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Acute Care Hospital

Newark-Wayne Community Hospital

Newark, New York · Wayne County · Emergency services listed

Summary

Newark-Wayne Community Hospital is an acute care hospital in Newark, New York. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 32 services, specialties and programs. Medicare lists 292 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(315) 332‑2022 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
120Beds (hospital website)
292Doctors and clinicians
32Services listed

Quick answers

Does Newark-Wayne Community Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Newark-Wayne Community Hospital. In a medical emergency, call 911.
Where is Newark-Wayne Community Hospital?
1200 Driving Park Avenue, Newark, NY 14513, in Wayne County, New York.
What is the phone number of Newark-Wayne Community Hospital?
(315) 332-2022, as listed by Medicare (CMS).
What is the Medicare star rating of Newark-Wayne Community 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][6][7]

Conditions treated[5][6]

Treatments[5][6]

Procedures[7]

Programs and centers[4][6]

  • Telemedicine program
  • NY State-designated Stroke Center
  • NICHE Exemplar (geriatric nursing care)
  • Rehabilitation programs for stroke, brain injury and medical rehabilitation

Emergency care (hospital website)[4]

Emergency roomYes
Stroke designationNew York State-designated Stroke Center

Visiting and practical information

VisitingVisitor hours 8 a.m. to 8 p.m[4]
ParkingFree parking is listed among accommodations for the hospital's Emergency Department, imaging and rehabilitation offices[5][7][6]
Interpreters and languagesFree interpreters. In-house Spanish Mon-Fri 8-6:30; ASL interpreters on call 24/7; recording devices for blind or low-vision patients[4]
Patient portalMyCare

Recognition[4]

  • WHO Baby-Friendly designation
  • DNV Healthcare accredited
  • ACS Geriatric Surgery Verification Program
  • ACS Surgical Quality Partner
  • ACS Quality Verification Program
  • NICHE Exemplar hospital
  • New York State-designated Stroke Center

Doctors and clinicians (292)

292 doctors and other clinicians list Newark-Wayne Community Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (292)

And 268 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Newark-Wayne Community 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) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well4 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean2 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1064%National average: 72%
Would definitely recommend the hospital66%National average: 71%
Nurses “always” communicated well79%National average: 80%
Doctors “always” communicated well79%National average: 80%
Staff “always” explained medicines before giving them60%National average: 62%
Were given information about recovery at home87%National average: 86%
Room and bathroom “always” clean60%National average: 74%
Area around the room “always” quiet at night46%National average: 60%
Completed surveys792Response rate: 25%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)0No different from the national benchmark
Surgical site infections after colon surgeryNot reported to Medicare
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infectionsNot reported to Medicare
Clostridioides difficile (C. diff) intestinal infections0.481No 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 patientsToo few cases to report
Deaths within 30 days: heart failure patients9.6%
Deaths within 30 days: pneumonia patients12.9%
Deaths within 30 days: COPD patients8.2%
Deaths within 30 days: stroke patients8.1%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)1.12No different from the national rate
Complications after hip or knee replacementNot reported to Medicare

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 attack14.3%
Readmitted within 30 days: heart failure22.6%
Readmitted within 30 days: pneumonia19.8%
Readmitted within 30 days: COPD22.4%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementNot reported to Medicare

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)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)205 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)55%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 New YorkBest hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as Newark-Wayne Community 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 →

