $134.04 AMERIHEALTH — AMERIHEALTH: $167.10
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)	Not listed in the file	$7,774.13	$56.18 – $2,785
Colonoscopy with removal of polyps (snare): 10 of 21 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $551 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $57.30 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $570 AMBETTER — AMBETTER MARKETPLACE: $100.28 CIGNA — CIGNA EXCHANGE: $473.55 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $56.71 GROUP PENSION ADMINISTRATORS — REEDMAN TOLL MANAGEMENT GROUP: $126.40 HEALTH AMERICA ADVANTRA — HEALTH AMERICA MEDICARE ADVANTAGE: $67.41 HEALTH PARTNERS MEDICARE ADVANTAGE — HEALTH PARTNERS MEDICARE ADVANTAGE: $59.55 HOMESTEAD HEALTH PLANS WOODS CENTER — HOMESTEAD HEALTH PLAN MEDICARE ADVANTAGE: $109.55
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	$470	$470	$58.47 – $446.50
Screening colonoscopy (not high risk): 10 of 494 insurance plan rates AETNA — AETNA: $231.39 AETNA DOMESTIC — AETNA: $231.39 AETNA MEDICAID — AETNA MEDICAID: $235 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.01 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.01 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $235 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $235 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	Not listed in the file	$470	$58.47 – $553.07
Screening colonoscopy (not high risk): 10 of 494 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $84.01 AETNA — AETNA: $231.39 AETNA DOMESTIC — AETNA: $231.39 AETNA MEDICAID — AETNA MEDICAID: $291.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.01 ALIGN SENIOR CARE — MEDICARE: $84.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.01 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $291.09 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	Not listed in the file	$4,274.40	$473.55 – $4,104.05
Screening colonoscopy (not high risk): 10 of 83 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,061.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $1,022.60 AMBETTER — AMBETTER MARKETPLACE: $1,789.54 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81 BLUE CROSS - CA (ANTHEM) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,416.81
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,451	$1,451	$16.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,378.45
Gallbladder removal by laparoscope: 10 of 752 insurance plan rates AETNA DOMESTIC — AETNA: $796.46 AETNA MEDICAID — AETNA MEDICAID: $427.28 AETNA MEDICARE TRANSPLANT — MEDICARE: $324.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $324.96 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLY ALIGN CARE ADV — MEDICARE: $324.96 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $324.96 AMERICAN HEALTH PLAN — MEDICARE: $324.96 AMERIGROUP MEDICAID — MEDICAID: $294.68 AMERIHEALTH — AMERIHEALTH: $373.06
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,460	$1,460	$213.64 – $1,387
Gallbladder removal by laparoscope: 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $324.96 AETNA — AETNA: $796.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $357.45 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $324.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $294.68 ALIGN SENIOR CARE — MEDICARE: $324.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $324.96 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $358.11 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $358.11
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)	Not listed in the file	$19,146.57	$56.18 – $17,623.08
Gallbladder removal by laparoscope: 10 of 88 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,898.03 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $6,647.76 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 AMBETTER — AMBETTER MARKETPLACE: $11,633.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $8,957.28 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $8,957.28 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $8,957.28 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $8,957.28 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $8,957.28
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,157	$1,157	$13.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,099.15
Groin (inguinal) hernia repair, age 5 or older: 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $261.12 AETNA — AETNA: $631.60 AETNA MEDICARE TRANSPLANT — MEDICARE: $261.12 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $158.75 ALIGN SENIOR CARE — MEDICARE: $261.12 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $261.12 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLY ALIGN CARE ADV — MEDICARE: $261.12
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,155	$1,155	$158.75 – $1,099.15
Groin (inguinal) hernia repair, age 5 or older: 10 of 752 insurance plan rates AETNA DOMESTIC — AETNA: $631.60 AETNA MEDICAID — AETNA MEDICAID: $230.19 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $261.12 AETNA MEDICARE TRANSPLANT — MEDICARE: $261.12 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLY ALIGN CARE ADV — MEDICARE: $261.12 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $261.12 AMERIGROUP MEDICAID — MEDICAID: $158.75 AMERIHEALTH — AMERIHEALTH: $295.74 AMERIHEALTH MEDICARE — MEDICARE: $261.12
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH)	Not listed in the file	$13,621.49	$10,437.09
Groin (inguinal) hernia repair, age 5 or older: 10 of 87 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,168.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,085.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $3,937.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,209 AMBETTER — AMBETTER MARKETPLACE: $6,889.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $4,174.49 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $4,174.49 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $4,174.49 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $4,174.49 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $4,174.49
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$660	$660	$73.91 – $627
Hysteroscopy with biopsy of the uterus lining: 10 of 756 insurance plan rates AETNA DOMESTIC — AETNA: $229.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $114.98 AETNA MEDICARE TRANSPLANT — MEDICARE: $104.53 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $119.39 ALIGN SENIOR CARE — MEDICARE: $104.53 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $179.08 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $115.20 AMBETTER — AMBETTER: $152.31 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $104.53 AMERICAN HEALTH PLAN — MEDICARE: $104.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$498	$498	$5.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $473.10
Hysteroscopy with biopsy of the uterus lining: 10 of 756 insurance plan rates AETNA DOMESTIC — AETNA: $229.75 AETNA MEDICAID — AETNA MEDICAID: $173.11 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $104.53 AETNA MEDICARE TRANSPLANT — MEDICARE: $104.53 ALIGN SENIOR CARE — MEDICARE: $104.53 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $104.53 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $179.08 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $115.20 AMBETTER — AMBETTER: $152.31 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $119.39
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	Not listed in the file	$9,155.48	$56.18 – $9,436.42
Hysteroscopy with biopsy of the uterus lining: 10 of 88 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,693.60 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $3,559.60 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 AMBETTER — AMBETTER MARKETPLACE: $6,229.29 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,856.23
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt	Not listed in the file	$4,559.50	$249.96 – $3,742
Nerve root injection, lower back, with imaging guidance: 10 of 87 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,009.20 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $972.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 AMBETTER — AMBETTER MARKETPLACE: $1,702.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,318.26 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,318.26 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,318.26 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $1,318.26 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $1,318.26
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Rem Cataract Extracapsular Insert Intraocular Lens Prosth Man/Mech Tech	Not listed in the file	$7,550.71	$9.34 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $10,446.66
Cataract removal with lens implant: 10 of 88 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $2,398.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,633.26 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $2,537.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $2,481 AMBETTER — AMBETTER MARKETPLACE: $4,441.01 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $6,151.88 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $6,151.88 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $6,151.88 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $6,151.88 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $6,151.88

