Does Ocean Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Ocean Medical Center. In a medical emergency, call 911.

Where is Ocean Medical Center?

425 Jack Martin Blvd, Brick, NJ 08724, in Ocean County, New Jersey.

What is the phone number of Ocean Medical Center?

(732) 840-2200, as listed by Medicare (CMS).

What is the Medicare star rating of Ocean Medical Center?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Ocean Medical Center for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for Ocean Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0162; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Ocean Medical Center — Phone, Address, ER & Ratings

Quick answers

Does Ocean Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Ocean Medical Center. In a medical emergency, call 911.
Where is Ocean Medical Center?: 425 Jack Martin Blvd, Brick, NJ 08724, in Ocean County, New Jersey.
What is the phone number of Ocean Medical Center?: (732) 840-2200, as listed by Medicare (CMS).
What is the Medicare star rating of Ocean Medical Center?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Ocean Medical Center for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for Ocean Medical Center under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0162; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4][5][6]

Audiology
Bariatrics
Cancer care
Children's health
Concussion and brain trauma
Emergency care
Heart care
Home health care and hospice
Internal medicine
Neurosciences
Neurological rehabilitation
Orthopedics
Palliative care
Radiology and imaging
Rehabilitation
Stroke care
Surgical services
Urology
Wound care
Behavioral health
Heart and vascular
Vascular surgery
General thoracic surgery
Critical care
Oncology
Sleep medicine

Conditions treated^[5][6]

Treatments^[4][5]

HyperArc radiosurgery
Prostate SBRT (five-treatment)
SpaceOAR Hydrogel
High-dose-rate brachytherapy for nonmelanoma skin tumors
Pluvicto
Hospital from home
Radiation therapy
Outpatient oncology infusion

Procedures^[4][5][6]

Robotic-assisted surgery (da Vinci Xi, Mazor)
Joint replacement
Endoscopy
Same-day surgery

Programs and centers^[4][5][6]

Harris Heart and Vascular Center
Jersey Coast Vascular Institute
Johnson Rehabilitation Institute
Incontinence Center
Cancer care
Heart care
Orthopedic care
Outpatient rehabilitation
Sleep center
Center for Wound Healing
Primary stroke program
Palliative care
Joint replacement program
Sepsis program

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

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center (Joint Commission)

Visiting and practical information

Parking	Ample parking in lots surrounding the hospital; bus stop for OC3 and OC4 routes^[4]

Recognition^[4][5][6]

U.S. News & World Report 2026-2027: top 3 physical rehabilitation program in New Jersey
Joint Commission accredited orthopedic program
Joint Commission Primary Stroke Center
Joint Commission disease-specific designation: joint replacement
Joint Commission disease-specific designation: palliative care
Joint Commission disease-specific designation: colon cancer surgery
Joint Commission disease-specific designation: sepsis
U.S. News & World Report top 3 Physical Rehabilitation Program in New Jersey 2026

Doctors and clinicians (1,359)

1,359 doctors and other clinicians list Ocean Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 1,335 more: the button below opens the full list.

Other emergency rooms nearby

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

Monmouth Medical Center-Southern Campus4.7 mi · Lakewood, NJ · Acute Care Hospital
Community Medical Center9.1 mi · Toms River, NJ · Acute Care Hospital
Jersey Shore University Medical Center10 mi · Neptune, NJ · Acute Care Hospital
Centrastate Medical Center15 mi · Freehold, NJ · Acute Care Hospital
Monmouth Medical Center17 mi · Long Branch, NJ · Acute Care Hospital

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

Other hospitals near Brick

Specialty Hospital of Central Jersey4.7 mi · Lakewood, NJ · Long-Term Acute Care Hospital
Saint Barnabas Behavioral Health Center6.5 mi · Toms River, NJ · Psychiatric Hospital
Encompass Health Rehab Hospital of Toms River9.2 mi · Toms River, NJ · Inpatient Rehabilitation Hospital