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $69.26 – $144.32
New patient office visit (about 30–44 minutes): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $69.26
  • EXCELLUS — COMMERCIAL: $144.32
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES $280.87 $182.57 Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M NEW PATIENT LEVEL 3 $427.64 $277.97 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $113.42 – $236.33
New patient office visit (about 45–59 minutes): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $113.42
  • EXCELLUS — COMMERCIAL: $236.33
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES $345.22 $224.39 Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M NEW PATIENT LEVEL 4 $449.03 $291.87 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new Not listed in the file Not listed in the file $155.18 – $323.35
New patient office visit (about 60–74 minutes): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $155.18
  • EXCELLUS — COMMERCIAL: $323.35
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES $432.31 $281 Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M NEW PATIENT LEVEL 5 $471.48 $306.46 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $56.01 – $116.71
Established patient office visit (about 20–29 minutes): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $56.01
  • EXCELLUS — COMMERCIAL: $116.71
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT ESTABLISHED LOW MDM 20 MIN $234.05 $152.13 Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M EST PATIENT LEVEL 3 $356.37 $231.64 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est Not listed in the file Not listed in the file $82.33 – $171.55
Established patient office visit (about 30–39 minutes): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $82.33
  • EXCELLUS — COMMERCIAL: $171.55
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE_OUTPATIENT ESTABLISHED MOD MDM 30 MIN $287.69 $187 Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN E_M EST PATIENT LEVEL 4 $374.19 $243.22 Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE $178.88 $116.27 Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE $259.97 $168.98 Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS $497.07 $323.10 Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS $575.73 $374.22 Not listed in the file
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $67.02 – $139.65
Emergency room visit (moderate): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $67.02
  • EXCELLUS — COMMERCIAL: $139.65
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EMERGENCY DEPT E_M VISIT_LEVEL III $1,768.14 $1,149.29 Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $114.02 – $237.58
Emergency room visit (moderately high): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $114.02
  • EXCELLUS — COMMERCIAL: $237.58
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EMERGENCY DEPT E_M VISIT_LEVEL IV $2,712.33 $1,763.01 Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit Not listed in the file Not listed in the file $165.50 – $344.85
Emergency room visit (high): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $165.50
  • EXCELLUS — COMMERCIAL: $344.85
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EMERGENCY DEPT E_M VISIT_LEVEL V $3,292.77 $2,140.30 Not listed in the file

