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

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

Northern Light Mercy Hospital

Portland, Maine · Cumberland County · Emergency services listed

Summary

Northern Light Mercy Hospital is an acute care hospital in Portland, Maine. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 66 services, specialties and programs. Medicare lists 556 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(207) 879‑3000 Directions Website Medicare profile
Compare

Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-11-02). 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
4 of 5 stars4 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
556Doctors and clinicians
66Services listed

Quick answers

Does Northern Light Mercy Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Northern Light Mercy Hospital. In a medical emergency, call 911.
Where is Northern Light Mercy Hospital?
144 State Street, Portland, ME 04101, in Cumberland County, Maine.
What is the phone number of Northern Light Mercy Hospital?
(207) 879-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Northern Light Mercy Hospital?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4]

Conditions treated[4]

Treatments[4]

  • Sports medicine care
  • Fracture care
  • Dialysis access and maintenance
  • Catheter-based varicose vein treatment
  • Endovascular deep venous therapy
  • Walk-in care for minor illness and injury

Procedures[4]

  • Hip replacement
  • Knee replacement (total and partial)
  • Total shoulder replacement
  • Reverse shoulder replacement
  • Shoulder surgery
  • Hand and wrist surgery
  • Elbow surgery
  • Arthroscopic procedures
  • Rotator cuff repair
  • Labral tear repair
  • Meniscal debridement and repair
  • Ligament and tendon repair
  • Spine surgery
  • Spinal fusion
  • Minimally invasive surgery
  • Aquablation
  • Robotic surgery (urology)
  • Laparoscopic surgery (urology)

Programs and centers[4][5]

  • Joint Commission certification for hip, knee and spine surgery
  • Women's Health Center
  • Birthing program
  • Walk-In Care
  • Bruni Family-Centered Integrated Behavioral Health Program

Emergency care (hospital website)[4]

Emergency roomYes

Visiting and practical information

Interpreters and languagesLanguage assistance is offered in many languages, including Spanish, French, Arabic and Vietnamese[4]
Patient portalmyNorthernLightHealth

Recognition[4]

  • Joint Commission accredited; certified for hip, knee and spine surgery since 2012

Doctors and clinicians (556)

556 doctors and other clinicians list Northern Light Mercy 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 (556)

And 532 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

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 Northern Light Mercy 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) 4 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital5 of 5 stars
Nurses communicated well5 of 5 stars
Doctors communicated well4 of 5 stars
Staff explained medicines4 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night4 of 5 stars
Rated the hospital 9 or 10 out of 1081%National average: 72%
Would definitely recommend the hospital85%National average: 71%
Nurses “always” communicated well85%National average: 80%
Doctors “always” communicated well83%National average: 80%
Staff “always” explained medicines before giving them66%National average: 62%
Were given information about recovery at home90%National average: 86%
Room and bathroom “always” clean67%National average: 74%
Area around the room “always” quiet at night69%National average: 60%
Completed surveys861Response rate: 31%

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)0No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.875No different from the national benchmark
Surgical site infections after colon surgery0.85No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.94No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.689No 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 patients11.6%
Deaths within 30 days: pneumonia patients11.9%
Deaths within 30 days: COPD patients7.6%
Deaths within 30 days: stroke patients9.7%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.89No different from the national rate
Complications after hip or knee replacement4.5%

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 attackToo few cases to report
Readmitted within 30 days: heart failure21.2%
Readmitted within 30 days: pneumonia17%
Readmitted within 30 days: COPD22%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacement5.5%

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)208 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)43%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 Portland

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Northern Light Mercy 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: HC OFFIC/OUTPT VISIT LVL 3 NEW $178 $46.28 $95.05 – $135.64
New patient office visit (about 30–44 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $135.64
  • Aetna — MCR Advantage: $95.05
  • Anthem — Commercial: $115.70
  • Anthem — Enhanced Pathways: $115.70
  • CHO — Commercial: $115.70
  • Cigna — Commercial: $132.79
  • Harvard — Commercial: $125.21
  • UHC — Commercial: $127.52
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AMWELL NEW PT OFF VIS LVL 3 $178 $46.28 $95.05 – $135.64
New patient office visit (about 30–44 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $135.64
  • Aetna — MCR Advantage: $95.05
  • Anthem — Commercial: $115.70
  • Anthem — Enhanced Pathways: $115.70
  • CHO — Commercial: $115.70
  • Cigna — Commercial: $132.79
  • Harvard — Commercial: $125.21
  • UHC — Commercial: $127.52
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH OFFICE VISIT LEVEL 3 NEW $418 $108.68 $223.21 – $318.52
New patient office visit (about 30–44 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $318.52
  • Aetna — MCR Advantage: $223.21
  • Anthem — Commercial: $271.70
  • Anthem — Enhanced Pathways: $271.70
  • CHO — Commercial: $271.70
  • Cigna — Commercial: $311.83
  • Harvard — Commercial: $294.02
  • UHC — Commercial: $299.46
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFIC/OUTPT VISIT LVL 4 NEW $243 $63.18 $129.76 – $185.17
New patient office visit (about 45–59 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $185.17
  • Aetna — MCR Advantage: $129.76
  • Anthem — Commercial: $157.95
  • Anthem — Enhanced Pathways: $157.95
  • CHO — Commercial: $157.95
  • Cigna — Commercial: $181.28
  • Harvard — Commercial: $170.93
  • UHC — Commercial: $174.09
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AMWELL NEW PT OFF VIS LVL 4 $243 $63.18 $129.76 – $185.17
New patient office visit (about 45–59 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $185.17
  • Aetna — MCR Advantage: $129.76
  • Anthem — Commercial: $157.95
  • Anthem — Enhanced Pathways: $157.95
  • CHO — Commercial: $157.95
  • Cigna — Commercial: $181.28
  • Harvard — Commercial: $170.93
  • UHC — Commercial: $174.09
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH OFFICE VISIT LEVEL 4 NEW $604 $157.04 $322.54 – $460.25
New patient office visit (about 45–59 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $460.25
  • Aetna — MCR Advantage: $322.54
  • Anthem — Commercial: $392.60
  • Anthem — Enhanced Pathways: $392.60
  • CHO — Commercial: $392.60
  • Cigna — Commercial: $450.58
  • Harvard — Commercial: $424.85
  • UHC — Commercial: $432.71
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFIC/OUTPT VISIT LVL 5 NEW $428 $111.28 $228.55 – $326.14
New patient office visit (about 60–74 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $326.14
  • Aetna — MCR Advantage: $228.55
  • Anthem — Commercial: $278.20
  • Anthem — Enhanced Pathways: $278.20
  • CHO — Commercial: $278.20
  • Cigna — Commercial: $319.29
  • Harvard — Commercial: $301.06
  • UHC — Commercial: $306.62
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC AMWELL NEW PT OFF VIS LVL 5 $428 $111.28 $228.55 – $326.14
New patient office visit (about 60–74 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $326.14
  • Aetna — MCR Advantage: $228.55
  • Anthem — Commercial: $278.20
  • Anthem — Enhanced Pathways: $278.20
  • CHO — Commercial: $278.20
  • Cigna — Commercial: $319.29
  • Harvard — Commercial: $301.06
  • UHC — Commercial: $306.62
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH OFFICE VISIT LEVEL 5 NEW $902 $234.52 $481.67 – $687.32
New patient office visit (about 60–74 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $687.32
  • Aetna — MCR Advantage: $481.67
  • Anthem — Commercial: $586.30
  • Anthem — Enhanced Pathways: $586.30
  • CHO — Commercial: $586.30
  • Cigna — Commercial: $672.89
  • Harvard — Commercial: $634.47
  • UHC — Commercial: $646.19
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFIC/OUTPT VISIT LVL 3 EST $164 $42.64 $87.58 – $124.97
Established patient office visit (about 20–29 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $124.97
  • Aetna — MCR Advantage: $87.58
  • Anthem — Commercial: $106.60
  • Anthem — Enhanced Pathways: $106.60
  • CHO — Commercial: $106.60
  • Cigna — Commercial: $122.34
  • Harvard — Commercial: $115.36
  • UHC — Commercial: $117.49
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED FU RECHECK VISIT LEVEL 3 $164 $42.64 $87.58 – $124.97
Established patient office visit (about 20–29 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $124.97
  • Aetna — MCR Advantage: $87.58
  • Anthem — Commercial: $106.60
  • Anthem — Enhanced Pathways: $106.60
  • CHO — Commercial: $106.60
  • Cigna — Commercial: $122.34
  • Harvard — Commercial: $115.36
  • UHC — Commercial: $117.49
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTB PT LEVEL 3 $164 $42.64 $87.58 – $124.97
Established patient office visit (about 20–29 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $124.97
  • Aetna — MCR Advantage: $87.58
  • Anthem — Commercial: $106.60
  • Anthem — Enhanced Pathways: $106.60
  • CHO — Commercial: $106.60
  • Cigna — Commercial: $122.34
  • Harvard — Commercial: $115.36
  • UHC — Commercial: $117.49
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTAB PT LEVEL4 $215 $55.90 $114.81 – $163.83
Established patient office visit (about 30–39 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $163.83
  • Aetna — MCR Advantage: $114.81
  • Anthem — Commercial: $139.75
  • Anthem — Enhanced Pathways: $139.75
  • CHO — Commercial: $139.75
  • Cigna — Commercial: $160.39
  • Harvard — Commercial: $151.23
  • UHC — Commercial: $154.03
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED FU RECHECK VISIT LEVEL 4 $215 $55.90 $114.81 – $163.83
Established patient office visit (about 30–39 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $163.83
  • Aetna — MCR Advantage: $114.81
  • Anthem — Commercial: $139.75
  • Anthem — Enhanced Pathways: $139.75
  • CHO — Commercial: $139.75
  • Cigna — Commercial: $160.39
  • Harvard — Commercial: $151.23
  • UHC — Commercial: $154.03
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTB PT LEVEL 4 $215 $55.90 $114.81 – $163.83
Established patient office visit (about 30–39 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $163.83
  • Aetna — MCR Advantage: $114.81
  • Anthem — Commercial: $139.75
  • Anthem — Enhanced Pathways: $139.75
  • CHO — Commercial: $139.75
  • Cigna — Commercial: $160.39
  • Harvard — Commercial: $151.23
  • UHC — Commercial: $154.03
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE CONSULTATION $263 $68.38 $140.44 – $200.41
Office consultation with a specialist (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $200.41
  • Aetna — MCR Advantage: $140.44
  • Anthem — Commercial: $170.95
  • Anthem — Enhanced Pathways: $170.95
  • CHO — Commercial: $170.95
  • Cigna — Commercial: $196.20
  • Harvard — Commercial: $184.99
  • UHC — Commercial: $188.41
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE CONSULTATION LVL 3 $263 $68.38 $140.44 – $200.41
Office consultation with a specialist (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $200.41
  • Aetna — MCR Advantage: $140.44
  • Anthem — Commercial: $170.95
  • Anthem — Enhanced Pathways: $170.95
  • CHO — Commercial: $170.95
  • Cigna — Commercial: $196.20
  • Harvard — Commercial: $184.99
  • UHC — Commercial: $188.41
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE CONSULT LVL 3 EST $338 $87.88 $180.49 – $257.56
Office consultation with a specialist (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $257.56
  • Aetna — MCR Advantage: $180.49
  • Anthem — Commercial: $219.70
  • Anthem — Enhanced Pathways: $219.70
  • CHO — Commercial: $219.70
  • Cigna — Commercial: $252.15
  • Harvard — Commercial: $237.75
  • UHC — Commercial: $242.14
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE CONSULTATION $309 $80.34 $165.01 – $235.46
Office consultation with a specialist (moderate to high): rates for 8 insurance plans
  • Aetna — Commercial: $235.46
  • Aetna — MCR Advantage: $165.01
  • Anthem — Commercial: $200.85
  • Anthem — Enhanced Pathways: $200.85
  • CHO — Commercial: $200.85
  • Cigna — Commercial: $230.51
  • Harvard — Commercial: $217.35
  • UHC — Commercial: $221.37
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE CONSULTATION LVL 4 $309 $80.34 $165.01 – $235.46
Office consultation with a specialist (moderate to high): rates for 8 insurance plans
  • Aetna — Commercial: $235.46
  • Aetna — MCR Advantage: $165.01
  • Anthem — Commercial: $200.85
  • Anthem — Enhanced Pathways: $200.85
  • CHO — Commercial: $200.85
  • Cigna — Commercial: $230.51
  • Harvard — Commercial: $217.35
  • UHC — Commercial: $221.37
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OFFICE CONSULT LVL 4 EST $535 $139.10 $285.69 – $407.67
Office consultation with a specialist (moderate to high): rates for 8 insurance plans
  • Aetna — Commercial: $407.67
  • Aetna — MCR Advantage: $285.69
  • Anthem — Commercial: $347.75
  • Anthem — Enhanced Pathways: $347.75
  • CHO — Commercial: $347.75
  • Cigna — Commercial: $399.11
  • Harvard — Commercial: $376.32
  • UHC — Commercial: $383.27
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH PREV VISIT NEW AGE 18-39 $396 $102.96 $211.46 – $301.75
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
  • Aetna — Commercial: $301.75
  • Aetna — MCR Advantage: $211.46
  • Anthem — Commercial: $257.40
  • Anthem — Enhanced Pathways: $257.40
  • CHO — Commercial: $257.40
  • Cigna — Commercial: $295.42
  • Harvard — Commercial: $278.55
  • UHC — Commercial: $283.69
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PREV VISIT NEW AGE 18-39 $144 $37.44 $76.90 – $109.73
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
  • Aetna — Commercial: $109.73
  • Aetna — MCR Advantage: $76.90
  • Anthem — Commercial: $93.60
  • Anthem — Enhanced Pathways: $93.60
  • CHO — Commercial: $93.60
  • Cigna — Commercial: $107.42
  • Harvard — Commercial: $101.29
  • UHC — Commercial: $103.16
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PREV VISIT NEW AGE 18-39YRS $158 $41.08 $84.37 – $120.40
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans
  • Aetna — Commercial: $120.40
  • Aetna — MCR Advantage: $84.37
  • Anthem — Commercial: $102.70
  • Anthem — Enhanced Pathways: $102.70
  • CHO — Commercial: $102.70
  • Cigna — Commercial: $117.87
  • Harvard — Commercial: $111.14
  • UHC — Commercial: $113.19
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH PREV VISIT NEW AGE 40-64 $479 $124.54 $255.79 – $365
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans
  • Aetna — Commercial: $365
  • Aetna — MCR Advantage: $255.79
  • Anthem — Commercial: $311.35
  • Anthem — Enhanced Pathways: $311.35
  • CHO — Commercial: $311.35
  • Cigna — Commercial: $357.33
  • Harvard — Commercial: $336.93
  • UHC — Commercial: $343.16
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PREV VISIT NEW AGE 40-64 $174 $45.24 $92.92 – $132.59
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans
  • Aetna — Commercial: $132.59
  • Aetna — MCR Advantage: $92.92
  • Anthem — Commercial: $113.10
  • Anthem — Enhanced Pathways: $113.10
  • CHO — Commercial: $113.10
  • Cigna — Commercial: $129.80
  • Harvard — Commercial: $122.39
  • UHC — Commercial: $124.65
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF PREV VISIT NEW AGE 40-64 $305 $79.30 $162.87 – $232.41
Preventive checkup, new patient, age 40–64: rates for 8 insurance plans
  • Aetna — Commercial: $232.41
  • Aetna — MCR Advantage: $162.87
  • Anthem — Commercial: $198.25
  • Anthem — Enhanced Pathways: $198.25
  • CHO — Commercial: $198.25
  • Cigna — Commercial: $227.53
  • Harvard — Commercial: $214.54
  • UHC — Commercial: $218.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ER LEVEL 3 $1,597 $415.22 $852.80 – $1,216.91
Emergency room visit (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $1,216.91
  • Aetna — MCR Advantage: $852.80
  • Anthem — Commercial: $1,038.05
  • Anthem — Enhanced Pathways: $1,038.05
  • CHO — Commercial: $1,038.05
  • Cigna — Commercial: $1,191.36
  • Harvard — Commercial: $1,123.33
  • UHC — Commercial: $1,144.09
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ER LEVEL 3 $319 $82.94 $170.35 – $243.08
Emergency room visit (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $243.08
  • Aetna — MCR Advantage: $170.35
  • Anthem — Commercial: $207.35
  • Anthem — Enhanced Pathways: $207.35
  • CHO — Commercial: $207.35
  • Cigna — Commercial: $237.97
  • Harvard — Commercial: $224.38
  • UHC — Commercial: $228.53
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ER VISIT MOD/LEVEL 3 $319 $82.94 $170.35 – $243.08
Emergency room visit (moderate): rates for 8 insurance plans
  • Aetna — Commercial: $243.08
  • Aetna — MCR Advantage: $170.35
  • Anthem — Commercial: $207.35
  • Anthem — Enhanced Pathways: $207.35
  • CHO — Commercial: $207.35
  • Cigna — Commercial: $237.97
  • Harvard — Commercial: $224.38
  • UHC — Commercial: $228.53
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ER LEVEL 4 $512 $133.12 $273.41 – $390.14
Emergency room visit (moderately high): rates for 8 insurance plans
  • Aetna — Commercial: $390.14
  • Aetna — MCR Advantage: $273.41
  • Anthem — Commercial: $332.80
  • Anthem — Enhanced Pathways: $332.80
  • CHO — Commercial: $332.80
  • Cigna — Commercial: $381.95
  • Harvard — Commercial: $360.14
  • UHC — Commercial: $366.80
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ER VISIT HIGH/LEVEL 4 $512 $133.12 $273.41 – $390.14
Emergency room visit (moderately high): rates for 8 insurance plans
  • Aetna — Commercial: $390.14
  • Aetna — MCR Advantage: $273.41
  • Anthem — Commercial: $332.80
  • Anthem — Enhanced Pathways: $332.80
  • CHO — Commercial: $332.80
  • Cigna — Commercial: $381.95
  • Harvard — Commercial: $360.14
  • UHC — Commercial: $366.80
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EMERG DEPT VISIT HIGH $512 $133.12 $273.41 – $390.14
Emergency room visit (moderately high): rates for 8 insurance plans
  • Aetna — Commercial: $390.14
  • Aetna — MCR Advantage: $273.41
  • Anthem — Commercial: $332.80
  • Anthem — Enhanced Pathways: $332.80
  • CHO — Commercial: $332.80
  • Cigna — Commercial: $381.95
  • Harvard — Commercial: $360.14
  • UHC — Commercial: $366.80
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ER LEVEL 5 $905 $235.30 $483.27 – $689.61
Emergency room visit (high): rates for 8 insurance plans
  • Aetna — Commercial: $689.61
  • Aetna — MCR Advantage: $483.27
  • Anthem — Commercial: $588.25
  • Anthem — Enhanced Pathways: $588.25
  • CHO — Commercial: $588.25
  • Cigna — Commercial: $675.13
  • Harvard — Commercial: $636.58
  • UHC — Commercial: $648.34
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF ER VISIT HIGH SEVERE/LEVEL5 $905 $235.30 $483.27 – $689.61
Emergency room visit (high): rates for 8 insurance plans
  • Aetna — Commercial: $689.61
  • Aetna — MCR Advantage: $483.27
  • Anthem — Commercial: $588.25
  • Anthem — Enhanced Pathways: $588.25
  • CHO — Commercial: $588.25
  • Cigna — Commercial: $675.13
  • Harvard — Commercial: $636.58
  • UHC — Commercial: $648.34
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EMER DEPT VISIT HIGH SEVERE $905 $235.30 $483.27 – $689.61
Emergency room visit (high): rates for 8 insurance plans
  • Aetna — Commercial: $689.61
  • Aetna — MCR Advantage: $483.27
  • Anthem — Commercial: $588.25
  • Anthem — Enhanced Pathways: $588.25
  • CHO — Commercial: $588.25
  • Cigna — Commercial: $675.13
  • Harvard — Commercial: $636.58
  • UHC — Commercial: $648.34