Hospitals in Ocean County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Complete Care at Brick LLC0.1 mi · Brick, NJ · 3 of 5 stars
Complete Care at Laurelton, LLC0.3 mi · Brick, NJ · 4 of 5 stars
Willow Springs Rehabilitation and Healthcare Cente1.1 mi · Brick, NJ · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Affinity Care of NJ, LLC2.9 mi · Brick, NJ · 3 of 5 stars
Swan Hospice3.7 mi · Lakewood, NJ · 2 of 5 stars
Holisticare Hospice of New Jersey, LLC6.9 mi · Toms River, NJ · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Hackensack Meridian at Home Ocean County1.2 mi · Brick, NJ · 3.5 of 5 stars
Visiting Nurse Association of Central Jersey Home Care and Hospice6.9 mi · Toms River, NJ · 4 of 5 stars
Hackensack Meridian at Home Monmouth County9.6 mi · Neptune, NJ · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

FKC Brick Township TCU1.2 mi · Brick, NJ
Meridian Fresenius Dialysis at Brick1.2 mi · Brick, NJ · 5 of 5 stars
FKC Brick Boulevard2.9 mi · Brick, NJ · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Seashore Surgical Institute, LLC1.2 mi · Brick, NJ
Jasper Ambulatory Surgical Center, LLC2.9 mi · Brick, NJ
Lakewood Surgery Center, LLC3.7 mi · Lakewood, NJ

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

Ohi Brick Township0.3 mi · Brick, NJ · Community health center
OHI - SBHC at Lakewood High School3.8 mi · Lakewood, NJ · Community health center
Ocean Health Initiatives Lakewood Site4.3 mi · Lakewood, NJ · Community health center

Clinics and urgent care

Summit Medical Group PA1.2 mi · Brick, NJ · Urgent care center
County Line Urgent Care LLC3.7 mi · Lakewood, NJ · Urgent care center
First Aide Healthcare LLC3.7 mi · Lakewood, NJ · Urgent care center

Pharmacies

Adhipati1.2 mi · Brick, NJ · Community/retail pharmacy
Dharmsutay LLC1.2 mi · Brick, NJ · Pharmacy
HMH Hospitals Corporation1.2 mi · Brick, NJ · Pharmacy

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 of 5 stars
Patients got help quickly from staff	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Restfulness of Environment	1 of 5 stars
Care Coordination	2 of 5 stars
Symptoms After Stay	2 of 5 stars
Rated the hospital 9 or 10 out of 10	67%National average: 72%
Would definitely recommend the hospital	69%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	71%National average: 80%
“Always” got help as soon as they wanted	57%National average: 64%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	84%National average: 86%
Room and bathroom “always” clean	71%National average: 73%
Completed surveys	2,393Response rate: 22%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.416No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.519No different from the national benchmark
Surgical site infections after colon surgery	0.286Better than the national benchmark
MRSA bloodstream infections	1.109No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	1.392No different from the national benchmark
Not reported to Medicare	Surgical site infections after abdominal hysterectomy

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	10.9%
Deaths within 30 days: heart failure patients	9.4%
Deaths within 30 days: pneumonia patients	12.9%
Deaths within 30 days: COPD patients	7.8%
Deaths within 30 days: stroke patients	10%
Serious complications (patient safety indicator PSI-90)	1.02No different from the national rate
Complications after hip or knee replacement	4.9%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	14.6%
Readmitted within 30 days: heart attack	14.4%
Readmitted within 30 days: heart failure	21.1%
Readmitted within 30 days: pneumonia	17%
Readmitted within 30 days: COPD	18.9%
Readmitted within 30 days: hip or knee replacement	6.1%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	147 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	74%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Ocean Medical Center, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	0.0162Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack	1.0350More readmissions than expected
Heart failure	0.9140Fewer readmissions than expected
Pneumonia	1.0045More readmissions than expected
COPD (chronic lung disease)	0.9619Fewer readmissions than expected
Hip or knee replacement	1.2375More readmissions than expected
No result published	Coronary bypass surgery (CABG) (not reported, or too few cases)

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score	28.67 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	38.00 out of 100
Person and community engagement (patient survey)	25.00 out of 100
Safety (infections and sepsis care)	51.67 out of 100
Efficiency and cost reduction (Medicare spending)	0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio	1.11Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