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca Not listed in the file Not listed in the file $7.06 – $13.20
Basic metabolic panel (blood test): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $13.20
  • CHAMPUS-TRICARE — COMMERCIAL: $8.46
  • EXCELLUS — COMMERCIAL: $9.22
  • EXCELLUS — MEDICAID: $7.06
  • EXCELLUS — MEDICARE ADVANTAGE: $7.28
  • FIDELIS CARE NEW YORK — MEDICAID: $8.42
  • MVP - CIGNA — COMMERCIAL: $7.95
  • UNITED HEALTHCARE — COMMERCIAL: $7.61
  • WELLCARE — MEDICARE ADVANTAGE: $8.46
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $10.58
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL _8_ $47.09 $30.61 Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel Not listed in the file Not listed in the file $9.08 – $16.47
Comprehensive metabolic panel (blood test): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $16.47
  • CHAMPUS-TRICARE — COMMERCIAL: $10.56
  • EXCELLUS — COMMERCIAL: $11.51
  • EXCELLUS — MEDICAID: $9.31
  • EXCELLUS — MEDICARE ADVANTAGE: $9.08
  • FIDELIS CARE NEW YORK — MEDICAID: $11.62
  • MVP - CIGNA — COMMERCIAL: $9.93
  • UNITED HEALTHCARE — COMMERCIAL: $9.50
  • WELLCARE — MEDICARE ADVANTAGE: $10.56
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $13.20
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL _14_ $58.81 $38.23 Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel Not listed in the file Not listed in the file $22.26 – $74.58
Obstetric blood test panel: rates for 9 insurance plans
  • AETNA — COMMERCIAL: $74.58
  • CHAMPUS-TRICARE — COMMERCIAL: $47.81
  • EXCELLUS — COMMERCIAL: $52.11
  • EXCELLUS — MEDICAID: $22.26
  • EXCELLUS — MEDICARE ADVANTAGE: $41.12
  • MVP - CIGNA — COMMERCIAL: $44.94
  • UNITED HEALTHCARE — COMMERCIAL: $43.03
  • WELLCARE — MEDICARE ADVANTAGE: $47.81
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $59.76
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC OBSTETRIC PANEL $163.06 $105.99 Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel Not listed in the file Not listed in the file $7.02 – $20.89
Cholesterol panel (lipid panel): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $20.89
  • CHAMPUS-TRICARE — COMMERCIAL: $13.39
  • EXCELLUS — COMMERCIAL: $14.60
  • EXCELLUS — MEDICAID: $11.81
  • EXCELLUS — MEDICARE ADVANTAGE: $11.52
  • FIDELIS CARE NEW YORK — MEDICAID: $7.02
  • MVP - CIGNA — COMMERCIAL: $12.59
  • UNITED HEALTHCARE — COMMERCIAL: $12.05
  • WELLCARE — MEDICARE ADVANTAGE: $13.39
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $16.74
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PROFILE $74.54 $48.45 Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel Not listed in the file Not listed in the file $7.46 – $13.54
Kidney function panel: rates for 10 insurance plans
  • AETNA — COMMERCIAL: $13.54
  • CHAMPUS-TRICARE — COMMERCIAL: $8.68
  • EXCELLUS — COMMERCIAL: $9.46
  • EXCELLUS — MEDICAID: $7.65
  • EXCELLUS — MEDICARE ADVANTAGE: $7.46
  • FIDELIS CARE NEW YORK — MEDICAID: $9.98
  • MVP - CIGNA — COMMERCIAL: $8.16
  • UNITED HEALTHCARE — COMMERCIAL: $7.81
  • WELLCARE — MEDICARE ADVANTAGE: $8.68
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $10.85
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL $48.34 $31.42 Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel Not listed in the file Not listed in the file $7.03 – $12.75
Liver function panel: rates for 10 insurance plans
  • AETNA — COMMERCIAL: $12.75
  • CHAMPUS-TRICARE — COMMERCIAL: $8.17
  • EXCELLUS — COMMERCIAL: $8.91
  • EXCELLUS — MEDICAID: $7.06
  • EXCELLUS — MEDICARE ADVANTAGE: $7.03
  • FIDELIS CARE NEW YORK — MEDICAID: $8.42
  • MVP - CIGNA — COMMERCIAL: $7.68
  • UNITED HEALTHCARE — COMMERCIAL: $7.35
  • WELLCARE — MEDICARE ADVANTAGE: $8.17
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $10.21
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL _7_ $45.50 $29.58 Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $2.73 – $4.95
Urine test (automated, with microscope): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $4.95
  • CHAMPUS-TRICARE — COMMERCIAL: $3.17
  • EXCELLUS — COMMERCIAL: $3.46
  • EXCELLUS — MEDICAID: $2.79
  • EXCELLUS — MEDICARE ADVANTAGE: $2.73
  • FIDELIS CARE NEW YORK — MEDICAID: $3.65
  • MVP - CIGNA — COMMERCIAL: $2.98
  • UNITED HEALTHCARE — COMMERCIAL: $2.85
  • WELLCARE — MEDICARE ADVANTAGE: $3.17
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $3.96
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS _ ROUTINE $17.69 $11.50 Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope Not listed in the file Not listed in the file $2.25 – $5.43
Urine test (manual, without microscope): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $5.43
  • CHAMPUS-TRICARE — COMMERCIAL: $3.48
  • EXCELLUS — COMMERCIAL: $3.79
  • EXCELLUS — MEDICAID: $2.25
  • EXCELLUS — MEDICARE ADVANTAGE: $2.99
  • FIDELIS CARE NEW YORK — MEDICAID: $2.32