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 $193 $50.18 $103.06 – $147.07
Basic metabolic panel (blood test): rates for 8 insurance plans
  • Aetna — Commercial: $147.07
  • Aetna — MCR Advantage: $103.06
  • Anthem — Commercial: $125.45
  • Anthem — Enhanced Pathways: $125.45
  • CHO — Commercial: $125.45
  • Cigna — Commercial: $143.98
  • Harvard — Commercial: $135.76
  • UHC — Commercial: $138.27
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL-Q $193 $50.18 $103.06 – $147.07
Basic metabolic panel (blood test): rates for 8 insurance plans
  • Aetna — Commercial: $147.07
  • Aetna — MCR Advantage: $103.06
  • Anthem — Commercial: $125.45
  • Anthem — Enhanced Pathways: $125.45
  • CHO — Commercial: $125.45
  • Cigna — Commercial: $143.98
  • Harvard — Commercial: $135.76
  • UHC — Commercial: $138.27
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA $193 $50.18 $125.45 – $143.98
Basic metabolic panel (blood test): rates for 6 insurance plans
  • Aetna — Commercial: $140.50
  • Anthem — Commercial: $125.45
  • Anthem — Enhanced Pathways: $125.45
  • CHO — Commercial: $125.45
  • Cigna — Commercial: $143.98
  • UHC — Commercial: $135.29
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL $310 $80.60 $165.54 – $236.22
Comprehensive metabolic panel (blood test): rates for 8 insurance plans
  • Aetna — Commercial: $236.22
  • Aetna — MCR Advantage: $165.54
  • Anthem — Commercial: $201.50
  • Anthem — Enhanced Pathways: $201.50
  • CHO — Commercial: $201.50
  • Cigna — Commercial: $231.26
  • Harvard — Commercial: $218.05
  • UHC — Commercial: $222.08
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANL-Q $310 $80.60 $165.54 – $236.22
Comprehensive metabolic panel (blood test): rates for 8 insurance plans
  • Aetna — Commercial: $236.22
  • Aetna — MCR Advantage: $165.54
  • Anthem — Commercial: $201.50
  • Anthem — Enhanced Pathways: $201.50
  • CHO — Commercial: $201.50
  • Cigna — Commercial: $231.26
  • Harvard — Commercial: $218.05
  • UHC — Commercial: $222.08
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL $310 $80.60 $201.50 – $231.26
Comprehensive metabolic panel (blood test): rates for 6 insurance plans
  • Aetna — Commercial: $225.68
  • Anthem — Commercial: $201.50
  • Anthem — Enhanced Pathways: $201.50
  • CHO — Commercial: $201.50
  • Cigna — Commercial: $231.26
  • UHC — Commercial: $217.31
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRENATAL PROFILE $476 $123.76 $254.18 – $362.71
Obstetric blood test panel: rates for 8 insurance plans
  • Aetna — Commercial: $362.71
  • Aetna — MCR Advantage: $254.18
  • Anthem — Commercial: $309.40
  • Anthem — Enhanced Pathways: $309.40
  • CHO — Commercial: $309.40
  • Cigna — Commercial: $355.10
  • Harvard — Commercial: $334.82
  • UHC — Commercial: $341.01
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PRENATAL PROFILE $476 $123.76 $309.40 – $355.10
Obstetric blood test panel: rates for 6 insurance plans
  • Aetna — Commercial: $346.53
  • Anthem — Commercial: $309.40
  • Anthem — Enhanced Pathways: $309.40
  • CHO — Commercial: $309.40
  • Cigna — Commercial: $355.10
  • UHC — Commercial: $333.68
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetric panel Not listed in the file Not listed in the file $28.69 – $113.96
Obstetric blood test panel: 10 of 11 insurance plan rates
  • Aetna — Commercial: $38.73
  • Aetna — MCR Advantage: $38.73
  • Anthem — Commercial: $28.69
  • Anthem — Enhanced Pathways: $28.69
  • Anthem — MCR Advantage: $47.81
  • CHO — Commercial: $83.67
  • Harvard — Commercial: $47.81
  • Martin's Point — MCR Advantage: $48.77
  • UHC — Commercial: $113.96
  • UHC — MCR Advantage: $48.77
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $142 $36.92 $75.83 – $108.20
Cholesterol panel (lipid panel): rates for 8 insurance plans
  • Aetna — Commercial: $108.20
  • Aetna — MCR Advantage: $75.83
  • Anthem — Commercial: $92.30
  • Anthem — Enhanced Pathways: $92.30
  • CHO — Commercial: $92.30
  • Cigna — Commercial: $105.93
  • Harvard — Commercial: $99.88
  • UHC — Commercial: $101.73
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL $142 $36.92 $92.30 – $105.93
Cholesterol panel (lipid panel): rates for 6 insurance plans
  • Aetna — Commercial: $103.38
  • Anthem — Commercial: $92.30
  • Anthem — Enhanced Pathways: $92.30
  • CHO — Commercial: $92.30
  • Cigna — Commercial: $105.93
  • UHC — Commercial: $99.54
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 $12.96 – $98.01
Cholesterol panel (lipid panel): rates for 10 insurance plans
  • Aetna — Commercial: $13.39
  • Aetna — MCR Advantage: $13.66
  • Anthem — Commercial: $16.61
  • Anthem — Enhanced Pathways: $12.96
  • Anthem — MCR Advantage: $13.66
  • CHO — Commercial: $16.74
  • Cigna — Commercial: $98.01
  • Martin's Point — MCR Advantage: $13.66
  • UHC — MCR Advantage: $13.66
  • Wellcare — MCR Advantage: $13.66
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $79 $20.54 $42.19 – $60.20
Kidney function panel: rates for 8 insurance plans
  • Aetna — Commercial: $60.20
  • Aetna — MCR Advantage: $42.19
  • Anthem — Commercial: $51.35
  • Anthem — Enhanced Pathways: $51.35
  • CHO — Commercial: $51.35
  • Cigna — Commercial: $58.93
  • Harvard — Commercial: $55.57
  • UHC — Commercial: $56.60
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL-Q $79 $20.54 $42.19 – $60.20
Kidney function panel: rates for 8 insurance plans
  • Aetna — Commercial: $60.20
  • Aetna — MCR Advantage: $42.19
  • Anthem — Commercial: $51.35
  • Anthem — Enhanced Pathways: $51.35
  • CHO — Commercial: $51.35
  • Cigna — Commercial: $58.93
  • Harvard — Commercial: $55.57
  • UHC — Commercial: $56.60
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $79 $20.54 $51.35 – $58.93
Kidney function panel: rates for 6 insurance plans
  • Aetna — Commercial: $57.51
  • Anthem — Commercial: $51.35
  • Anthem — Enhanced Pathways: $51.35
  • CHO — Commercial: $51.35
  • Cigna — Commercial: $58.93
  • UHC — Commercial: $55.38
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $119 $30.94 $63.55 – $90.68
Liver function panel: rates for 8 insurance plans
  • Aetna — Commercial: $90.68
  • Aetna — MCR Advantage: $63.55
  • Anthem — Commercial: $77.35
  • Anthem — Enhanced Pathways: $77.35
  • CHO — Commercial: $77.35
  • Cigna — Commercial: $88.77
  • Harvard — Commercial: $83.70
  • UHC — Commercial: $85.25
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL-Q $119 $30.94 $63.55 – $90.68
Liver function panel: rates for 8 insurance plans
  • Aetna — Commercial: $90.68
  • Aetna — MCR Advantage: $63.55
  • Anthem — Commercial: $77.35
  • Anthem — Enhanced Pathways: $77.35
  • CHO — Commercial: $77.35
  • Cigna — Commercial: $88.77
  • Harvard — Commercial: $83.70
  • UHC — Commercial: $85.25
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $119 $30.94 $77.35 – $88.77
Liver function panel: rates for 6 insurance plans
  • Aetna — Commercial: $86.63
  • Anthem — Commercial: $77.35
  • Anthem — Enhanced Pathways: $77.35
  • CHO — Commercial: $77.35
  • Cigna — Commercial: $88.77
  • UHC — Commercial: $83.42
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS REFLEX TO CULTURE-Q $45 $11.70 $24.03 – $34.29
Urine test (automated, with microscope): rates for 8 insurance plans
  • Aetna — Commercial: $34.29
  • Aetna — MCR Advantage: $24.03
  • Anthem — Commercial: $29.25
  • Anthem — Enhanced Pathways: $29.25
  • CHO — Commercial: $29.25
  • Cigna — Commercial: $33.57
  • Harvard — Commercial: $31.65
  • UHC — Commercial: $32.24
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS REFLEX TO CULTURE-Q $45 $11.70 $29.25 – $33.57
Urine test (automated, with microscope): rates for 6 insurance plans
  • Aetna — Commercial: $32.76
  • Anthem — Commercial: $29.25
  • Anthem — Enhanced Pathways: $29.25
  • CHO — Commercial: $29.25
  • Cigna — Commercial: $33.57
  • UHC — Commercial: $31.54
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Urinalysis auto w/scope Not listed in the file Not listed in the file $1.90 – $7.56
Urine test (automated, with microscope): 10 of 11 insurance plan rates
  • Aetna — Commercial: $2.57
  • Aetna — MCR Advantage: $2.57
  • Anthem — Commercial: $1.90
  • Anthem — Enhanced Pathways: $1.90
  • Anthem — MCR Advantage: $3.17
  • CHO — Commercial: $5.55
  • Harvard — Commercial: $3.17
  • Martin's Point — MCR Advantage: $3.23
  • UHC — Commercial: $7.56
  • UHC — MCR Advantage: $3.23
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POCT URINALYS NONAUTO WO MICRO $13 $3.38 $6.94 – $9.91
Urine test (manual, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $9.91
  • Aetna — MCR Advantage: $6.94
  • Anthem — Commercial: $8.45
  • Anthem — Enhanced Pathways: $8.45
  • CHO — Commercial: $8.45
  • Cigna — Commercial: $9.70
  • Harvard — Commercial: $9.14
  • UHC — Commercial: $9.31
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: N-AUTOM URINALYS WO MICRO $13 $3.38 $6.94 – $9.91
Urine test (manual, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $9.91
  • Aetna — MCR Advantage: $6.94
  • Anthem — Commercial: $8.45
  • Anthem — Enhanced Pathways: $8.45
  • CHO — Commercial: $8.45
  • Cigna — Commercial: $9.70
  • Harvard — Commercial: $9.14
  • UHC — Commercial: $9.31
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RH POCT URINE NONAUTO WO MICRO $13 $3.38 $6.94 – $9.91
Urine test (manual, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $9.91
  • Aetna — MCR Advantage: $6.94
  • Anthem — Commercial: $8.45
  • Anthem — Enhanced Pathways: $8.45
  • CHO — Commercial: $8.45
  • Cigna — Commercial: $9.70
  • Harvard — Commercial: $9.14
  • UHC — Commercial: $9.31
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O SCOPE $35 $9.10 $18.69 – $26.67
Urine test (automated, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $26.67
  • Aetna — MCR Advantage: $18.69
  • Anthem — Commercial: $22.75
  • Anthem — Enhanced Pathways: $22.75
  • CHO — Commercial: $22.75
  • Cigna — Commercial: $26.11
  • Harvard — Commercial: $24.62
  • UHC — Commercial: $25.07
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RH URINE ALYSIS AUTO W/O SCOPE $35 $9.10 $18.69 – $26.67
Urine test (automated, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $26.67
  • Aetna — MCR Advantage: $18.69
  • Anthem — Commercial: $22.75
  • Anthem — Enhanced Pathways: $22.75
  • CHO — Commercial: $22.75
  • Cigna — Commercial: $26.11
  • Harvard — Commercial: $24.62
  • UHC — Commercial: $25.07
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO MICRO $35 $9.10 $18.69 – $26.67
Urine test (automated, without microscope): rates for 8 insurance plans
  • Aetna — Commercial: $26.67
  • Aetna — MCR Advantage: $18.69
  • Anthem — Commercial: $22.75
  • Anthem — Enhanced Pathways: $22.75
  • CHO — Commercial: $22.75
  • Cigna — Commercial: $26.11
  • Harvard — Commercial: $24.62
  • UHC — Commercial: $25.07
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL (PART OF PSA FREE) $140 $36.40 $74.76 – $106.68
PSA (prostate specific antigen) blood test: rates for 8 insurance plans
  • Aetna — Commercial: $106.68
  • Aetna — MCR Advantage: $74.76
  • Anthem — Commercial: $91
  • Anthem — Enhanced Pathways: $91
  • CHO — Commercial: $91
  • Cigna — Commercial: $104.44
  • Harvard — Commercial: $98.48
  • UHC — Commercial: $100.30
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL $140 $36.40 $74.76 – $106.68
PSA (prostate specific antigen) blood test: rates for 8 insurance plans
  • Aetna — Commercial: $106.68
  • Aetna — MCR Advantage: $74.76
  • Anthem — Commercial: $91
  • Anthem — Enhanced Pathways: $91
  • CHO — Commercial: $91
  • Cigna — Commercial: $104.44
  • Harvard — Commercial: $98.48
  • UHC — Commercial: $100.30
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA TOTAL (PART OF PSA FREE) $140 $36.40 $91 – $104.44
PSA (prostate specific antigen) blood test: rates for 6 insurance plans
  • Aetna — Commercial: $101.92
  • Anthem — Commercial: $91
  • Anthem — Enhanced Pathways: $91
  • CHO — Commercial: $91
  • Cigna — Commercial: $104.44
  • UHC — Commercial: $98.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH/LAB $232 $60.32 $123.89 – $176.78
Thyroid stimulating hormone (TSH) test: rates for 8 insurance plans
  • Aetna — Commercial: $176.78
  • Aetna — MCR Advantage: $123.89
  • Anthem — Commercial: $150.80
  • Anthem — Enhanced Pathways: $150.80
  • CHO — Commercial: $150.80
  • Cigna — Commercial: $173.07
  • Harvard — Commercial: $163.19
  • UHC — Commercial: $166.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE $232 $60.32 $123.89 – $176.78
Thyroid stimulating hormone (TSH) test: rates for 8 insurance plans
  • Aetna — Commercial: $176.78
  • Aetna — MCR Advantage: $123.89
  • Anthem — Commercial: $150.80
  • Anthem — Enhanced Pathways: $150.80
  • CHO — Commercial: $150.80
  • Cigna — Commercial: $173.07
  • Harvard — Commercial: $163.19
  • UHC — Commercial: $166.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TSH/LAB $232 $60.32 $150.80 – $173.07
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans
  • Aetna — Commercial: $168.90
  • Anthem — Commercial: $150.80
  • Anthem — Enhanced Pathways: $150.80
  • CHO — Commercial: $150.80
  • Cigna — Commercial: $173.07
  • UHC — Commercial: $162.63
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLT CBC W PLT W AUTO DIFF $109 $28.34 $58.21 – $83.06
Complete blood count (CBC) with differential: rates for 8 insurance plans
  • Aetna — Commercial: $83.06
  • Aetna — MCR Advantage: $58.21
  • Anthem — Commercial: $70.85
  • Anthem — Enhanced Pathways: $70.85
  • CHO — Commercial: $70.85
  • Cigna — Commercial: $81.31
  • Harvard — Commercial: $76.67
  • UHC — Commercial: $78.09
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITH DIFF-Q $109 $28.34 $58.21 – $83.06
Complete blood count (CBC) with differential: rates for 8 insurance plans
  • Aetna — Commercial: $83.06
  • Aetna — MCR Advantage: $58.21
  • Anthem — Commercial: $70.85
  • Anthem — Enhanced Pathways: $70.85
  • CHO — Commercial: $70.85
  • Cigna — Commercial: $81.31
  • Harvard — Commercial: $76.67
  • UHC — Commercial: $78.09
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPLT CBC W PLT W AUTO DIFF $109 $28.34 $70.85 – $81.31
Complete blood count (CBC) with differential: rates for 6 insurance plans
  • Aetna — Commercial: $79.35
  • Anthem — Commercial: $70.85
  • Anthem — Enhanced Pathways: $70.85
  • CHO — Commercial: $70.85
  • Cigna — Commercial: $81.31
  • UHC — Commercial: $76.41
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLT AUTO CBC W PLT $104 $27.04 $55.54 – $79.25
Complete blood count (CBC), automated: rates for 8 insurance plans
  • Aetna — Commercial: $79.25
  • Aetna — MCR Advantage: $55.54
  • Anthem — Commercial: $67.60
  • Anthem — Enhanced Pathways: $67.60
  • CHO — Commercial: $67.60
  • Cigna — Commercial: $77.58
  • Harvard — Commercial: $73.15
  • UHC — Commercial: $74.51
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITHOUT DIFFERENTIAL-Q $104 $27.04 $55.54 – $79.25
Complete blood count (CBC), automated: rates for 8 insurance plans
  • Aetna — Commercial: $79.25
  • Aetna — MCR Advantage: $55.54
  • Anthem — Commercial: $67.60
  • Anthem — Enhanced Pathways: $67.60
  • CHO — Commercial: $67.60
  • Cigna — Commercial: $77.58
  • Harvard — Commercial: $73.15
  • UHC — Commercial: $74.51
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPLT AUTO CBC W PLT $104 $27.04 $67.60 – $77.58
Complete blood count (CBC), automated: rates for 6 insurance plans
  • Aetna — Commercial: $75.71
  • Anthem — Commercial: $67.60
  • Anthem — Enhanced Pathways: $67.60
  • CHO — Commercial: $67.60
  • Cigna — Commercial: $77.58
  • UHC — Commercial: $72.90
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $36 $9.36 $19.22 – $27.43
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans
  • Aetna — Commercial: $27.43
  • Aetna — MCR Advantage: $19.22
  • Anthem — Commercial: $23.40
  • Anthem — Enhanced Pathways: $23.40
  • CHO — Commercial: $23.40
  • Cigna — Commercial: $26.86
  • Harvard — Commercial: $25.32
  • UHC — Commercial: $25.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $36 $9.36 $23.40 – $26.86
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans
  • Aetna — Commercial: $26.21
  • Anthem — Commercial: $23.40
  • Anthem — Enhanced Pathways: $23.40
  • CHO — Commercial: $23.40
  • Cigna — Commercial: $26.86
  • UHC — Commercial: $25.24
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 $4.15 – $31.40
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans
  • Aetna — Commercial: $4.29
  • Aetna — MCR Advantage: $4.38
  • Anthem — Commercial: $5.32
  • Anthem — Enhanced Pathways: $4.15
  • Anthem — MCR Advantage: $4.38
  • CHO — Commercial: $5.36
  • Cigna — Commercial: $31.40
  • Martin's Point — MCR Advantage: $4.38
  • UHC — MCR Advantage: $4.38
  • Wellcare — MCR Advantage: $4.38
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $62 $16.12 $33.11 – $47.24
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans
  • Aetna — Commercial: $47.24
  • Aetna — MCR Advantage: $33.11
  • Anthem — Commercial: $40.30
  • Anthem — Enhanced Pathways: $40.30
  • CHO — Commercial: $40.30
  • Cigna — Commercial: $46.25
  • Harvard — Commercial: $43.61
  • UHC — Commercial: $44.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT $62 $16.12 $33.11 – $47.24
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans
  • Aetna — Commercial: $47.24
  • Aetna — MCR Advantage: $33.11
  • Anthem — Commercial: $40.30
  • Anthem — Enhanced Pathways: $40.30
  • CHO — Commercial: $40.30
  • Cigna — Commercial: $46.25
  • Harvard — Commercial: $43.61
  • UHC — Commercial: $44.42
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $62 $16.12 $40.30 – $46.25
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans
  • Aetna — Commercial: $45.14
  • Anthem — Commercial: $40.30
  • Anthem — Enhanced Pathways: $40.30
  • CHO — Commercial: $40.30
  • Cigna — Commercial: $46.25
  • UHC — Commercial: $43.46