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

ER wait times in New Jersey Best hospitals in New Jersey

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as Ocean Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 87 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NMDP OFFICE OUTPATIENT NEW 30 MINUTES	$1,870	Not listed in the file	$336.60 – $1,819.88
New patient office visit (about 30–44 minutes): 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $1,589.50 AETNA — ASA: $1,464.21 AETNA — HMO: $1,683 AETNA — MANAGED MEDICAID: $121.57 AETNA — MEDICARE ADVANTAGE: $381.48 AETNA — PPO: $1,683 AMERIHEALTH — LOCAL HMO: $1,606.70 AMERIHEALTH — REGIONAL HMO: $1,819.88 BERGEN RISK — ALL PRODUCTS: $1,402.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $1,683
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$523	Not listed in the file	$94.14 – $508.98
New patient office visit (about 30–44 minutes): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $444.55 AETNA — ASA: $409.51 AETNA — HMO: $470.70 AETNA — MANAGED MEDICAID: $121.57 AETNA — MEDICARE ADVANTAGE: $106.69 AETNA — PPO: $470.70 AMERIHEALTH — LOCAL HMO: $449.36 AMERIHEALTH — REGIONAL HMO: $508.98 BERGEN RISK — ALL PRODUCTS: $392.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $470.70
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NMDP OFFICE OUTPATIENT NEW 45 MINUTES	$2,057	Not listed in the file	$292.09 – $2,001.87
New patient office visit (about 45–59 minutes): 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $1,748.45 AETNA — ASA: $1,610.63 AETNA — HMO: $1,851.30 AETNA — MANAGED MEDICAID: $292.09 AETNA — MEDICARE ADVANTAGE: $419.63 AETNA — PPO: $1,851.30 AMERIHEALTH — LOCAL HMO: $1,767.37 AMERIHEALTH — REGIONAL HMO: $2,001.87 BERGEN RISK — ALL PRODUCTS: $1,542.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $1,851.30
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$605	Not listed in the file	$85.91 – $588.79
New patient office visit (about 45–59 minutes): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $514.25 AETNA — ASA: $473.72 AETNA — HMO: $544.50 AETNA — MANAGED MEDICAID: $85.91 AETNA — MEDICARE ADVANTAGE: $123.42 AETNA — PPO: $544.50 AMERIHEALTH — LOCAL HMO: $519.82 AMERIHEALTH — REGIONAL HMO: $588.79 BERGEN RISK — ALL PRODUCTS: $453.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $544.50
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$770	Not listed in the file	$138.60 – $749.36
New patient office visit (about 60–74 minutes): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $654.50 AETNA — ASA: $602.91 AETNA — HMO: $693 AETNA — MANAGED MEDICAID: $232.21 AETNA — MEDICARE ADVANTAGE: $157.08 AETNA — PPO: $693 AMERIHEALTH — LOCAL HMO: $661.58 AMERIHEALTH — REGIONAL HMO: $749.36 BERGEN RISK — ALL PRODUCTS: $577.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $693
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$374	Not listed in the file	$67.32 – $363.98
Established patient office visit (about 20–29 minutes): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $317.90 AETNA — ASA: $292.84 AETNA — HMO: $336.60 AETNA — MANAGED MEDICAID: $84.85 AETNA — MEDICARE ADVANTAGE: $76.30 AETNA — PPO: $336.60 AMERIHEALTH — LOCAL HMO: $321.34 AMERIHEALTH — REGIONAL HMO: $363.98 BERGEN RISK — ALL PRODUCTS: $280.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $336.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$495	Not listed in the file	$89.10 – $481.73
Established patient office visit (about 30–39 minutes): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $420.75 AETNA — ASA: $387.59 AETNA — HMO: $445.50 AETNA — MANAGED MEDICAID: $122.61 AETNA — MEDICARE ADVANTAGE: $100.98 AETNA — PPO: $445.50 AMERIHEALTH — LOCAL HMO: $425.30 AMERIHEALTH — REGIONAL HMO: $481.73 BERGEN RISK — ALL PRODUCTS: $371.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $445.50
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$550	Not listed in the file	$78.10 – $535.26
Office consultation with a specialist (moderate): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $467.50 AETNA — ASA: $430.65 AETNA — HMO: $495 AETNA — MANAGED MEDICAID: $78.10 AETNA — MEDICARE ADVANTAGE: $112.20 AETNA — PPO: $495 AMERIHEALTH — LOCAL HMO: $472.56 AMERIHEALTH — REGIONAL HMO: $535.26 BERGEN RISK — ALL PRODUCTS: $412.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $495
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$825	Not listed in the file	$117.15 – $802.89