  • MVP - CIGNA — COMMERCIAL: $3.27
  • UNITED HEALTHCARE — COMMERCIAL: $3.13
  • WELLCARE — MEDICARE ADVANTAGE: $3.48
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $4.35
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINE DIPSTICK_ NON_AUTOMATED $15.70 $10.20 Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope Not listed in the file Not listed in the file $1.94 – $3.51
Urine test (automated, without microscope): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $3.51
  • CHAMPUS-TRICARE — COMMERCIAL: $2.25
  • EXCELLUS — COMMERCIAL: $2.45
  • EXCELLUS — MEDICAID: $1.98
  • EXCELLUS — MEDICARE ADVANTAGE: $1.94
  • FIDELIS CARE NEW YORK — MEDICAID: $2.32
  • MVP - CIGNA — COMMERCIAL: $2.12
  • UNITED HEALTHCARE — COMMERCIAL: $2.02
  • WELLCARE — MEDICARE ADVANTAGE: $2.25
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $2.81
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URINALYSIS WO MICROSCOPY $12.51 $8.13 Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total Not listed in the file Not listed in the file $15.82 – $28.69
PSA (prostate specific antigen) blood test: rates for 10 insurance plans
  • AETNA — COMMERCIAL: $28.69
  • CHAMPUS-TRICARE — COMMERCIAL: $18.39
  • EXCELLUS — COMMERCIAL: $20.05
  • EXCELLUS — MEDICAID: $16.21
  • EXCELLUS — MEDICARE ADVANTAGE: $15.82
  • FIDELIS CARE NEW YORK — MEDICAID: $21.15
  • MVP - CIGNA — COMMERCIAL: $17.29
  • UNITED HEALTHCARE — COMMERCIAL: $16.55
  • WELLCARE — MEDICARE ADVANTAGE: $18.39
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $22.99
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSA_ TOTAL $102.44 $66.59 Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone Not listed in the file Not listed in the file $10.45 – $26.21
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans
  • AETNA — COMMERCIAL: $26.21
  • CHAMPUS-TRICARE — COMMERCIAL: $16.80
  • EXCELLUS — COMMERCIAL: $18.31
  • EXCELLUS — MEDICAID: $14.81
  • EXCELLUS — MEDICARE ADVANTAGE: $14.45
  • FIDELIS CARE NEW YORK — MEDICAID: $10.45
  • MVP - CIGNA — COMMERCIAL: $15.79
  • UNITED HEALTHCARE — COMMERCIAL: $15.12
  • WELLCARE — MEDICARE ADVANTAGE: $16.80
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $21
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE _TSH_ $93.57 $60.82 Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc Not listed in the file Not listed in the file $3.68 – $12.12
Complete blood count (CBC) with differential: rates for 10 insurance plans
  • AETNA — COMMERCIAL: $12.12
  • CHAMPUS-TRICARE — COMMERCIAL: $7.77
  • EXCELLUS — COMMERCIAL: $8.47
  • EXCELLUS — MEDICAID: $6.81
  • EXCELLUS — MEDICARE ADVANTAGE: $6.68
  • FIDELIS CARE NEW YORK — MEDICAID: $3.68
  • MVP - CIGNA — COMMERCIAL: $7.30
  • UNITED HEALTHCARE — COMMERCIAL: $6.99
  • WELLCARE — MEDICARE ADVANTAGE: $7.77
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $9.71
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC WITH AUTO DIFFERENTIAL $43.26 $28.12 Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated Not listed in the file Not listed in the file $3.68 – $10.09
Complete blood count (CBC), automated: rates for 10 insurance plans
  • AETNA — COMMERCIAL: $10.09
  • CHAMPUS-TRICARE — COMMERCIAL: $6.47
  • EXCELLUS — COMMERCIAL: $7.05
  • EXCELLUS — MEDICAID: $5.71
  • EXCELLUS — MEDICARE ADVANTAGE: $5.56
  • FIDELIS CARE NEW YORK — MEDICAID: $3.68
  • MVP - CIGNA — COMMERCIAL: $6.08
  • UNITED HEALTHCARE — COMMERCIAL: $5.82
  • WELLCARE — MEDICARE ADVANTAGE: $6.47
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $8.09
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC _HEMOGRAM _ PLT_ $36 $23.40 Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time Not listed in the file Not listed in the file $3.46 – $6.69
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $6.69
  • CHAMPUS-TRICARE — COMMERCIAL: $4.29
  • EXCELLUS — COMMERCIAL: $4.68
  • EXCELLUS — MEDICAID: $3.46
  • EXCELLUS — MEDICARE ADVANTAGE: $3.69
  • FIDELIS CARE NEW YORK — MEDICAID: $4.54
  • MVP - CIGNA — COMMERCIAL: $4.03
  • UNITED HEALTHCARE — COMMERCIAL: $3.86
  • WELLCARE — MEDICARE ADVANTAGE: $4.29
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $5.36
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROTHROMBIN TIME $21.86 $14.21 Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial Not listed in the file Not listed in the file $5.17 – $9.38
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans
  • AETNA — COMMERCIAL: $9.38
  • CHAMPUS-TRICARE — COMMERCIAL: $6.01
  • EXCELLUS — COMMERCIAL: $6.55
  • EXCELLUS — MEDICAID: $5.29
  • EXCELLUS — MEDICARE ADVANTAGE: $5.17
  • FIDELIS CARE NEW YORK — MEDICAID: $6.91
  • MVP - CIGNA — COMMERCIAL: $5.65
  • UNITED HEALTHCARE — COMMERCIAL: $5.41
  • WELLCARE — MEDICARE ADVANTAGE: $6.01
  • WELLCARE — MEDICARE ADVANTAGE DUAL: $7.51
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC APTT $33.46 $21.75 Not listed in the file