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 $103.85 – $576.03
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates
  • Aetna — Commercial: $278.01
  • Aetna — MCR Advantage: $105.93
  • Anthem — Commercial: $489.60
  • Anthem — Enhanced Pathways: $381.89
  • Anthem — MCR Advantage: $103.85
  • CHO — Commercial: $407.11
  • Cigna — Commercial: $576.03
  • Martin's Point — MCR Advantage: $105.93
  • UHC — MCR Advantage: $105.93
  • Wellcare — MCR Advantage: $105.93
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Ct head/brain w/o dye Not listed in the file Not listed in the file $171.41
CT scan of the head or brain, without contrast: rates for 1 insurance plan
  • CHO — Commercial: $171.41
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT HEAD/BRAIN WO CONT $1,537 $399.62 $820.76 – $1,171.19
CT scan of the head or brain, without contrast: rates for 8 insurance plans
  • Aetna — Commercial: $1,171.19
  • Aetna — MCR Advantage: $820.76
  • Anthem — Commercial: $999.05
  • Anthem — Enhanced Pathways: $999.05
  • CHO — Commercial: $999.05
  • Cigna — Commercial: $1,146.60
  • Harvard — Commercial: $1,081.13
  • UHC — Commercial: $1,101.11
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 $348.77 – $1,934.46
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates
  • Aetna — Commercial: $877.52
  • Aetna — MCR Advantage: $355.75
  • Anthem — Commercial: $1,644.21
  • Anthem — Enhanced Pathways: $1,282.49
  • Anthem — MCR Advantage: $348.77
  • CHO — Commercial: $1,367.19
  • Cigna — Commercial: $1,934.46
  • Martin's Point — MCR Advantage: $355.75
  • UHC — MCR Advantage: $355.75
  • Wellcare — MCR Advantage: $355.75
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Mri brain stem w/o & w/dye Not listed in the file Not listed in the file $510.72
MRI of the brain, before and after contrast: rates for 1 insurance plan
  • CHO — Commercial: $510.72
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI HEAD W & W/O CONTRAST $3,479 $904.54 $1,857.79 – $2,651
MRI of the brain, before and after contrast: rates for 8 insurance plans
  • Aetna — Commercial: $2,651
  • Aetna — MCR Advantage: $1,857.79
  • Anthem — Commercial: $2,261.35
  • Anthem — Enhanced Pathways: $2,261.35
  • CHO — Commercial: $2,261.35
  • Cigna — Commercial: $2,595.33
  • Harvard — Commercial: $2,447.13
  • UHC — Commercial: $2,492.36
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR CHEST 2 VIEWS PA/LAT $432 $112.32 $230.69 – $329.18
Chest X-ray, 2 views: rates for 8 insurance plans
  • Aetna — Commercial: $329.18
  • Aetna — MCR Advantage: $230.69
  • Anthem — Commercial: $280.80
  • Anthem — Enhanced Pathways: $280.80
  • CHO — Commercial: $280.80
  • Cigna — Commercial: $322.27
  • Harvard — Commercial: $303.87
  • UHC — Commercial: $309.48
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: XR CHEST 2 VIEWS PA/LAT $432 $112.32 $280.80 – $322.27
Chest X-ray, 2 views: rates for 6 insurance plans
  • Aetna — Commercial: $314.50
  • Anthem — Commercial: $280.80
  • Anthem — Enhanced Pathways: $280.80
  • CHO — Commercial: $280.80
  • Cigna — Commercial: $322.27
  • UHC — Commercial: $302.83
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 $85.99 – $476.91
Chest X-ray, 2 views: rates for 10 insurance plans
  • Aetna — Commercial: $94.62
  • Aetna — MCR Advantage: $87.70
  • Anthem — Commercial: $405.36
  • Anthem — Enhanced Pathways: $316.18
  • Anthem — MCR Advantage: $85.99
  • CHO — Commercial: $337.06
  • Cigna — Commercial: $476.91
  • Martin's Point — MCR Advantage: $87.70
  • UHC — MCR Advantage: $87.70
  • Wellcare — MCR Advantage: $87.70
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 $103.85 – $576.03
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans
  • Aetna — Commercial: $159.82
  • Aetna — MCR Advantage: $105.93
  • Anthem — Commercial: $489.60
  • Anthem — Enhanced Pathways: $381.89
  • Anthem — MCR Advantage: $103.85
  • CHO — Commercial: $407.11
  • Cigna — Commercial: $576.03
  • Martin's Point — MCR Advantage: $105.93
  • UHC — MCR Advantage: $105.93
  • Wellcare — MCR Advantage: $105.93
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: X-ray exam l-2 spine 4/>vws Not listed in the file Not listed in the file $81.60
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan
  • CHO — Commercial: $81.60
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: XR L/S SPINE 4+ VIEWS $525 $136.50 $280.35 – $400.05
X-ray of the lower spine, at least 4 views: rates for 8 insurance plans
  • Aetna — Commercial: $400.05
  • Aetna — MCR Advantage: $280.35
  • Anthem — Commercial: $341.25
  • Anthem — Enhanced Pathways: $341.25
  • CHO — Commercial: $341.25
  • Cigna — Commercial: $391.65
  • Harvard — Commercial: $369.28
  • UHC — Commercial: $376.11
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 $236.06 – $1,309.32
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates
  • Aetna — Commercial: $505.76
  • Aetna — MCR Advantage: $240.78
  • Anthem — Commercial: $1,112.86
  • Anthem — Enhanced Pathways: $868.03
  • Anthem — MCR Advantage: $236.06
  • CHO — Commercial: $925.37
  • Cigna — Commercial: $1,309.32
  • Martin's Point — MCR Advantage: $240.78
  • UHC — MCR Advantage: $240.78
  • Wellcare — MCR Advantage: $240.78
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Mri lumbar spine w/o dye Not listed in the file Not listed in the file $306.74
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan
  • CHO — Commercial: $306.74
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SPINE LUMBAR WO CONTRAST $1,864 $484.64 $995.38 – $1,420.37
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans
  • Aetna — Commercial: $1,420.37
  • Aetna — MCR Advantage: $995.38
  • Anthem — Commercial: $1,211.60
  • Anthem — Enhanced Pathways: $1,211.60
  • CHO — Commercial: $1,211.60
  • Cigna — Commercial: $1,390.54
  • Harvard — Commercial: $1,311.14
  • UHC — Commercial: $1,335.37
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 $173.85 – $964.26
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — Commercial: $714.96
  • Aetna — MCR Advantage: $177.33
  • Anthem — Commercial: $819.58
  • Anthem — Enhanced Pathways: $639.27
  • Anthem — MCR Advantage: $173.85
  • CHO — Commercial: $681.50
  • Cigna — Commercial: $964.26
  • Martin's Point — MCR Advantage: $177.33
  • UHC — MCR Advantage: $177.33
  • Wellcare — MCR Advantage: $177.33
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Ct pelvis w/dye Not listed in the file Not listed in the file $361.27
CT scan of the pelvis, with contrast: rates for 1 insurance plan
  • CHO — Commercial: $361.27
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT PELVIS W CONT $1,461 $379.86 $780.17 – $1,113.28
CT scan of the pelvis, with contrast: rates for 8 insurance plans
  • Aetna — Commercial: $1,113.28
  • Aetna — MCR Advantage: $780.17
  • Anthem — Commercial: $949.65
  • Anthem — Enhanced Pathways: $949.65
  • CHO — Commercial: $949.65
  • Cigna — Commercial: $1,089.91
  • Harvard — Commercial: $1,027.67
  • UHC — Commercial: $1,046.66
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 $236.06 – $1,309.32
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates
  • Aetna — Commercial: $580
  • Aetna — MCR Advantage: $240.78
  • Anthem — Commercial: $1,112.86
  • Anthem — Enhanced Pathways: $868.03
  • Anthem — MCR Advantage: $236.06
  • CHO — Commercial: $925.37
  • Cigna — Commercial: $1,309.32
  • Martin's Point — MCR Advantage: $240.78
  • UHC — MCR Advantage: $240.78
  • Wellcare — MCR Advantage: $240.78
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Mri jnt of lwr extre w/o dye Not listed in the file Not listed in the file $325.22
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan
  • CHO — Commercial: $325.22
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI ANKLE W/O CONTRAST LT $1,228 $319.28 $655.75 – $935.74
MRI of a leg joint (such as the knee), without contrast: rates for 8 insurance plans
  • Aetna — Commercial: $935.74
  • Aetna — MCR Advantage: $655.75
  • Anthem — Commercial: $798.20
  • Anthem — Enhanced Pathways: $798.20
  • CHO — Commercial: $798.20
  • Cigna — Commercial: $916.09
  • Harvard — Commercial: $863.78
  • UHC — Commercial: $879.74
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelvis w/contrast Not listed in the file Not listed in the file $348.77 – $1,934.46
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — Commercial: $897.02
  • Aetna — MCR Advantage: $355.75
  • Anthem — Commercial: $1,644.21
  • Anthem — Enhanced Pathways: $1,282.49
  • Anthem — MCR Advantage: $348.77
  • CHO — Commercial: $1,367.19
  • Cigna — Commercial: $1,934.46
  • Martin's Point — MCR Advantage: $355.75
  • UHC — MCR Advantage: $355.75
  • Wellcare — MCR Advantage: $355.75
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Ct abd & pelvis w/contrast Not listed in the file Not listed in the file $482.13
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan
  • CHO — Commercial: $482.13
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT ABDOMEN & PELVIS W CONT $3,772 $980.72 $2,014.25 – $2,874.26
CT scan of the abdomen and pelvis, with contrast: rates for 8 insurance plans
  • Aetna — Commercial: $2,874.26
  • Aetna — MCR Advantage: $2,014.25
  • Anthem — Commercial: $2,451.80
  • Anthem — Enhanced Pathways: $2,451.80
  • CHO — Commercial: $2,451.80
  • Cigna — Commercial: $2,813.91
  • Harvard — Commercial: $2,653.22
  • UHC — Commercial: $2,702.26
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 $103.85 – $576.03
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates
  • Aetna — Commercial: $314.20
  • Aetna — MCR Advantage: $105.93
  • Anthem — Commercial: $489.60
  • Anthem — Enhanced Pathways: $381.89
  • Anthem — MCR Advantage: $103.85
  • CHO — Commercial: $407.11
  • Cigna — Commercial: $576.03
  • Martin's Point — MCR Advantage: $105.93
  • UHC — MCR Advantage: $105.93
  • Wellcare — MCR Advantage: $105.93
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Us exam abdom complete Not listed in the file Not listed in the file $181.91
Ultrasound of the abdomen, complete: rates for 1 insurance plan
  • CHO — Commercial: $181.91
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC US EXAM ABDOMEN COMPLETE $881 $229.06 $470.45 – $671.32
Ultrasound of the abdomen, complete: rates for 8 insurance plans
  • Aetna — Commercial: $671.32
  • Aetna — MCR Advantage: $470.45
  • Anthem — Commercial: $572.65
  • Anthem — Enhanced Pathways: $572.65
  • CHO — Commercial: $572.65
  • Cigna — Commercial: $657.23
  • Harvard — Commercial: $619.70
  • UHC — Commercial: $631.15
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 $103.85 – $576.03
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates
  • Aetna — Commercial: $353.62
  • Aetna — MCR Advantage: $105.93
  • Anthem — Commercial: $489.60
  • Anthem — Enhanced Pathways: $381.89
  • Anthem — MCR Advantage: $103.85
  • CHO — Commercial: $407.11
  • Cigna — Commercial: $576.03
  • Martin's Point — MCR Advantage: $105.93
  • UHC — MCR Advantage: $105.93
  • Wellcare — MCR Advantage: $105.93
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Ob us >/ 14 wks sngl fetus Not listed in the file Not listed in the file $211.75
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan
  • CHO — Commercial: $211.75
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC US PREG UTERUS>=14WK SNGL $746 $193.96 $398.36 – $568.45
Pregnancy ultrasound (after the first trimester): rates for 8 insurance plans
  • Aetna — Commercial: $568.45
  • Aetna — MCR Advantage: $398.36
  • Anthem — Commercial: $484.90
  • Anthem — Enhanced Pathways: $484.90
  • CHO — Commercial: $484.90
  • Cigna — Commercial: $556.52
  • Harvard — Commercial: $524.74
  • UHC — Commercial: $534.43
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 $103.85 – $576.03
Transvaginal ultrasound: 10 of 11 insurance plan rates
  • Aetna — Commercial: $345.45
  • Aetna — MCR Advantage: $105.93
  • Anthem — Commercial: $489.60
  • Anthem — Enhanced Pathways: $381.89
  • Anthem — MCR Advantage: $103.85
  • CHO — Commercial: $407.11
  • Cigna — Commercial: $576.03
  • Martin's Point — MCR Advantage: $105.93
  • UHC — MCR Advantage: $105.93
  • Wellcare — MCR Advantage: $105.93
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Transvaginal us non-ob Not listed in the file Not listed in the file $185.10
Transvaginal ultrasound: rates for 1 insurance plan
  • CHO — Commercial: $185.10
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: HC US TRANSVAGINAL NON OB $595 $154.70 $317.73 – $453.39
Transvaginal ultrasound: rates for 8 insurance plans
  • Aetna — Commercial: $453.39
  • Aetna — MCR Advantage: $317.73
  • Anthem — Commercial: $386.75
  • Anthem — Enhanced Pathways: $386.75
  • CHO — Commercial: $386.75
  • Cigna — Commercial: $443.87
  • Harvard — Commercial: $418.52
  • UHC — Commercial: $426.26
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 $83.09 – $356.32
Diagnostic mammogram, one breast: rates for 10 insurance plans
  • Aetna — Commercial: $356.32
  • Aetna — MCR Advantage: $87.58
  • Anthem — Commercial: $106.53
  • Anthem — Enhanced Pathways: $83.09
  • Anthem — MCR Advantage: $85.86
  • CHO — Commercial: $107.33
  • Cigna — Commercial: $214.65
  • Martin's Point — MCR Advantage: $87.58
  • UHC — MCR Advantage: $87.58
  • Wellcare — MCR Advantage: $87.58
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Dx mammo incl cad uni Not listed in the file Not listed in the file $197.94
Diagnostic mammogram, one breast: rates for 1 insurance plan
  • CHO — Commercial: $197.94
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MAMMO DIGITAL DIAGN UNILAT LT $494 $128.44 $263.80 – $376.43
Diagnostic mammogram, one breast: rates for 8 insurance plans
  • Aetna — Commercial: $376.43
  • Aetna — MCR Advantage: $263.80
  • Anthem — Commercial: $321.10
  • Anthem — Enhanced Pathways: $321.10
  • CHO — Commercial: $321.10
  • Cigna — Commercial: $368.52
  • Harvard — Commercial: $347.48
  • UHC — Commercial: $353.90
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DIAGNOSTIC BILAT $632 $164.32 $337.49 – $481.58
Diagnostic mammogram, both breasts: rates for 8 insurance plans
  • Aetna — Commercial: $481.58
  • Aetna — MCR Advantage: $337.49
  • Anthem — Commercial: $410.80
  • Anthem — Enhanced Pathways: $410.80
  • CHO — Commercial: $410.80
  • Cigna — Commercial: $471.47
  • Harvard — Commercial: $444.55
  • UHC — Commercial: $452.76
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DIAGNOSTIC BILAT $632 $164.32 $410.80 – $471.47
Diagnostic mammogram, both breasts: rates for 6 insurance plans
  • Aetna — Commercial: $460.10
  • Anthem — Commercial: $410.80
  • Anthem — Enhanced Pathways: $410.80
  • CHO — Commercial: $410.80
  • Cigna — Commercial: $471.47
  • UHC — Commercial: $443.03
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 $105.90 – $454.13
Diagnostic mammogram, both breasts: rates for 10 insurance plans
  • Aetna — Commercial: $454.13
  • Aetna — MCR Advantage: $111.62
  • Anthem — Commercial: $135.77
  • Anthem — Enhanced Pathways: $105.90
  • Anthem — MCR Advantage: $109.43
  • CHO — Commercial: $136.79
  • Cigna — Commercial: $273.58
  • Martin's Point — MCR Advantage: $111.62
  • UHC — MCR Advantage: $111.62
  • Wellcare — MCR Advantage: $111.62
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIGITAL SCREENING BILAT $522 $135.72 $278.75 – $397.76
Screening mammogram, both breasts: rates for 8 insurance plans
  • Aetna — Commercial: $397.76
  • Aetna — MCR Advantage: $278.75
  • Anthem — Commercial: $339.30
  • Anthem — Enhanced Pathways: $339.30
  • CHO — Commercial: $339.30
  • Cigna — Commercial: $389.41
  • Harvard — Commercial: $367.17
  • UHC — Commercial: $373.96
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIGITAL SCREENING BILAT $522 $135.72 $339.30 – $389.41
Screening mammogram, both breasts: rates for 6 insurance plans
  • Aetna — Commercial: $380.02
  • Anthem — Commercial: $339.30
  • Anthem — Enhanced Pathways: $339.30
  • CHO — Commercial: $339.30
  • Cigna — Commercial: $389.41
  • UHC — Commercial: $365.92
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 $87.64 – $375.82
Screening mammogram, both breasts: rates for 10 insurance plans
  • Aetna — Commercial: $375.82
  • Aetna — MCR Advantage: $92.37
  • Anthem — Commercial: $112.36
  • Anthem — Enhanced Pathways: $87.64
  • Anthem — MCR Advantage: $90.56
  • CHO — Commercial: $113.20
  • Cigna — Commercial: $226.40
  • Martin's Point — MCR Advantage: $92.37
  • UHC — MCR Advantage: $92.37
  • Wellcare — MCR Advantage: $92.37