Office consultation with a specialist (moderate to high): 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $701.25 AETNA — ASA: $645.98 AETNA — HMO: $742.50 AETNA — MANAGED MEDICAID: $117.15 AETNA — MEDICARE ADVANTAGE: $168.30 AETNA — PPO: $742.50 AMERIHEALTH — LOCAL HMO: $708.84 AMERIHEALTH — REGIONAL HMO: $802.89 BERGEN RISK — ALL PRODUCTS: $618.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $742.50
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$173	Not listed in the file	$24.57 – $168.36
Preventive checkup, new patient, age 18–39: 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $147.05 AETNA — ASA: $135.46 AETNA — HMO: $155.70 AETNA — MANAGED MEDICAID: $24.57 AETNA — MEDICARE ADVANTAGE: $35.29 AETNA — PPO: $155.70 AMERIHEALTH — LOCAL HMO: $148.64 AMERIHEALTH — REGIONAL HMO: $168.36 BERGEN RISK — ALL PRODUCTS: $129.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $155.70
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$132	Not listed in the file	$18.74 – $128.46
Preventive checkup, new patient, age 40–64: 10 of 28 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $112.20 AETNA — ASA: $103.36 AETNA — HMO: $118.80 AETNA — MANAGED MEDICAID: $18.74 AETNA — MEDICARE ADVANTAGE: $26.93 AETNA — PPO: $118.80 AMERIHEALTH — LOCAL HMO: $113.41 AMERIHEALTH — REGIONAL HMO: $128.46 BERGEN RISK — ALL PRODUCTS: $99 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $118.80
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM (LEVEL 3)	$2,090	$302.61	$296.78 – $1,839.20
Emergency room visit (moderate): 10 of 37 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $1,776.50 AETNA — ASA: $1,636.47 AETNA — HMO: $2,746 AETNA — MANAGED MEDICAID: $296.78 AETNA — MEDICARE ADVANTAGE: $329.84 AETNA — PPO: $2,746 AMERIGROUP — MANAGED MEDICAID: $140 AMERIHEALTH — LOCAL HMO: $1,416 AMERIHEALTH — REGIONAL HMO: $1,599 BERGEN RISK — ALL PRODUCTS: $1,522
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT MODERATE SEVERITY MOD 25 (LEVEL 3)	$2,090	$302.61	$296.78 – $1,839.20
Emergency room visit (moderate): 10 of 37 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $1,776.50 AETNA — ASA: $1,636.47 AETNA — HMO: $2,746 AETNA — MANAGED MEDICAID: $296.78 AETNA — MEDICARE ADVANTAGE: $329.84 AETNA — PPO: $2,746 AMERIGROUP — MANAGED MEDICAID: $140 AMERIHEALTH — LOCAL HMO: $1,416 AMERIHEALTH — REGIONAL HMO: $1,599 BERGEN RISK — ALL PRODUCTS: $1,522
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM (LEVEL 4)	$3,025	$465.37	$429.55 – $2,662
Emergency room visit (moderately high): 10 of 37 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $2,571.25 AETNA — ASA: $2,368.58 AETNA — HMO: $2,934 AETNA — MANAGED MEDICAID: $429.55 AETNA — MEDICARE ADVANTAGE: $507.25 AETNA — PPO: $2,934 AMERIGROUP — MANAGED MEDICAID: $140 AMERIHEALTH — LOCAL HMO: $1,416 AMERIHEALTH — REGIONAL HMO: $1,599 BERGEN RISK — ALL PRODUCTS: $1,522
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT HIGH/URGENT SEVERITY MOD 25 (LEVEL 4)	$3,025	$465.37	$429.55 – $2,662
Emergency room visit (moderately high): 10 of 37 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $2,571.25 AETNA — ASA: $2,368.58 AETNA — HMO: $2,934 AETNA — MANAGED MEDICAID: $429.55 AETNA — MEDICARE ADVANTAGE: $507.25 AETNA — PPO: $2,934 AMERIGROUP — MANAGED MEDICAID: $140 AMERIHEALTH — LOCAL HMO: $1,416 AMERIHEALTH — REGIONAL HMO: $1,599 BERGEN RISK — ALL PRODUCTS: $1,522
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM (LEVEL 5)	$4,125	$670.04	$585.75 – $3,630
Emergency room visit (high): 10 of 37 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,506.25 AETNA — ASA: $3,229.88 AETNA — HMO: $3,144 AETNA — MANAGED MEDICAID: $585.75 AETNA — MEDICARE ADVANTAGE: $730.35 AETNA — PPO: $3,144 AMERIGROUP — MANAGED MEDICAID: $140 AMERIHEALTH — LOCAL HMO: $1,416 AMERIHEALTH — REGIONAL HMO: $1,599 BERGEN RISK — ALL PRODUCTS: $1,522
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED VISIT HIGH SEVERITY&THREAT FUNCJ MOD 25 (LEVEL 5)	$4,125	$670.04	$585.75 – $3,630
Emergency room visit (high): 10 of 37 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,506.25 AETNA — ASA: $3,229.88 AETNA — HMO: $3,144 AETNA — MANAGED MEDICAID: $585.75 AETNA — MEDICARE ADVANTAGE: $730.35 AETNA — PPO: $3,144 AMERIGROUP — MANAGED MEDICAID: $140 AMERIHEALTH — LOCAL HMO: $1,416 AMERIHEALTH — REGIONAL HMO: $1,599 BERGEN RISK — ALL PRODUCTS: $1,522