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	$26,140	$3,796 – $30,720.83
Uterus and ovary surgery (not for cancer), without complications: 10 of 82 insurance plan rates AETNA — AETNA: $26,184.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11,788.31 ALIGN SENIOR CARE — ALLY ALIGN HEALTH MEDICARE ADVANTAGE: $11,360.62 AMBETTER — AMBETTER MARKETPLACE: $19,881.08 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $22,303.24 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $22,303.24 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $22,303.24 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $22,303.24 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $22,303.24 BLUE CROSS - AZ — INDEPENDENCE BLUE CROSS HMO/PPO: $22,303.24

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

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

Hospital information

Hospital type	Acute Care Hospital
Address	2601 Holme Ave, Philadelphia, PA 19152
County	Philadelphia County
State	Pennsylvania
Phone	(215) 335‑6000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
CMS Certification Number	390204
Name in Medicare records	NAZARETH HOSPITAL
Profile level	Medicare data + hospital website
Official website	trinityhealthma.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Nazareth Hospital - Trinity Health Mid-Atlantic — trinityhealthma.org
Nazareth Hospital — trinityhealthma.org
Nazareth Hospital Emergency Department | Trinity Health Mid-Atlantic — trinityhealthma.org
Stroke Centers | Trinity Health Mid-Atlantic — trinityhealthma.org

Nazareth Hospital

Summary

Profile from official sources

At a glance