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Electrocardiogram complete Not listed in the file Not listed in the file $13.78 – $31.50
Electrocardiogram (ECG/EKG) with reading: 10 of 12 insurance plan rates
  • Aetna — Commercial: $22.77
  • Aetna — MCR Advantage: $18.98
  • Anthem — Commercial: $26.99
  • Anthem — Enhanced Pathways: $26.99
  • Anthem — MCR Advantage: $13.78
  • CHO — Commercial: $22.77
  • Cigna — Commercial: $31.03
  • Harvard — Commercial: $31.50
  • Martin's Point — MCR Advantage: $14.06
  • UHC — Commercial: $28.14
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 $70.34
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
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 $3,141.15 – $17,422.29
Left heart catheterization (diagnostic): rates for 10 insurance plans
  • Aetna — MCR Advantage: $3,203.97
  • Anthem — Commercial: $14,808.23
  • Anthem — Enhanced Pathways: $11,550.42
  • Anthem — MCR Advantage: $3,141.15
  • CHO — Commercial: $12,313.31
  • Cigna — Commercial: $17,422.29
  • Martin's Point — MCR Advantage: $3,203.97
  • UHC — MCR Advantage: $3,203.97
  • Wellcare — MCR Advantage: $3,203.97
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Left hrt cath w/ventrclgrphy Not listed in the file Not listed in the file $1,335.36
Left heart catheterization (diagnostic): rates for 1 insurance plan
  • CHO — Commercial: $1,335.36
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: Left hrt cath w/ventrclgrphy Not listed in the file Not listed in the file $214.24 – $504.94
Left heart catheterization (diagnostic): 10 of 11 insurance plan rates
  • Aetna — Commercial: $365.89
  • Aetna — MCR Advantage: $263.80
  • Anthem — Commercial: $432.37
  • Anthem — Enhanced Pathways: $432.37
  • Anthem — MCR Advantage: $214.24
  • Cigna — Commercial: $498.68
  • Harvard — Commercial: $504.94
  • Martin's Point — MCR Advantage: $218.52
  • UHC — Commercial: $428.16
  • UHC — MCR Advantage: $218.52
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive ep evaluation Not listed in the file Not listed in the file $7,410.54 – $41,102.33
Heart rhythm study (electrophysiology evaluation): rates for 10 insurance plans
  • Aetna — MCR Advantage: $7,558.75
  • Anthem — Commercial: $34,935.28
  • Anthem — Enhanced Pathways: $27,249.52
  • Anthem — MCR Advantage: $7,410.54
  • CHO — Commercial: $29,049.33
  • Cigna — Commercial: $41,102.33
  • Martin's Point — MCR Advantage: $7,558.75
  • UHC — MCR Advantage: $7,558.75
  • Wellcare — MCR Advantage: $7,558.75
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Comprehensive ep evaluation Not listed in the file Not listed in the file $1,117.13
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan
  • CHO — Commercial: $1,117.13
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: Comprehensive ep evaluation Not listed in the file Not listed in the file $348.38 – $821.46
Heart rhythm study (electrophysiology evaluation): 10 of 11 insurance plan rates
  • Aetna — Commercial: $593.37
  • Aetna — MCR Advantage: $436.46
  • Anthem — Commercial: $701.56
  • Anthem — Enhanced Pathways: $701.56
  • Anthem — MCR Advantage: $348.38
  • Cigna — Commercial: $821.46
  • Harvard — Commercial: $820.80
  • Martin's Point — MCR Advantage: $355.35
  • UHC — Commercial: $683.80
  • UHC — MCR Advantage: $355.35
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Compre ep eval abltj atr fib Not listed in the file Not listed in the file $856.93 – $2,351.22
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates
  • Aetna — Commercial: $1,459.62
  • Aetna — MCR Advantage: $1,247.94
  • Anthem — Commercial: $1,739.48
  • Anthem — Enhanced Pathways: $1,739.48
  • Anthem — MCR Advantage: $856.93
  • CHO — Commercial: $1,459.62
  • Cigna — Commercial: $2,351.22
  • Harvard — Commercial: $2,029.26
  • Martin's Point — MCR Advantage: $874.07
  • UHC — Commercial: $1,910.25
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre ep eval abltj atr fib Not listed in the file Not listed in the file $23,958.24 – $132,883.64
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans
  • Aetna — MCR Advantage: $24,437.41
  • Anthem — Commercial: $112,945.59
  • Anthem — Enhanced Pathways: $88,097.56
  • Anthem — MCR Advantage: $23,958.24
  • CHO — Commercial: $93,916.32
  • Cigna — Commercial: $132,883.64
  • Martin's Point — MCR Advantage: $24,437.41
  • UHC — MCR Advantage: $24,437.41
  • Wellcare — MCR Advantage: $24,437.41
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
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 $993.58 – $5,510.89
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans
  • Aetna — MCR Advantage: $1,013.46
  • Anthem — Commercial: $4,684.02
  • Anthem — Enhanced Pathways: $3,653.54
  • Anthem — MCR Advantage: $993.58
  • CHO — Commercial: $3,894.85
  • Cigna — Commercial: $5,510.89
  • Martin's Point — MCR Advantage: $1,013.46
  • UHC — MCR Advantage: $1,013.46
  • Wellcare — MCR Advantage: $1,013.46
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $980.88
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan
  • CHO — Commercial: $980.88
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: Polysom 6/> yrs 4/> param Not listed in the file Not listed in the file $111.70 – $259.35
Sleep study (overnight, in a sleep lab): 10 of 11 insurance plan rates
  • Aetna — Commercial: $190.45
  • Aetna — MCR Advantage: $127.17
  • Anthem — Commercial: $217.75
  • Anthem — Enhanced Pathways: $217.75
  • Anthem — MCR Advantage: $111.70
  • Cigna — Commercial: $259.35
  • Harvard — Commercial: $254.31
  • Martin's Point — MCR Advantage: $113.93
  • UHC — Commercial: $209.97
  • UHC — MCR Advantage: $113.93