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: I-STAT CHEM 8 PANEL	$187	$8.46	$26.55 – $181.99
Basic metabolic panel (blood test): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $158.95 AETNA — ASA: $146.42 AETNA — HMO: $128.66 AETNA — MANAGED MEDICAID: $26.55 AETNA — MEDICARE ADVANTAGE: $9.22 AETNA — PPO: $128.66 AMERIGROUP — MANAGED MEDICAID: $8.46 AMERIHEALTH — LOCAL HMO: $160.67 AMERIHEALTH — REGIONAL HMO: $181.99 BERGEN RISK — ALL PRODUCTS: $140.25
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$187	$8.46	$26.55 – $181.99
Basic metabolic panel (blood test): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $158.95 AETNA — ASA: $146.42 AETNA — HMO: $128.66 AETNA — MANAGED MEDICAID: $26.55 AETNA — MEDICARE ADVANTAGE: $9.22 AETNA — PPO: $128.66 AMERIGROUP — MANAGED MEDICAID: $8.46 AMERIHEALTH — LOCAL HMO: $160.67 AMERIHEALTH — REGIONAL HMO: $181.99 BERGEN RISK — ALL PRODUCTS: $140.25
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL DIABETIC	$187	$8.46	$26.55 – $181.99
Basic metabolic panel (blood test): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $158.95 AETNA — ASA: $146.42 AETNA — HMO: $128.66 AETNA — MANAGED MEDICAID: $26.55 AETNA — MEDICARE ADVANTAGE: $9.22 AETNA — PPO: $128.66 AMERIGROUP — MANAGED MEDICAID: $8.46 AMERIHEALTH — LOCAL HMO: $160.67 AMERIHEALTH — REGIONAL HMO: $181.99 BERGEN RISK — ALL PRODUCTS: $140.25
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$341	$10.56	$48.42 – $331.86
Comprehensive metabolic panel (blood test): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $289.85 AETNA — ASA: $267 AETNA — HMO: $234.61 AETNA — MANAGED MEDICAID: $48.42 AETNA — MEDICARE ADVANTAGE: $11.51 AETNA — PPO: $234.61 AMERIGROUP — MANAGED MEDICAID: $10.56 AMERIHEALTH — LOCAL HMO: $292.99 AMERIHEALTH — REGIONAL HMO: $331.86 BERGEN RISK — ALL PRODUCTS: $255.75
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL DIABETIC	$341	$10.56	$48.42 – $331.86
Comprehensive metabolic panel (blood test): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $289.85 AETNA — ASA: $267 AETNA — HMO: $234.61 AETNA — MANAGED MEDICAID: $48.42 AETNA — MEDICARE ADVANTAGE: $11.51 AETNA — PPO: $234.61 AMERIGROUP — MANAGED MEDICAID: $10.56 AMERIHEALTH — LOCAL HMO: $292.99 AMERIHEALTH — REGIONAL HMO: $331.86 BERGEN RISK — ALL PRODUCTS: $255.75
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMP METABOLIC CMP	$341	$10.56	$48.42 – $331.86
Comprehensive metabolic panel (blood test): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $289.85 AETNA — ASA: $267 AETNA — HMO: $234.61 AETNA — MANAGED MEDICAID: $48.42 AETNA — MEDICARE ADVANTAGE: $11.51 AETNA — PPO: $234.61 AMERIGROUP — MANAGED MEDICAID: $10.56 AMERIHEALTH — LOCAL HMO: $292.99 AMERIHEALTH — REGIONAL HMO: $331.86 BERGEN RISK — ALL PRODUCTS: $255.75