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $63.70 – $132.73
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $99.37
  • CHAMPUS-TRICARE — COMMERCIAL: $63.70
  • EXCELLUS — COMMERCIAL: $132.73
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT HEAD_BRAIN WO CONTRAST $800.48 $520.31 Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $200.93 – $418.68
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $313.45
  • CHAMPUS-TRICARE — COMMERCIAL: $200.93
  • EXCELLUS — COMMERCIAL: $418.68
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI BRAIN WO _ W CONTRAST $2,536.89 $1,648.98 Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views Not listed in the file Not listed in the file $21.81 – $45.45
Chest X-ray, 2 views: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $34.02
  • CHAMPUS-TRICARE — COMMERCIAL: $21.81
  • EXCELLUS — COMMERCIAL: $45.45
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC XR CHEST 2 VIEWS $310.38 $201.75 Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $38.63 – $80.49
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $60.26
  • CHAMPUS-TRICARE — COMMERCIAL: $38.63
  • EXCELLUS — COMMERCIAL: $80.49
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $423.33 $275.16 Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $116.92 – $243.63
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $182.40
  • CHAMPUS-TRICARE — COMMERCIAL: $116.92
  • EXCELLUS — COMMERCIAL: $243.63
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI SPINE LUMBAR WO CONTRAST $1,548.25 $1,006.36 Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $163.57 – $340.83
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $255.17
  • CHAMPUS-TRICARE — COMMERCIAL: $163.57
  • EXCELLUS — COMMERCIAL: $340.83
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST $1,301.42 $845.92 Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $134.37 – $279.99
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $209.62
  • CHAMPUS-TRICARE — COMMERCIAL: $134.37
  • EXCELLUS — COMMERCIAL: $279.99
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 ANY JOINT WO CONTRAST $1,548.25 $1,006.36 Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast Not listed in the file Not listed in the file $205.45 – $428.10
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $320.50
  • CHAMPUS-TRICARE — COMMERCIAL: $205.45
  • EXCELLUS — COMMERCIAL: $428.10
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST $1,947.80 $1,266.07 Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $72.82 – $151.74
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $113.60
  • CHAMPUS-TRICARE — COMMERCIAL: $72.82
  • EXCELLUS — COMMERCIAL: $151.74
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE $654.54 $425.45 Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus Not listed in the file Not listed in the file $84.24 – $175.53
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • AETNA — COMMERCIAL: $131.41
  • CHAMPUS-TRICARE — COMMERCIAL: $84.24
  • EXCELLUS — COMMERCIAL: $175.53
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION $654.54 $425.45 Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $80.75 – $168.26
Transvaginal ultrasound: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $125.97
  • CHAMPUS-TRICARE — COMMERCIAL: $80.75
  • EXCELLUS — COMMERCIAL: $168.26
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US ECHOGRAPHY_TRANSVAGINAL $654.54 $425.45 Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $81.78 – $170.40
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $127.58
  • CHAMPUS-TRICARE — COMMERCIAL: $81.78
  • EXCELLUS — COMMERCIAL: $170.40
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNI $382.53 $248.64 Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi Not listed in the file Not listed in the file $104.86 – $218.50
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $163.58
  • CHAMPUS-TRICARE — COMMERCIAL: $104.86
  • EXCELLUS — COMMERCIAL: $218.50
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD BI $479.18 $311.47 Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad Not listed in the file Not listed in the file $86.54 – $180.32
Screening mammogram, both breasts: rates for 3 insurance plans
  • AETNA — COMMERCIAL: $135
  • CHAMPUS-TRICARE — COMMERCIAL: $86.54
  • EXCELLUS — COMMERCIAL: $180.32
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC SCR MAMMO BI INCL CAD $437.51 $284.38 Not listed in the file