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: PT THERAPEUTIC EXER EA 15 MIN $95 $24.70 $50.73 – $72.39
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $72.39
  • Aetna — MCR Advantage: $50.73
  • Anthem — Commercial: $61.75
  • Anthem — Enhanced Pathways: $61.75
  • CHO — Commercial: $61.75
  • Cigna — Commercial: $70.87
  • Harvard — Commercial: $66.82
  • UHC — Commercial: $68.06
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTA THERAPEUTIC EXER EA 15 MIN $95 $24.70 $50.73 – $72.39
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $72.39
  • Aetna — MCR Advantage: $50.73
  • Anthem — Commercial: $61.75
  • Anthem — Enhanced Pathways: $61.75
  • CHO — Commercial: $61.75
  • Cigna — Commercial: $70.87
  • Harvard — Commercial: $66.82
  • UHC — Commercial: $68.06
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OT THERAPEUTIC EXERCISE 15MIN $95 $24.70 $50.73 – $72.39
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans
  • Aetna — Commercial: $72.39
  • Aetna — MCR Advantage: $50.73
  • Anthem — Commercial: $61.75
  • Anthem — Enhanced Pathways: $61.75
  • CHO — Commercial: $61.75
  • Cigna — Commercial: $70.87
  • Harvard — Commercial: $66.82
  • UHC — Commercial: $68.06
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION LOW COMPLEXITY $449 $116.74 $239.77 – $342.14
Physical therapy evaluation (low complexity): rates for 8 insurance plans
  • Aetna — Commercial: $342.14
  • Aetna — MCR Advantage: $239.77
  • Anthem — Commercial: $291.85
  • Anthem — Enhanced Pathways: $291.85
  • CHO — Commercial: $291.85
  • Cigna — Commercial: $334.95
  • Harvard — Commercial: $315.83
  • UHC — Commercial: $321.66
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION LOW COMPLEXITY $449 $116.74 $291.85 – $334.95
Physical therapy evaluation (low complexity): rates for 6 insurance plans
  • Aetna — Commercial: $326.87
  • Anthem — Commercial: $291.85
  • Anthem — Enhanced Pathways: $291.85
  • CHO — Commercial: $291.85
  • Cigna — Commercial: $334.95
  • UHC — Commercial: $314.75
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval low complex 20 min Not listed in the file Not listed in the file $90.66 – $220.64
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial: $163.59
  • Aetna — MCR Advantage: $90.66
  • Anthem — Commercial: $190.14
  • Anthem — Enhanced Pathways: $190.14
  • Anthem — MCR Advantage: $98.13
  • CHO — Commercial: $163.59
  • Cigna — Commercial: $220.64
  • Harvard — Commercial: $220.58
  • Martin's Point — MCR Advantage: $100.09
  • UHC — Commercial: $135.57
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION MOD COMPLEXITY $483 $125.58 $257.92 – $368.05
Physical therapy evaluation (moderate complexity): rates for 8 insurance plans
  • Aetna — Commercial: $368.05
  • Aetna — MCR Advantage: $257.92
  • Anthem — Commercial: $313.95
  • Anthem — Enhanced Pathways: $313.95
  • CHO — Commercial: $313.95
  • Cigna — Commercial: $360.32
  • Harvard — Commercial: $339.74
  • UHC — Commercial: $346.02
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION MOD COMPLEXITY $483 $125.58 $313.95 – $360.32
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans
  • Aetna — Commercial: $351.62
  • Anthem — Commercial: $313.95
  • Anthem — Enhanced Pathways: $313.95
  • CHO — Commercial: $313.95
  • Cigna — Commercial: $360.32
  • UHC — Commercial: $338.58
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval mod complex 30 min Not listed in the file Not listed in the file $90.66 – $220.64
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial: $163.59
  • Aetna — MCR Advantage: $90.66
  • Anthem — Commercial: $190.14
  • Anthem — Enhanced Pathways: $190.14
  • Anthem — MCR Advantage: $98.13
  • CHO — Commercial: $163.59
  • Cigna — Commercial: $220.64
  • Harvard — Commercial: $220.58
  • Martin's Point — MCR Advantage: $100.09
  • UHC — Commercial: $135.57
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVALUATION HIGH COMPLEXITY $507 $131.82 $270.74 – $386.33
Physical therapy evaluation (high complexity): rates for 8 insurance plans
  • Aetna — Commercial: $386.33
  • Aetna — MCR Advantage: $270.74
  • Anthem — Commercial: $329.55
  • Anthem — Enhanced Pathways: $329.55
  • CHO — Commercial: $329.55
  • Cigna — Commercial: $378.22
  • Harvard — Commercial: $356.62
  • UHC — Commercial: $363.21
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVALUATION HIGH COMPLEXITY $507 $131.82 $329.55 – $378.22
Physical therapy evaluation (high complexity): rates for 6 insurance plans
  • Aetna — Commercial: $369.10
  • Anthem — Commercial: $329.55
  • Anthem — Enhanced Pathways: $329.55
  • CHO — Commercial: $329.55
  • Cigna — Commercial: $378.22
  • UHC — Commercial: $355.41
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval high complex 45 min Not listed in the file Not listed in the file $90.66 – $220.64
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates
  • Aetna — Commercial: $163.59
  • Aetna — MCR Advantage: $90.66
  • Anthem — Commercial: $190.14
  • Anthem — Enhanced Pathways: $190.14
  • Anthem — MCR Advantage: $98.13
  • CHO — Commercial: $163.59
  • Cigna — Commercial: $220.64
  • Harvard — Commercial: $220.58
  • Martin's Point — MCR Advantage: $100.09
  • UHC — Commercial: $135.57
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH PSYTX PT&/FAMILY 30 MIN $430 $111.80 $229.62 – $327.66
Psychotherapy, 30 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $327.66
  • Aetna — MCR Advantage: $229.62
  • Anthem — Commercial: $279.50
  • Anthem — Enhanced Pathways: $279.50
  • CHO — Commercial: $279.50
  • Cigna — Commercial: $320.78
  • Harvard — Commercial: $302.46
  • UHC — Commercial: $308.05
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 30 MIN $249 $64.74 $132.97 – $189.74
Psychotherapy, 30 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $189.74
  • Aetna — MCR Advantage: $132.97
  • Anthem — Commercial: $161.85
  • Anthem — Enhanced Pathways: $161.85
  • CHO — Commercial: $161.85
  • Cigna — Commercial: $185.75
  • Harvard — Commercial: $175.15
  • UHC — Commercial: $178.38
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHRPY PT&/FAMILY 30MIN $249 $64.74 $132.97 – $189.74
Psychotherapy, 30 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $189.74
  • Aetna — MCR Advantage: $132.97
  • Anthem — Commercial: $161.85
  • Anthem — Enhanced Pathways: $161.85
  • CHO — Commercial: $161.85
  • Cigna — Commercial: $185.75
  • Harvard — Commercial: $175.15
  • UHC — Commercial: $178.38
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH PSYTX PT&/FAMILY 45 MIN $551 $143.26 $294.23 – $419.86
Psychotherapy, 45 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $419.86
  • Aetna — MCR Advantage: $294.23
  • Anthem — Commercial: $358.15
  • Anthem — Enhanced Pathways: $358.15
  • CHO — Commercial: $358.15
  • Cigna — Commercial: $411.05
  • Harvard — Commercial: $387.57
  • UHC — Commercial: $394.74
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN $261 $67.86 $139.37 – $198.88
Psychotherapy, 45 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $198.88
  • Aetna — MCR Advantage: $139.37
  • Anthem — Commercial: $169.65
  • Anthem — Enhanced Pathways: $169.65
  • CHO — Commercial: $169.65
  • Cigna — Commercial: $194.71
  • Harvard — Commercial: $183.59
  • UHC — Commercial: $186.98
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHRPY PT&/FAMILY 45MIN $261 $67.86 $139.37 – $198.88
Psychotherapy, 45 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $198.88
  • Aetna — MCR Advantage: $139.37
  • Anthem — Commercial: $169.65
  • Anthem — Enhanced Pathways: $169.65
  • CHO — Commercial: $169.65
  • Cigna — Commercial: $194.71
  • Harvard — Commercial: $183.59
  • UHC — Commercial: $186.98
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH PSYTX PT&/FAMILY 60 MIN $596 $154.96 $318.26 – $454.15
Psychotherapy, 60 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $454.15
  • Aetna — MCR Advantage: $318.26
  • Anthem — Commercial: $387.40
  • Anthem — Enhanced Pathways: $387.40
  • CHO — Commercial: $387.40
  • Cigna — Commercial: $444.62
  • Harvard — Commercial: $419.23
  • UHC — Commercial: $426.97
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN $274 $71.24 $146.32 – $208.79
Psychotherapy, 60 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $208.79
  • Aetna — MCR Advantage: $146.32
  • Anthem — Commercial: $178.10
  • Anthem — Enhanced Pathways: $178.10
  • CHO — Commercial: $178.10
  • Cigna — Commercial: $204.40
  • Harvard — Commercial: $192.73
  • UHC — Commercial: $196.29
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX PT&/FAMILY 60 MINUTES $274 $71.24 $146.32 – $208.79
Psychotherapy, 60 minutes: rates for 8 insurance plans
  • Aetna — Commercial: $208.79
  • Aetna — MCR Advantage: $146.32
  • Anthem — Commercial: $178.10
  • Anthem — Enhanced Pathways: $178.10
  • CHO — Commercial: $178.10
  • Cigna — Commercial: $204.40
  • Harvard — Commercial: $192.73
  • UHC — Commercial: $196.29
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH FAM PSYTX W/O PT 50 MIN $718 $186.68 $383.41 – $547.12
Family psychotherapy, without the patient: rates for 8 insurance plans
  • Aetna — Commercial: $547.12
  • Aetna — MCR Advantage: $383.41
  • Anthem — Commercial: $466.70
  • Anthem — Enhanced Pathways: $466.70
  • CHO — Commercial: $466.70
  • Cigna — Commercial: $535.63
  • Harvard — Commercial: $505.04
  • UHC — Commercial: $514.38
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYTX W/O PT 50 MIN $516 $134.16 $275.54 – $393.19
Family psychotherapy, without the patient: rates for 8 insurance plans
  • Aetna — Commercial: $393.19
  • Aetna — MCR Advantage: $275.54
  • Anthem — Commercial: $335.40
  • Anthem — Enhanced Pathways: $335.40
  • CHO — Commercial: $335.40
  • Cigna — Commercial: $384.94
  • Harvard — Commercial: $362.95
  • UHC — Commercial: $369.66
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF FAMILY PSYTX W/O PT 50 MIN $202 $52.52 $107.87 – $153.92
Family psychotherapy, without the patient: rates for 8 insurance plans
  • Aetna — Commercial: $153.92
  • Aetna — MCR Advantage: $107.87
  • Anthem — Commercial: $131.30
  • Anthem — Enhanced Pathways: $131.30
  • CHO — Commercial: $131.30
  • Cigna — Commercial: $150.69
  • Harvard — Commercial: $142.09
  • UHC — Commercial: $144.71
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RH BH FAMILY PSYTX W/PT 50 MIN $1,019 $264.94 $544.15 – $776.48
Family psychotherapy, with the patient: rates for 8 insurance plans
  • Aetna — Commercial: $776.48
  • Aetna — MCR Advantage: $544.15
  • Anthem — Commercial: $662.35
  • Anthem — Enhanced Pathways: $662.35
  • CHO — Commercial: $662.35
  • Cigna — Commercial: $760.17
  • Harvard — Commercial: $716.76
  • UHC — Commercial: $730.01
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Doctor (professional) fee In the file: RH BH FAMILY PSYTX W/PT 50 MIN $1,019 $264.94 $662.35 – $760.17
Family psychotherapy, with the patient: rates for 6 insurance plans
  • Aetna — Commercial: $741.83
  • Anthem — Commercial: $662.35
  • Anthem — Enhanced Pathways: $662.35
  • CHO — Commercial: $662.35
  • Cigna — Commercial: $760.17
  • UHC — Commercial: $714.32
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Family psytx w/pt 50 min Not listed in the file Not listed in the file $102.01 – $223.51
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna — Commercial: $176.44
  • Aetna — MCR Advantage: $106.11
  • Anthem — Commercial: $198.93
  • Anthem — Enhanced Pathways: $198.93
  • Anthem — MCR Advantage: $102.01
  • CHO — Commercial: $176.44
  • Cigna — Commercial: $218.08
  • Harvard — Commercial: $223.51
  • Martin's Point — MCR Advantage: $104.05
  • UHC — Commercial: $182.12
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY GROUP $201 $52.26 $107.33 – $153.16
Group psychotherapy: rates for 8 insurance plans
  • Aetna — Commercial: $153.16
  • Aetna — MCR Advantage: $107.33
  • Anthem — Commercial: $130.65
  • Anthem — Enhanced Pathways: $130.65
  • CHO — Commercial: $130.65
  • Cigna — Commercial: $149.95
  • Harvard — Commercial: $141.38
  • UHC — Commercial: $144
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF GROUP PSYCHOTHERAPY $92 $23.92 $49.13 – $70.10
Group psychotherapy: rates for 8 insurance plans
  • Aetna — Commercial: $70.10
  • Aetna — MCR Advantage: $49.13
  • Anthem — Commercial: $59.80
  • Anthem — Enhanced Pathways: $59.80
  • CHO — Commercial: $59.80
  • Cigna — Commercial: $68.63
  • Harvard — Commercial: $64.71
  • UHC — Commercial: $65.91
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY GROUP $201 $52.26 $130.65 – $149.95
Group psychotherapy: rates for 6 insurance plans
  • Aetna — Commercial: $146.33
  • Anthem — Commercial: $130.65
  • Anthem — Enhanced Pathways: $130.65
  • CHO — Commercial: $130.65
  • Cigna — Commercial: $149.95
  • UHC — Commercial: $140.90