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL PRENATAL PROFILE	$326	$47.81	$46.29 – $317.26
Obstetric blood test panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $277.10 AETNA — ASA: $255.26 AETNA — HMO: $224.29 AETNA — MANAGED MEDICAID: $46.29 AETNA — MEDICARE ADVANTAGE: $52.11 AETNA — PPO: $224.29 AMERIGROUP — MANAGED MEDICAID: $47.81 AMERIHEALTH — LOCAL HMO: $280.10 AMERIHEALTH — REGIONAL HMO: $317.26 BERGEN RISK — ALL PRODUCTS: $244.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL.	$255	$13.39	$36.21 – $248.17
Cholesterol panel (lipid panel): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $216.75 AETNA — ASA: $199.67 AETNA — HMO: $175.44 AETNA — MANAGED MEDICAID: $36.21 AETNA — MEDICARE ADVANTAGE: $14.60 AETNA — PPO: $175.44 AMERIGROUP — MANAGED MEDICAID: $13.39 AMERIHEALTH — LOCAL HMO: $219.10 AMERIHEALTH — REGIONAL HMO: $248.17 BERGEN RISK — ALL PRODUCTS: $191.25
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$260	$13.39	$36.92 – $253.03
Cholesterol panel (lipid panel): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $221 AETNA — ASA: $203.58 AETNA — HMO: $178.88 AETNA — MANAGED MEDICAID: $36.92 AETNA — MEDICARE ADVANTAGE: $14.60 AETNA — PPO: $178.88 AMERIGROUP — MANAGED MEDICAID: $13.39 AMERIHEALTH — LOCAL HMO: $223.39 AMERIHEALTH — REGIONAL HMO: $253.03 BERGEN RISK — ALL PRODUCTS: $195
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL ARUP	$255	$13.39	$36.21 – $248.17
Cholesterol panel (lipid panel): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $216.75 AETNA — ASA: $199.67 AETNA — HMO: $175.44 AETNA — MANAGED MEDICAID: $36.21 AETNA — MEDICARE ADVANTAGE: $14.60 AETNA — PPO: $175.44 AMERIGROUP — MANAGED MEDICAID: $13.39 AMERIHEALTH — LOCAL HMO: $219.10 AMERIHEALTH — REGIONAL HMO: $248.17 BERGEN RISK — ALL PRODUCTS: $191.25
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUCTION PANEL	$197	$8.68	$27.97 – $191.72
Kidney function panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $167.45 AETNA — ASA: $154.25 AETNA — HMO: $135.54 AETNA — MANAGED MEDICAID: $27.97 AETNA — MEDICARE ADVANTAGE: $9.46 AETNA — PPO: $135.54 AMERIGROUP — MANAGED MEDICAID: $8.68 AMERIHEALTH — LOCAL HMO: $169.26 AMERIHEALTH — REGIONAL HMO: $191.72 BERGEN RISK — ALL PRODUCTS: $147.75
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUCTION PANEL DIABETIC	$197	$8.68	$27.97 – $191.72
Kidney function panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $167.45 AETNA — ASA: $154.25 AETNA — HMO: $135.54 AETNA — MANAGED MEDICAID: $27.97 AETNA — MEDICARE ADVANTAGE: $9.46 AETNA — PPO: $135.54 AMERIGROUP — MANAGED MEDICAID: $8.68 AMERIHEALTH — LOCAL HMO: $169.26 AMERIHEALTH — REGIONAL HMO: $191.72 BERGEN RISK — ALL PRODUCTS: $147.75