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $14.72 – $30.67
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $14.72
  • EXCELLUS — COMMERCIAL: $30.67
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy Not listed in the file Not listed in the file $612.31 – $1,275.87
Left heart catheterization (diagnostic): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $612.31
  • EXCELLUS — COMMERCIAL: $1,275.87
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LEFT HRT CATH W_VENTRCLGRPHY $12,727.73 $8,273.02 Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EP EVAL R ATRIAL_VENTRIC PACING_RECORD HIS BUNDLE_INSERT MULTI ELECTRODE CATHS WO INDUCT ARRHY $17,793.40 $11,565.71 Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol Not listed in the file Not listed in the file $761.73 – $1,587.22
Heart rhythm study with ablation for atrial fibrillation: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $761.73
  • EXCELLUS — COMMERCIAL: $1,587.22
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EP EVAL INSERT ELEC CATH INDUCT ARRHY_ HIS BUND AF ARRHYTHMOGENIC FOCUS. TX AF ABLAT PULM VEIN $57,786.18 $37,561.02 Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $525.18 – $1,094.32
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $525.18
  • EXCELLUS — COMMERCIAL: $1,094.32
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED $4,989.26 $3,243.02 Not listed in the file

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises Not listed in the file Not listed in the file $25.49 – $58.91
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $28.27
  • EXCELLUS — COMMERCIAL: $58.91
  • MVP - CIGNA — COMMERCIAL: $43.05
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $31.19
  • MVP - CIGNA — MEDICAID: $25.49
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $25.49
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $31.24
  • UNITED HEALTHCARE — COMMERCIAL: $28.27
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PULMONARY REHABILITATION THERAPEUTIC EXCERCISES EA 15 MINUTES $68.54 $44.55 Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS $143.83 $93.49 Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $71.18 – $198.91
Physical therapy evaluation (low complexity): rates for 8 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $95.46
  • EXCELLUS — COMMERCIAL: $198.91
  • MVP - CIGNA — COMMERCIAL: $120.20
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $87.09
  • MVP - CIGNA — MEDICAID: $71.18
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $71.18
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $87.21
  • UNITED HEALTHCARE — COMMERCIAL: $95.46
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX $278.70 $181.16 Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $71.18 – $198.91
Physical therapy evaluation (moderate complexity): rates for 8 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $95.46
  • EXCELLUS — COMMERCIAL: $198.91
  • MVP - CIGNA — COMMERCIAL: $120.20
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $87.09
  • MVP - CIGNA — MEDICAID: $71.18
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $71.18
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $87.21
  • UNITED HEALTHCARE — COMMERCIAL: $95.46
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL MOD COMPLEX $418.85 $272.25 Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $71.18 – $198.91
Physical therapy evaluation (high complexity): rates for 8 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $95.46
  • EXCELLUS — COMMERCIAL: $198.91
  • MVP - CIGNA — COMMERCIAL: $120.20
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $87.09
  • MVP - CIGNA — MEDICAID: $71.18
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $71.18
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $87.21
  • UNITED HEALTHCARE — COMMERCIAL: $95.46
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX $555.84 $361.30 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes Not listed in the file Not listed in the file $69.16 – $144.11
Psychotherapy, 30 minutes: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $69.16
  • EXCELLUS — COMMERCIAL: $144.11
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER $595.30 $386.94 Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN PSYCHOTHERAPY 30 MINS $368.96 $239.82 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes Not listed in the file Not listed in the file $91.37 – $190.39
Psychotherapy, 45 minutes: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $91.37
  • EXCELLUS — COMMERCIAL: $190.39
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER $595.30 $386.94 Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN PSYCHOTHERAPY 45MINS $480.37 $312.24 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes Not listed in the file Not listed in the file $134.66 – $280.59
Psychotherapy, 60 minutes: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $134.66
  • EXCELLUS — COMMERCIAL: $280.59
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PSYCHOTHERAPY 60 MINUTES W PATIENT $595.30 $386.94 Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN PSYCHOTHERAPY 60 MINS $595.30 $386.94 Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min Not listed in the file Not listed in the file $62.23 – $205.39
Family psychotherapy, without the patient: rates for 5 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $98.57
  • EXCELLUS — COMMERCIAL: $205.39
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $62.23
  • MVP - CIGNA — MEDICAID: $62.23
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $78.39
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT $595.30 $386.94 Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY THERAPY W_OUT PATIENT PRESENT $639.96 $415.97 Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min Not listed in the file Not listed in the file $62.23 – $213.25
Family psychotherapy, with the patient: rates for 5 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $102.34
  • EXCELLUS — COMMERCIAL: $213.25
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $62.23
  • MVP - CIGNA — MEDICAID: $62.23
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $78.39
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT $595.30 $386.94 Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC FAMILY THERAPY W_PATIENT PRESENT $639.96 $415.97 Not listed in the file
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy Not listed in the file Not listed in the file $18.24 – $50.43
Group psychotherapy: rates for 5 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $24.20
  • EXCELLUS — COMMERCIAL: $50.43
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $18.24
  • MVP - CIGNA — MEDICAID: $18.24
  • MVP - CIGNA — MEDICARE ADVANTAGE DUAL: $32.21
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ $346.75 $225.39 Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BHN GROUP PSYCHOTHERAPY $346.75 $225.39 Not listed in the file