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 1+ $7,159 $1,861.34 $3,822.91 – $5,455.16
Removal of breast growth (open surgery): rates for 8 insurance plans
  • Aetna — Commercial: $5,455.16
  • Aetna — MCR Advantage: $3,822.91
  • Anthem — Commercial: $4,653.35
  • Anthem — Enhanced Pathways: $4,653.35
  • CHO — Commercial: $4,653.35
  • Cigna — Commercial: $5,340.61
  • Harvard — Commercial: $5,035.64
  • UHC — Commercial: $5,128.71
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC REMOVAL OF BREAST LESION 1+ $7,159 $1,861.34 $3,822.91 – $5,455.16
Removal of breast growth (open surgery): rates for 8 insurance plans
  • Aetna — Commercial: $5,455.16
  • Aetna — MCR Advantage: $3,822.91
  • Anthem — Commercial: $4,653.35
  • Anthem — Enhanced Pathways: $4,653.35
  • CHO — Commercial: $4,653.35
  • Cigna — Commercial: $5,340.61
  • Harvard — Commercial: $5,035.64
  • UHC — Commercial: $5,128.71
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC REMOVAL OF BREAST LESION $6,488 $1,686.88 $3,464.59 – $4,943.86
Removal of breast growth (open surgery): rates for 8 insurance plans
  • Aetna — Commercial: $4,943.86
  • Aetna — MCR Advantage: $3,464.59
  • Anthem — Commercial: $4,217.20
  • Anthem — Enhanced Pathways: $4,217.20
  • CHO — Commercial: $4,217.20
  • Cigna — Commercial: $4,840.05
  • Harvard — Commercial: $4,563.66
  • UHC — Commercial: $4,648
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF TOTAL HIP ARTHROPLASTY $3,308 $860.08 $1,766.47 – $2,520.70
Total hip replacement: rates for 8 insurance plans
  • Aetna — Commercial: $2,520.70
  • Aetna — MCR Advantage: $1,766.47
  • Anthem — Commercial: $2,150.20
  • Anthem — Enhanced Pathways: $2,150.20
  • CHO — Commercial: $2,150.20
  • Cigna — Commercial: $2,467.77
  • Harvard — Commercial: $2,326.85
  • UHC — Commercial: $2,369.85
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF TOTAL HIP ARTHROPLASTY $3,308 $860.08 $2,150.20 – $2,467.77
Total hip replacement: rates for 6 insurance plans
  • Aetna — Commercial: $2,408.22
  • Anthem — Commercial: $2,150.20
  • Anthem — Enhanced Pathways: $2,150.20
  • CHO — Commercial: $2,150.20
  • Cigna — Commercial: $2,467.77
  • UHC — Commercial: $2,318.91
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 $12,565.74 – $69,695.45
Total hip replacement: rates for 10 insurance plans
  • Aetna — MCR Advantage: $12,817.05
  • Anthem — Commercial: $59,238.25
  • Anthem — Enhanced Pathways: $46,205.83
  • Anthem — MCR Advantage: $12,565.74
  • CHO — Commercial: $49,257.69
  • Cigna — Commercial: $69,695.45
  • Martin's Point — MCR Advantage: $12,817.05
  • UHC — MCR Advantage: $12,817.05
  • Wellcare — MCR Advantage: $12,817.05
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF TOTAL KNEE ARTHROPLASTY $2,772 $720.72 $1,480.25 – $2,112.26
Total knee replacement: rates for 8 insurance plans
  • Aetna — Commercial: $2,112.26
  • Aetna — MCR Advantage: $1,480.25
  • Anthem — Commercial: $1,801.80
  • Anthem — Enhanced Pathways: $1,801.80
  • CHO — Commercial: $1,801.80
  • Cigna — Commercial: $2,067.91
  • Harvard — Commercial: $1,949.82
  • UHC — Commercial: $1,985.86
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF TOTAL KNEE ARTHROPLASTY $2,772 $720.72 $1,801.80 – $2,067.91
Total knee replacement: rates for 6 insurance plans
  • Aetna — Commercial: $2,018.02
  • Anthem — Commercial: $1,801.80
  • Anthem — Enhanced Pathways: $1,801.80
  • CHO — Commercial: $1,801.80
  • Cigna — Commercial: $2,067.91
  • UHC — Commercial: $1,943.17
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 $12,565.74 – $69,695.45
Total knee replacement: rates for 10 insurance plans
  • Aetna — MCR Advantage: $12,817.05
  • Anthem — Commercial: $59,238.25
  • Anthem — Enhanced Pathways: $46,205.83
  • Anthem — MCR Advantage: $12,565.74
  • CHO — Commercial: $49,257.69
  • Cigna — Commercial: $69,695.45
  • Martin's Point — MCR Advantage: $12,817.05
  • UHC — MCR Advantage: $12,817.05
  • Wellcare — MCR Advantage: $12,817.05
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF SHLDR ARTHROSCOP/SURG SPACE $512 $133.12 $273.41 – $390.14
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans
  • Aetna — Commercial: $390.14
  • Aetna — MCR Advantage: $273.41
  • Anthem — Commercial: $332.80
  • Anthem — Enhanced Pathways: $332.80
  • CHO — Commercial: $332.80
  • Cigna — Commercial: $381.95
  • Harvard — Commercial: $360.14
  • UHC — Commercial: $366.80
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF SHLDR ARTHROSCOP/SURG SPACE $512 $133.12 $332.80 – $381.95
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • Aetna — Commercial: $372.74
  • Anthem — Commercial: $332.80
  • Anthem — Enhanced Pathways: $332.80
  • CHO — Commercial: $332.80
  • Cigna — Commercial: $381.95
  • UHC — Commercial: $358.91
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $272.14 – $323.17
Shoulder arthroscopy: shaving of shoulder bone: rates for 3 insurance plans
  • Anthem — Commercial: $323.17
  • Anthem — Enhanced Pathways: $323.17
  • CHO — Commercial: $272.14
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF KNEE ARTH/SRG W MEN/DEB SHV $1,583 $411.58 $845.32 – $1,206.25
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans
  • Aetna — Commercial: $1,206.25
  • Aetna — MCR Advantage: $845.32
  • Anthem — Commercial: $1,028.95
  • Anthem — Enhanced Pathways: $1,028.95
  • CHO — Commercial: $1,028.95
  • Cigna — Commercial: $1,180.92
  • Harvard — Commercial: $1,113.48
  • UHC — Commercial: $1,134.06
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF KNEE ARTH/SRG W MEN/DEB SHV $1,583 $411.58 $1,028.95 – $1,180.92
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans
  • Aetna — Commercial: $1,152.42
  • Anthem — Commercial: $1,028.95
  • Anthem — Enhanced Pathways: $1,028.95
  • CHO — Commercial: $1,028.95
  • Cigna — Commercial: $1,180.92
  • UHC — Commercial: $1,109.68
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs kne srg mnisectmy m/l Not listed in the file Not listed in the file $3,168.69 – $17,575.02
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 10 insurance plans
  • Aetna — MCR Advantage: $3,232.06
  • Anthem — Commercial: $14,938.04
  • Anthem — Enhanced Pathways: $11,651.67
  • Anthem — MCR Advantage: $3,168.69
  • CHO — Commercial: $12,421.25
  • Cigna — Commercial: $17,575.02
  • Martin's Point — MCR Advantage: $3,232.06
  • UHC — MCR Advantage: $3,232.06
  • Wellcare — MCR Advantage: $3,232.06
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF REMOVE TONSILS AND ADENOIDS $1,046 $271.96 $558.56 – $797.05
Removal of tonsils and adenoids (under age 12): rates for 8 insurance plans
  • Aetna — Commercial: $797.05
  • Aetna — MCR Advantage: $558.56
  • Anthem — Commercial: $679.90
  • Anthem — Enhanced Pathways: $679.90
  • CHO — Commercial: $679.90
  • Cigna — Commercial: $780.32
  • Harvard — Commercial: $735.76
  • UHC — Commercial: $749.35
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF REMOVE TONSILS AND ADENOIDS $1,046 $271.96 $679.90 – $780.32
Removal of tonsils and adenoids (under age 12): rates for 6 insurance plans
  • Aetna — Commercial: $761.49
  • Anthem — Commercial: $679.90
  • Anthem — Enhanced Pathways: $679.90
  • CHO — Commercial: $679.90
  • Cigna — Commercial: $780.32
  • UHC — Commercial: $733.25
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 $5,777.23 – $32,043.23
Removal of tonsils and adenoids (under age 12): rates for 10 insurance plans
  • Aetna — MCR Advantage: $5,892.78
  • Anthem — Commercial: $27,235.42
  • Anthem — Enhanced Pathways: $21,243.63
  • Anthem — MCR Advantage: $5,777.23
  • CHO — Commercial: $22,646.75
  • Cigna — Commercial: $32,043.23
  • Martin's Point — MCR Advantage: $5,892.78
  • UHC — MCR Advantage: $5,892.78
  • Wellcare — MCR Advantage: $5,892.78
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EGD DIAGNOSTIC BRUSH WASH $618 $160.68 $330.01 – $470.92
Upper GI endoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $470.92
  • Aetna — MCR Advantage: $330.01
  • Anthem — Commercial: $401.70
  • Anthem — Enhanced Pathways: $401.70
  • CHO — Commercial: $401.70
  • Cigna — Commercial: $461.03
  • Harvard — Commercial: $434.70
  • UHC — Commercial: $442.74
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD FLX TRNSORL DX BRUSH/WASH $4,096 $1,064.96 $2,187.26 – $3,121.15
Upper GI endoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $3,121.15
  • Aetna — MCR Advantage: $2,187.26
  • Anthem — Commercial: $2,662.40
  • Anthem — Enhanced Pathways: $2,662.40
  • CHO — Commercial: $2,662.40
  • Cigna — Commercial: $3,055.62
  • Harvard — Commercial: $2,881.13
  • UHC — Commercial: $2,934.37
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF EGD DIAGNOSTIC BRUSH WASH $618 $160.68 $330.01 – $470.92
Upper GI endoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $470.92
  • Aetna — MCR Advantage: $330.01
  • Anthem — Commercial: $401.70
  • Anthem — Enhanced Pathways: $401.70
  • CHO — Commercial: $401.70
  • Cigna — Commercial: $461.03
  • Harvard — Commercial: $434.70
  • UHC — Commercial: $442.74
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD FLX TRNSORL BIOPSY(S) $4,626 $1,202.76 $2,470.28 – $3,525.01
Upper GI endoscopy with biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $3,525.01
  • Aetna — MCR Advantage: $2,470.28
  • Anthem — Commercial: $3,006.90
  • Anthem — Enhanced Pathways: $3,006.90
  • CHO — Commercial: $3,006.90
  • Cigna — Commercial: $3,451
  • Harvard — Commercial: $3,253.93
  • UHC — Commercial: $3,314.07
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF EGD BIOPSY SINGLE/MULTIPLE $814 $211.64 $434.68 – $620.27
Upper GI endoscopy with biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $620.27
  • Aetna — MCR Advantage: $434.68
  • Anthem — Commercial: $529.10
  • Anthem — Enhanced Pathways: $529.10
  • CHO — Commercial: $529.10
  • Cigna — Commercial: $607.24
  • Harvard — Commercial: $572.57
  • UHC — Commercial: $583.15
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD FLX TRNSORL BIOPSY(S) $4,626 $1,202.76 $3,006.90 – $3,451
Upper GI endoscopy with biopsy: rates for 6 insurance plans
  • Aetna — Commercial: $3,367.73
  • Anthem — Commercial: $3,006.90
  • Anthem — Enhanced Pathways: $3,006.90
  • CHO — Commercial: $3,006.90
  • Cigna — Commercial: $3,451
  • UHC — Commercial: $3,242.83
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLEXIBLE DX $4,661 $1,211.86 $2,488.97 – $3,551.68
Colonoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $3,551.68
  • Aetna — MCR Advantage: $2,488.97
  • Anthem — Commercial: $3,029.65
  • Anthem — Enhanced Pathways: $3,029.65
  • CHO — Commercial: $3,029.65
  • Cigna — Commercial: $3,477.11
  • Harvard — Commercial: $3,278.55
  • UHC — Commercial: $3,339.14
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY FLEX DX NOT HI $1,097 $285.22 $585.80 – $835.91
Colonoscopy (diagnostic): rates for 8 insurance plans
  • Aetna — Commercial: $835.91
  • Aetna — MCR Advantage: $585.80
  • Anthem — Commercial: $713.05
  • Anthem — Enhanced Pathways: $713.05
  • CHO — Commercial: $713.05
  • Cigna — Commercial: $818.36
  • Harvard — Commercial: $771.63
  • UHC — Commercial: $785.89
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY FLEXIBLE DX $4,661 $1,211.86 $3,029.65 – $3,477.11
Colonoscopy (diagnostic): rates for 6 insurance plans
  • Aetna — Commercial: $3,393.21
  • Anthem — Commercial: $3,029.65
  • Anthem — Enhanced Pathways: $3,029.65
  • CHO — Commercial: $3,029.65
  • Cigna — Commercial: $3,477.11
  • UHC — Commercial: $3,267.36
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLEX W BX(S) $6,017 $1,564.42 $3,213.08 – $4,584.95
Colonoscopy with biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $4,584.95
  • Aetna — MCR Advantage: $3,213.08
  • Anthem — Commercial: $3,911.05
  • Anthem — Enhanced Pathways: $3,911.05
  • CHO — Commercial: $3,911.05
  • Cigna — Commercial: $4,488.68
  • Harvard — Commercial: $4,232.36
  • UHC — Commercial: $4,310.58
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY BX SGL/MULTI $931 $242.06 $497.15 – $709.42
Colonoscopy with biopsy: rates for 8 insurance plans
  • Aetna — Commercial: $709.42
  • Aetna — MCR Advantage: $497.15
  • Anthem — Commercial: $605.15
  • Anthem — Enhanced Pathways: $605.15
  • CHO — Commercial: $605.15
  • Cigna — Commercial: $694.53
  • Harvard — Commercial: $654.87
  • UHC — Commercial: $666.97
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY FLEX W BX(S) $6,017 $1,564.42 $3,911.05 – $4,488.68
Colonoscopy with biopsy: rates for 6 insurance plans
  • Aetna — Commercial: $4,380.38
  • Anthem — Commercial: $3,911.05
  • Anthem — Enhanced Pathways: $3,911.05
  • CHO — Commercial: $3,911.05
  • Cigna — Commercial: $4,488.68
  • UHC — Commercial: $4,217.92
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W REMV LESN SNARE $5,291 $1,375.66 $2,825.39 – $4,031.74
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans
  • Aetna — Commercial: $4,031.74
  • Aetna — MCR Advantage: $2,825.39
  • Anthem — Commercial: $3,439.15
  • Anthem — Enhanced Pathways: $3,439.15
  • CHO — Commercial: $3,439.15
  • Cigna — Commercial: $3,947.09
  • Harvard — Commercial: $3,721.69
  • UHC — Commercial: $3,790.47
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CLNSCPY FLX REM LES SNARE $999 $259.74 $533.47 – $761.24
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans
  • Aetna — Commercial: $761.24
  • Aetna — MCR Advantage: $533.47
  • Anthem — Commercial: $649.35
  • Anthem — Enhanced Pathways: $649.35
  • CHO — Commercial: $649.35
  • Cigna — Commercial: $745.25
  • Harvard — Commercial: $702.70
  • UHC — Commercial: $715.68
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W REMV LESN SNARE $5,291 $1,375.66 $3,439.15 – $3,947.09
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • Aetna — Commercial: $3,851.85
  • Anthem — Commercial: $3,439.15
  • Anthem — Enhanced Pathways: $3,439.15
  • CHO — Commercial: $3,439.15
  • Cigna — Commercial: $3,947.09
  • UHC — Commercial: $3,708.99
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLONOSCOPY W/ENDOSCOPE US $723 $187.98 $386.08 – $550.93
Ultrasound of the lower bowel by endoscope: rates for 8 insurance plans
  • Aetna — Commercial: $550.93
  • Aetna — MCR Advantage: $386.08
  • Anthem — Commercial: $469.95
  • Anthem — Enhanced Pathways: $469.95
  • CHO — Commercial: $469.95
  • Cigna — Commercial: $539.36
  • Harvard — Commercial: $508.56
  • UHC — Commercial: $517.96
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF COLONOSCOPY W/ENDOSCOPE US $723 $187.98 $469.95 – $539.36
Ultrasound of the lower bowel by endoscope: rates for 6 insurance plans
  • Aetna — Commercial: $526.34
  • Anthem — Commercial: $469.95
  • Anthem — Enhanced Pathways: $469.95
  • CHO — Commercial: $469.95
  • Cigna — Commercial: $539.36
  • UHC — Commercial: $506.82
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $241.09 – $556.23
Ultrasound of the lower bowel by endoscope: 10 of 12 insurance plan rates
  • Aetna — Commercial: $408.12
  • Aetna — MCR Advantage: $312.16
  • Anthem — Commercial: $477.55
  • Anthem — Enhanced Pathways: $477.55
  • Anthem — MCR Advantage: $241.09
  • CHO — Commercial: $408.12
  • Cigna — Commercial: $553.58
  • Harvard — Commercial: $556.23
  • Martin's Point — MCR Advantage: $245.91
  • UHC — Commercial: $458.43
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF COLON CA SCR NOT HI RSK IND $1,097 $285.22 $585.80 – $835.91
Screening colonoscopy (not high risk): rates for 8 insurance plans
  • Aetna — Commercial: $835.91
  • Aetna — MCR Advantage: $585.80
  • Anthem — Commercial: $713.05
  • Anthem — Enhanced Pathways: $713.05
  • CHO — Commercial: $713.05
  • Cigna — Commercial: $818.36
  • Harvard — Commercial: $771.63
  • UHC — Commercial: $785.89
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONSCOPY SCREEN NON HI RISK $3,857 $1,002.82 $2,059.64 – $2,939.03
Screening colonoscopy (not high risk): rates for 8 insurance plans
  • Aetna — Commercial: $2,939.03
  • Aetna — MCR Advantage: $2,059.64
  • Anthem — Commercial: $2,507.05
  • Anthem — Enhanced Pathways: $2,507.05
  • CHO — Commercial: $2,507.05
  • Cigna — Commercial: $2,877.32
  • Harvard — Commercial: $2,713.01
  • UHC — Commercial: $2,763.15
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF COLON CA SCR NOT HI RSK IND $1,097 $285.22 $713.05 – $818.36
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • Aetna — Commercial: $798.62
  • Anthem — Commercial: $713.05
  • Anthem — Enhanced Pathways: $713.05
  • CHO — Commercial: $713.05
  • Cigna — Commercial: $818.36
  • UHC — Commercial: $769
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF LAPAROSCOPIC CHOLECYST $1,410 $366.60 $752.94 – $1,074.42
Gallbladder removal by laparoscope: rates for 8 insurance plans
  • Aetna — Commercial: $1,074.42
  • Aetna — MCR Advantage: $752.94
  • Anthem — Commercial: $916.50
  • Anthem — Enhanced Pathways: $916.50
  • CHO — Commercial: $916.50
  • Cigna — Commercial: $1,051.86
  • Harvard — Commercial: $991.79
  • UHC — Commercial: $1,010.12
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF LAPAROSCOPIC CHOLECYST $1,410 $366.60 $916.50 – $1,051.86
Gallbladder removal by laparoscope: rates for 6 insurance plans
  • Aetna — Commercial: $1,026.48
  • Anthem — Commercial: $916.50
  • Anthem — Enhanced Pathways: $916.50
  • CHO — Commercial: $916.50
  • Cigna — Commercial: $1,051.86
  • UHC — Commercial: $988.41
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 $5,697.84 – $31,602.88
Gallbladder removal by laparoscope: rates for 10 insurance plans
  • Aetna — MCR Advantage: $5,811.80
  • Anthem — Commercial: $26,861.14
  • Anthem — Enhanced Pathways: $20,951.69
  • Anthem — MCR Advantage: $5,697.84
  • CHO — Commercial: $22,335.53
  • Cigna — Commercial: $31,602.88
  • Martin's Point — MCR Advantage: $5,811.80
  • UHC — MCR Advantage: $5,811.80
  • Wellcare — MCR Advantage: $5,811.80
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF PRP I/HERN INIT REDUC >5 YR $1,120 $291.20 $598.08 – $853.44
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans
  • Aetna — Commercial: $853.44
  • Aetna — MCR Advantage: $598.08
  • Anthem — Commercial: $728
  • Anthem — Enhanced Pathways: $728
  • CHO — Commercial: $728
  • Cigna — Commercial: $835.52
  • Harvard — Commercial: $787.81
  • UHC — Commercial: $802.37
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF PRP I/HERN INIT REDUC >5 YR $1,120 $291.20 $728 – $835.52
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans
  • Aetna — Commercial: $815.36
  • Anthem — Commercial: $728
  • Anthem — Enhanced Pathways: $728
  • CHO — Commercial: $728
  • Cigna — Commercial: $835.52
  • UHC — Commercial: $785.12
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 $3,446.48 – $19,115.79
Groin (inguinal) hernia repair, age 5 or older: rates for 10 insurance plans
  • Aetna — MCR Advantage: $3,515.41
  • Anthem — Commercial: $16,247.63
  • Anthem — Enhanced Pathways: $12,673.15
  • Anthem — MCR Advantage: $3,446.48
  • CHO — Commercial: $13,510.20
  • Cigna — Commercial: $19,115.79
  • Martin's Point — MCR Advantage: $3,515.41
  • UHC — MCR Advantage: $3,515.41
  • Wellcare — MCR Advantage: $3,515.41
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $122.05 – $282.88
Prostate biopsy: 10 of 12 insurance plan rates
  • Aetna — Commercial: $207.48
  • Aetna — MCR Advantage: $130.05
  • Anthem — Commercial: $242.23
  • Anthem — Enhanced Pathways: $242.23
  • Anthem — MCR Advantage: $122.05
  • CHO — Commercial: $207.48
  • Cigna — Commercial: $276.67
  • Harvard — Commercial: $282.88
  • Martin's Point — MCR Advantage: $124.49
  • UHC — Commercial: $238.89
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $2,000.57 – $11,096.10
Prostate biopsy: rates for 10 insurance plans
  • Aetna — MCR Advantage: $2,040.58
  • Anthem — Commercial: $9,431.23
  • Anthem — Enhanced Pathways: $7,356.36
  • Anthem — MCR Advantage: $2,000.57
  • CHO — Commercial: $7,842.24
  • Cigna — Commercial: $11,096.10
  • Martin's Point — MCR Advantage: $2,040.58
  • UHC — MCR Advantage: $2,040.58
  • Wellcare — MCR Advantage: $2,040.58
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $10,167.60 – $56,394.26
Prostate removal by laparoscope (radical prostatectomy): rates for 10 insurance plans
  • Aetna — MCR Advantage: $10,370.95
  • Anthem — Commercial: $47,932.78
  • Anthem — Enhanced Pathways: $37,387.57
  • Anthem — MCR Advantage: $10,167.60
  • CHO — Commercial: $39,856.99
  • Cigna — Commercial: $56,394.26
  • Martin's Point — MCR Advantage: $10,370.95
  • UHC — MCR Advantage: $10,370.95
  • Wellcare — MCR Advantage: $10,370.95
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $1,917.95 – $2,244.02
Prostate removal by laparoscope (radical prostatectomy): rates for 3 insurance plans
  • Anthem — Commercial: $2,244.02
  • Anthem — Enhanced Pathways: $2,244.02
  • CHO — Commercial: $1,917.95
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $938.17 – $2,553.87
Prostate removal by laparoscope (radical prostatectomy): rates for 9 insurance plans
  • Aetna — Commercial: $1,591.90
  • Aetna — MCR Advantage: $1,193.76
  • Anthem — MCR Advantage: $938.17
  • Cigna — Commercial: $2,553.87
  • Harvard — Commercial: $2,161.16
  • Martin's Point — MCR Advantage: $956.93
  • UHC — Commercial: $1,981.05
  • UHC — MCR Advantage: $956.93
  • Wellcare — MCR Advantage: $956.93
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HYSTEROSCOPY BIOPSY $6,113 $1,589.38 $3,264.34 – $4,658.11
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans
  • Aetna — Commercial: $4,658.11
  • Aetna — MCR Advantage: $3,264.34
  • Anthem — Commercial: $3,973.45
  • Anthem — Enhanced Pathways: $3,973.45
  • CHO — Commercial: $3,973.45
  • Cigna — Commercial: $4,560.30
  • Harvard — Commercial: $4,299.88
  • UHC — Commercial: $4,379.35
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF HYSTEROSCOPY BIOPSY $1,405 $365.30 $750.27 – $1,070.61
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans
  • Aetna — Commercial: $1,070.61
  • Aetna — MCR Advantage: $750.27
  • Anthem — Commercial: $913.25
  • Anthem — Enhanced Pathways: $913.25
  • CHO — Commercial: $913.25
  • Cigna — Commercial: $1,048.13
  • Harvard — Commercial: $988.28
  • UHC — Commercial: $1,006.54
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HYSTEROSCOPY BIOPSY $6,113 $1,589.38 $3,973.45 – $4,560.30
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans
  • Aetna — Commercial: $4,450.26
  • Anthem — Commercial: $3,973.45
  • Anthem — Enhanced Pathways: $3,973.45
  • CHO — Commercial: $3,973.45
  • Cigna — Commercial: $4,560.30
  • UHC — Commercial: $4,285.21
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTRLMINR LMBR/SAC W IMAG $2,263 $588.38 $1,208.44 – $1,724.41
Spinal injection, lower back (epidural), with imaging guidance: rates for 8 insurance plans
  • Aetna — Commercial: $1,724.41
  • Aetna — MCR Advantage: $1,208.44
  • Anthem — Commercial: $1,470.95
  • Anthem — Enhanced Pathways: $1,470.95
  • CHO — Commercial: $1,470.95
  • Cigna — Commercial: $1,688.20
  • Harvard — Commercial: $1,591.79
  • UHC — Commercial: $1,621.21
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF NJX INTRLMINR LMBR/SAC W $263 $68.38 $140.44 – $200.41
Spinal injection, lower back (epidural), with imaging guidance: rates for 8 insurance plans
  • Aetna — Commercial: $200.41
  • Aetna — MCR Advantage: $140.44
  • Anthem — Commercial: $170.95
  • Anthem — Enhanced Pathways: $170.95
  • CHO — Commercial: $170.95
  • Cigna — Commercial: $196.20
  • Harvard — Commercial: $184.99
  • UHC — Commercial: $188.41
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX INTRLMINR LMBR/SAC W IMAG $2,263 $588.38 $1,470.95 – $1,688.20
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans
  • Aetna — Commercial: $1,647.46
  • Anthem — Commercial: $1,470.95
  • Anthem — Enhanced Pathways: $1,470.95
  • CHO — Commercial: $1,470.95
  • Cigna — Commercial: $1,688.20
  • UHC — Commercial: $1,586.36
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ A/S TRN EPI W IMG L/S SGL $4,474 $1,163.24 $2,389.12 – $3,409.19
Nerve root injection, lower back, with imaging guidance: rates for 8 insurance plans
  • Aetna — Commercial: $3,409.19
  • Aetna — MCR Advantage: $2,389.12
  • Anthem — Commercial: $2,908.10
  • Anthem — Enhanced Pathways: $2,908.10
  • CHO — Commercial: $2,908.10
  • Cigna — Commercial: $3,337.60
  • Harvard — Commercial: $3,147.01
  • UHC — Commercial: $3,205.17
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF INJ A/S TRN EPI W L/S SGL $526 $136.76 $280.88 – $400.81
Nerve root injection, lower back, with imaging guidance: rates for 8 insurance plans
  • Aetna — Commercial: $400.81
  • Aetna — MCR Advantage: $280.88
  • Anthem — Commercial: $341.90
  • Anthem — Enhanced Pathways: $341.90
  • CHO — Commercial: $341.90
  • Cigna — Commercial: $392.40
  • Harvard — Commercial: $369.99
  • UHC — Commercial: $376.83
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJ A/S TRN EPI W IMG L/S SGL $4,474 $1,163.24 $2,908.10 – $3,337.60
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans
  • Aetna — Commercial: $3,257.07
  • Anthem — Commercial: $2,908.10
  • Anthem — Enhanced Pathways: $2,908.10
  • CHO — Commercial: $2,908.10
  • Cigna — Commercial: $3,337.60
  • UHC — Commercial: $3,136.27
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 $1,907.08 – $10,577.56
Carpal tunnel release: rates for 10 insurance plans
  • Aetna — MCR Advantage: $1,945.22
  • Anthem — Commercial: $8,990.48
  • Anthem — Enhanced Pathways: $7,012.58
  • Anthem — MCR Advantage: $1,907.08
  • CHO — Commercial: $7,475.75
  • Cigna — Commercial: $10,577.56
  • Martin's Point — MCR Advantage: $1,945.22
  • UHC — MCR Advantage: $1,945.22
  • Wellcare — MCR Advantage: $1,945.22
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $706.93 – $846.52
Carpal tunnel release: rates for 3 insurance plans
  • Anthem — Commercial: $846.52
  • Anthem — Enhanced Pathways: $846.52
  • CHO — Commercial: $706.93
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Carpal tunnel surgery Not listed in the file Not listed in the file $642.39 – $1,469.73
Carpal tunnel release: rates for 9 insurance plans
  • Aetna — Commercial: $1,060.40
  • Aetna — MCR Advantage: $757.16
  • Anthem — MCR Advantage: $642.39
  • Cigna — Commercial: $1,422.95
  • Harvard — Commercial: $1,469.73
  • Martin's Point — MCR Advantage: $655.24
  • UHC — Commercial: $1,067.04
  • UHC — MCR Advantage: $655.24
  • Wellcare — MCR Advantage: $655.24
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 $535.77 – $2,971.61
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans
  • Aetna — MCR Advantage: $546.48
  • Anthem — Commercial: $2,525.74
  • Anthem — Enhanced Pathways: $1,970.08
  • Anthem — MCR Advantage: $535.77
  • CHO — Commercial: $2,100.20
  • Cigna — Commercial: $2,971.61
  • Martin's Point — MCR Advantage: $546.48
  • UHC — MCR Advantage: $546.48
  • Wellcare — MCR Advantage: $546.48
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: After cataract laser surgery Not listed in the file Not listed in the file $490.67 – $579.83
Laser treatment of clouding after cataract surgery: rates for 3 insurance plans
  • Anthem — Commercial: $579.83
  • Anthem — Enhanced Pathways: $579.83
  • CHO — Commercial: $490.67
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: After cataract laser surgery Not listed in the file Not listed in the file $447.39 – $1,021.22
Laser treatment of clouding after cataract surgery: rates for 9 insurance plans
  • Aetna — Commercial: $736.01
  • Aetna — MCR Advantage: $718.52
  • Anthem — MCR Advantage: $447.39
  • Cigna — Commercial: $1,008.90
  • Harvard — Commercial: $1,021.22
  • Martin's Point — MCR Advantage: $456.34
  • UHC — Commercial: $780
  • UHC — MCR Advantage: $456.34
  • Wellcare — MCR Advantage: $456.34
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $2,227.36 – $12,353.98
Cataract removal with lens implant: rates for 10 insurance plans
  • Aetna — MCR Advantage: $2,271.91
  • Anthem — Commercial: $10,500.37
  • Anthem — Enhanced Pathways: $8,190.29
  • Anthem — MCR Advantage: $2,227.36
  • CHO — Commercial: $8,731.25
  • Cigna — Commercial: $12,353.98
  • Martin's Point — MCR Advantage: $2,271.91
  • UHC — MCR Advantage: $2,271.91
  • Wellcare — MCR Advantage: $2,271.91
  • Harvard — Commercial: 70.34% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $861.63 – $1,012.20
Cataract removal with lens implant: rates for 3 insurance plans
  • Anthem — Commercial: $1,012.20
  • Anthem — Enhanced Pathways: $1,012.20
  • CHO — Commercial: $861.63
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $778.23 – $1,774.23
Cataract removal with lens implant: rates for 9 insurance plans
  • Aetna — Commercial: $1,292.45
  • Aetna — MCR Advantage: $1,257.75
  • Anthem — MCR Advantage: $778.23
  • Cigna — Commercial: $1,752.27
  • Harvard — Commercial: $1,774.23
  • Martin's Point — MCR Advantage: $793.79
  • UHC — Commercial: $1,612.35
  • UHC — MCR Advantage: $793.79
  • Wellcare — MCR Advantage: $793.79