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion Not listed in the file Not listed in the file $385.11 – $802.45
Removal of breast growth (open surgery): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $385.11
  • EXCELLUS — COMMERCIAL: $802.45
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EXCISION OF CYST_FIBROADENOMA_BENIGH OR MALIGNANT TUMOR_ BREAST TISSUE_ MALE_FEMALE_ 1 OR MORE $14,001.05 $9,100.68 Not listed in the file
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EXC CYST_ABERRANT BREAST TISSUE OPEN 1__ LESION $11,372.94 $7,392.41 Not listed in the file
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $1,102.42 – $2,297.11
Total hip replacement: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $1,102.42
  • EXCELLUS — COMMERCIAL: $2,297.11
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $1,100.13 – $2,292.34
Total knee replacement: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $1,100.13
  • EXCELLUS — COMMERCIAL: $2,292.34
Total knee replacement CPT 27447 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ARTHRP KHC NE CONDYLE_PLATU MEDIAL_LAT COMPARTMENTS $21,432.50 $13,931.12 Not listed in the file
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery Not listed in the file Not listed in the file $140.36 – $292.47
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $140.36
  • EXCELLUS — COMMERCIAL: $292.47
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery Not listed in the file Not listed in the file $489.81 – $1,020.62
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $489.81
  • EXCELLUS — COMMERCIAL: $1,020.62
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $249.81 – $520.53
Removal of tonsils and adenoids (under age 12): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $249.81
  • EXCELLUS — COMMERCIAL: $520.53
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash Not listed in the file Not listed in the file $106.46 – $221.83
Upper GI endoscopy (diagnostic): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $106.46
  • EXCELLUS — COMMERCIAL: $221.83
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $2,626.14 $1,706.99 Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple Not listed in the file Not listed in the file $119.07 – $248.11
Upper GI endoscopy with biopsy: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $119.07
  • EXCELLUS — COMMERCIAL: $248.11
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EGD TRANSORAL BIOPSY SINGLE_MULTIPLE $2,422.49 $1,574.62 Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy Not listed in the file Not listed in the file $158.36 – $329.97
Colonoscopy (diagnostic): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $158.36
  • EXCELLUS — COMMERCIAL: $329.97
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COLONOSCOPY_ FLEXIBLE_ PROXIMAL TO SPLENIC FLEXURE_ DIAGNOSTIC $3,682.17 $2,393.41 Not listed in the file
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy Not listed in the file Not listed in the file $171.14 – $356.60
Colonoscopy with biopsy: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $171.14
  • EXCELLUS — COMMERCIAL: $356.60
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal Not listed in the file Not listed in the file $215.52 – $449.08
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $215.52
  • EXCELLUS — COMMERCIAL: $449.08
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $218.32 – $454.91
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $218.32
  • EXCELLUS — COMMERCIAL: $454.91
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind Not listed in the file Not listed in the file $158.60 – $330.47
Screening colonoscopy (not high risk): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $158.60
  • EXCELLUS — COMMERCIAL: $330.47
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COLORECTAL CANCER SCREENING COLONOSCOPY NOT HIGH RISK PT $3,682.17 $2,393.41 Not listed in the file
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy Not listed in the file Not listed in the file $595.37 – $1,240.57
Gallbladder removal by laparoscope: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $595.37
  • EXCELLUS — COMMERCIAL: $1,240.57
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr Not listed in the file Not listed in the file $478.67 – $997.40
Groin (inguinal) hernia repair, age 5 or older: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $478.67
  • EXCELLUS — COMMERCIAL: $997.40
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH $7,986.77 $5,191.40 Not listed in the file
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy Not listed in the file Not listed in the file $1,040.99 – $2,169.11
Prostate removal by laparoscope (radical prostatectomy): rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $1,040.99
  • EXCELLUS — COMMERCIAL: $2,169.11
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy Not listed in the file Not listed in the file $195.05 – $406.43
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $195.05
  • EXCELLUS — COMMERCIAL: $406.43
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HYSTEROSCOPY_ SURGICAL_ W BIOPSY ENDOMETRIUM __OR POLYPECTOMY $11,734.46 $7,627.40 Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac Not listed in the file Not listed in the file $86.26 – $179.74
Spinal injection, lower back (epidural), with imaging guidance: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $86.26
  • EXCELLUS — COMMERCIAL: $179.74
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING $1,311.08 $852.20 Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s Not listed in the file Not listed in the file $96.25 – $200.56
Nerve root injection, lower back, with imaging guidance: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $96.25
  • EXCELLUS — COMMERCIAL: $200.56
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC NJX AA__STRD TFRML EPI LUMBAR_SACRAL 1 LEVEL $3,366.76 $2,188.39 Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL $3,366.76 $2,188.39 Not listed in the file
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $401.96 – $837.56
Carpal tunnel release: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $401.96
  • EXCELLUS — COMMERCIAL: $837.56
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $264.96 – $552.10
Laser treatment of clouding after cataract surgery: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $264.96
  • EXCELLUS — COMMERCIAL: $552.10
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Hospital (facility) fee In the file: HC DISCISSION SECONDARY MEMBRANOUS CATARACT_ LASER SURGERY $2,521.88 $1,639.22 Not listed in the file
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage Not listed in the file Not listed in the file $446.99 – $931.39
Cataract removal with lens implant: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $446.99
  • EXCELLUS — COMMERCIAL: $931.39
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Hospital (facility) fee In the file: HC EXTRACAPSULAR CATARACT EXTRACTION W IOL_1ST SAGE_ MANUAL OR MECHANICAL_ W_O ECP $7,610.63 $4,946.91 Not listed in the file