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF OBSTETRICAL CARE $10,446 $2,715.96 $5,578.16 – $7,959.85
Vaginal delivery, with care before and after: rates for 8 insurance plans
  • Aetna — Commercial: $7,959.85
  • Aetna — MCR Advantage: $5,578.16
  • Anthem — Commercial: $6,789.90
  • Anthem — Enhanced Pathways: $6,789.90
  • CHO — Commercial: $6,789.90
  • Cigna — Commercial: $7,792.72
  • Harvard — Commercial: $7,347.72
  • UHC — Commercial: $7,483.51
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF OBSTETRICAL CARE $10,446 $2,715.96 $6,789.90 – $7,792.72
Vaginal delivery, with care before and after: rates for 6 insurance plans
  • Aetna — Commercial: $7,604.69
  • Anthem — Commercial: $6,789.90
  • Anthem — Enhanced Pathways: $6,789.90
  • CHO — Commercial: $6,789.90
  • Cigna — Commercial: $7,792.72
  • UHC — Commercial: $7,322.65
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetrical care Not listed in the file Not listed in the file $2,253.53 – $5,349.80
Vaginal delivery, with care before and after: 10 of 12 insurance plan rates
  • Aetna — Commercial: $3,795.91
  • Aetna — MCR Advantage: $2,350
  • Anthem — Commercial: $4,569.61
  • Anthem — Enhanced Pathways: $4,569.61
  • Anthem — MCR Advantage: $2,253.53
  • CHO — Commercial: $3,795.91
  • Cigna — Commercial: $5,095.10
  • Harvard — Commercial: $5,349.80
  • Martin's Point — MCR Advantage: $2,298.60
  • UHC — Commercial: $3,491.65
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF CESAREAN DELIVERY $11,483 $2,985.58 $6,131.92 – $8,750.05
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans
  • Aetna — Commercial: $8,750.05
  • Aetna — MCR Advantage: $6,131.92
  • Anthem — Commercial: $7,463.95
  • Anthem — Enhanced Pathways: $7,463.95
  • CHO — Commercial: $7,463.95
  • Cigna — Commercial: $8,566.32
  • Harvard — Commercial: $8,077.14
  • UHC — Commercial: $8,226.42
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF CESAREAN DELIVERY $11,483 $2,985.58 $7,463.95 – $8,566.32
Cesarean delivery (C-section), with care before and after: rates for 6 insurance plans
  • Aetna — Commercial: $8,359.62
  • Anthem — Commercial: $7,463.95
  • Anthem — Enhanced Pathways: $7,463.95
  • CHO — Commercial: $7,463.95
  • Cigna — Commercial: $8,566.32
  • UHC — Commercial: $8,049.58
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $2,350 – $5,948.54
Cesarean delivery (C-section), with care before and after: 10 of 12 insurance plan rates
  • Aetna — Commercial: $4,199.58
  • Aetna — MCR Advantage: $2,350
  • Anthem — Commercial: $5,076.03
  • Anthem — Enhanced Pathways: $5,076.03
  • Anthem — MCR Advantage: $2,490.33
  • CHO — Commercial: $4,199.58
  • Cigna — Commercial: $5,601.09
  • Harvard — Commercial: $5,948.54
  • Martin's Point — MCR Advantage: $2,540.14
  • UHC — Commercial: $3,866.96
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PF VBAC DELIVERY $8,723 $2,267.98 $4,658.08 – $6,646.93
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans
  • Aetna — Commercial: $6,646.93
  • Aetna — MCR Advantage: $4,658.08
  • Anthem — Commercial: $5,669.95
  • Anthem — Enhanced Pathways: $5,669.95
  • CHO — Commercial: $5,669.95
  • Cigna — Commercial: $6,507.36
  • Harvard — Commercial: $6,135.76
  • UHC — Commercial: $6,249.16
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PF VBAC DELIVERY $8,723 $2,267.98 $5,669.95 – $6,507.36
Vaginal delivery after a previous C-section, with care before and after: rates for 6 insurance plans
  • Aetna — Commercial: $6,350.34
  • Anthem — Commercial: $5,669.95
  • Anthem — Enhanced Pathways: $5,669.95
  • CHO — Commercial: $5,669.95
  • Cigna — Commercial: $6,507.36
  • UHC — Commercial: $6,114.82
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Vbac delivery Not listed in the file Not listed in the file $2,346.78 – $5,608.49
Vaginal delivery after a previous C-section, with care before and after: 10 of 12 insurance plan rates
  • Aetna — Commercial: $3,958.13
  • Aetna — MCR Advantage: $2,350
  • Anthem — Commercial: $4,786.74
  • Anthem — Enhanced Pathways: $4,786.74
  • Anthem — MCR Advantage: $2,346.78
  • CHO — Commercial: $3,958.13
  • Cigna — Commercial: $5,301.19
  • Harvard — Commercial: $5,608.49
  • Martin's Point — MCR Advantage: $2,393.72
  • UHC — Commercial: $3,664.62

Source: Northern Light Mercy Hospital’s standard charges file (northernlighthealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 15, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address144 State Street, Portland, ME 04101
CountyCumberland County
StateMaine
Phone(207) 879‑3000
Emergency servicesYes
OwnershipVoluntary non-profit - Church
Medicare overall rating4 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number200008
Name in Medicare recordsNORTHERN LIGHT MERCY HOSPITAL
Profile levelMedicare data + hospital website
Official websitenorthernlighthealth.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 2026-11-02.

  1. Northern Light Mercy Hospital - Northern Light Mercy Hospital - Northern Light Health — northernlighthealth.org
  2. About Us - Northern Light Mercy Hospital - Northern Light Health — northernlighthealth.org