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $2,078.59 – $4,331.16
Vaginal delivery, with care before and after: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $2,078.59
  • EXCELLUS — COMMERCIAL: $4,331.16
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $2,310.97 – $4,815.37
Cesarean delivery (C-section), with care before and after: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $2,310.97
  • EXCELLUS — COMMERCIAL: $4,815.37
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $2,176.20 – $4,534.55
Vaginal delivery after a previous C-section, with care before and after: rates for 2 insurance plans
  • CHAMPUS-TRICARE — COMMERCIAL: $2,176.20
  • EXCELLUS — COMMERCIAL: $4,534.55

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc Not listed in the file Not listed in the file $60,334.68 – $172,435.84
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 8 insurance plans
  • AETNA — COMMERCIAL: $131,089.52
  • FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $60,334.68
  • HIGHMARK — COMMERCIAL: $172,435.84
  • HIGHMARK — MEDICAID ESSENTIAL: $123,696.07
  • MOLINA HEALTHCARE OF NY — ESSENTIAL 1&2: $123,696.07
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $65,971.19
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $123,696.07
  • UNITED HEALTHCARE — COMMERCIAL: $122,285
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc Not listed in the file Not listed in the file $23,794.06
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $23,794.06
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc Not listed in the file Not listed in the file $11,826.14 – $33,999.62
Hip or knee replacement (major joint of the leg), without major complications: rates for 8 insurance plans
  • AETNA — COMMERCIAL: $25,847.26
  • FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $11,826.14
  • HIGHMARK — COMMERCIAL: $33,999.62
  • HIGHMARK — MEDICAID ESSENTIAL: $24,389.47
  • MOLINA HEALTHCARE OF NY — ESSENTIAL 1&2: $24,389.47
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $13,007.71
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $24,389.47
  • UNITED HEALTHCARE — COMMERCIAL: $24,111.25
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc Not listed in the file Not listed in the file $15,094.49 – $43,031.40
Neck (cervical) spinal fusion, without complications: rates for 8 insurance plans
  • AETNA — COMMERCIAL: $32,713.42
  • FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $15,094.49
  • HIGHMARK — COMMERCIAL: $43,031.40
  • HIGHMARK — MEDICAID ESSENTIAL: $30,868.38
  • MOLINA HEALTHCARE OF NY — ESSENTIAL 1&2: $30,868.38
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $16,463.13
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $30,868.38
  • UNITED HEALTHCARE — COMMERCIAL: $30,516.25
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 Not listed in the file $6,900.18 – $21,869.11
Uterus and ovary surgery (not for cancer), without complications: rates for 8 insurance plans
  • AETNA — COMMERCIAL: $16,625.38
  • FIDELIS CARE NEW YORK — MEDICARE ADVANTAGE: $6,900.18
  • HIGHMARK — COMMERCIAL: $21,869.11
  • HIGHMARK — MEDICAID ESSENTIAL: $15,687.71
  • MOLINA HEALTHCARE OF NY — ESSENTIAL 1&2: $15,687.71
  • MVP - CIGNA — COMMERCIAL EXCHANGE: $8,366.77
  • MVP - CIGNA — MEDICAID ESSENTIAL 1&2: $15,687.71
  • UNITED HEALTHCARE — COMMERCIAL: $15,508.75

Source: Newark-Wayne Community Hospital’s standard charges file (msc.rochesterregional.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address1200 Driving Park Avenue, Newark, NY 14513
CountyWayne County
StateNew York
Phone(315) 332‑2022
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number330030
Name in Medicare recordsNEWARK-WAYNE COMMUNITY HOSPITAL
Profile levelMedicare data + hospital website
Official websiterochesterregional.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Newark-Wayne Community Hospital — rochesterregional.org
  2. Emergency Department - Newark | Rochester Regional Health — rochesterregional.org
  3. Physical Therapy & Rehabilitation - Newark | Rochester Regional Health — rochesterregional.org
  4. Imaging Center - Newark | Rochester Regional Health — rochesterregional.org