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL QST	$197	$8.68	$27.97 – $191.72
Kidney function panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $167.45 AETNA — ASA: $154.25 AETNA — HMO: $135.54 AETNA — MANAGED MEDICAID: $27.97 AETNA — MEDICARE ADVANTAGE: $9.46 AETNA — PPO: $135.54 AMERIGROUP — MANAGED MEDICAID: $8.68 AMERIHEALTH — LOCAL HMO: $169.26 AMERIHEALTH — REGIONAL HMO: $191.72 BERGEN RISK — ALL PRODUCTS: $147.75
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL.	$167	$8.17	$23.71 – $162.52
Liver function panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $141.95 AETNA — ASA: $130.76 AETNA — HMO: $114.90 AETNA — MANAGED MEDICAID: $23.71 AETNA — MEDICARE ADVANTAGE: $8.91 AETNA — PPO: $114.90 AMERIGROUP — MANAGED MEDICAID: $8.17 AMERIHEALTH — LOCAL HMO: $143.49 AMERIHEALTH — REGIONAL HMO: $162.52 BERGEN RISK — ALL PRODUCTS: $125.25
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL QST	$167	$8.17	$23.71 – $162.52
Liver function panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $141.95 AETNA — ASA: $130.76 AETNA — HMO: $114.90 AETNA — MANAGED MEDICAID: $23.71 AETNA — MEDICARE ADVANTAGE: $8.91 AETNA — PPO: $114.90 AMERIGROUP — MANAGED MEDICAID: $8.17 AMERIHEALTH — LOCAL HMO: $143.49 AMERIHEALTH — REGIONAL HMO: $162.52 BERGEN RISK — ALL PRODUCTS: $125.25
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$167	$8.17	$23.71 – $162.52
Liver function panel: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $141.95 AETNA — ASA: $130.76 AETNA — HMO: $114.90 AETNA — MANAGED MEDICAID: $23.71 AETNA — MEDICARE ADVANTAGE: $8.91 AETNA — PPO: $114.90 AMERIGROUP — MANAGED MEDICAID: $8.17 AMERIHEALTH — LOCAL HMO: $143.49 AMERIHEALTH — REGIONAL HMO: $162.52 BERGEN RISK — ALL PRODUCTS: $125.25
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W MICRO	$107	$3.17	$15.19 – $104.13
Urine test (automated, with microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $90.95 AETNA — ASA: $83.78 AETNA — HMO: $73.62 AETNA — MANAGED MEDICAID: $15.19 AETNA — MEDICARE ADVANTAGE: $3.46 AETNA — PPO: $73.62 AMERIGROUP — MANAGED MEDICAID: $3.17 AMERIHEALTH — LOCAL HMO: $91.93 AMERIHEALTH — REGIONAL HMO: $104.13 BERGEN RISK — ALL PRODUCTS: $80.25
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS COMPLETE QST	$107	$3.17	$15.19 – $104.13
Urine test (automated, with microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $90.95 AETNA — ASA: $83.78 AETNA — HMO: $73.62 AETNA — MANAGED MEDICAID: $15.19 AETNA — MEDICARE ADVANTAGE: $3.46 AETNA — PPO: $73.62 AMERIGROUP — MANAGED MEDICAID: $3.17 AMERIHEALTH — LOCAL HMO: $91.93 AMERIHEALTH — REGIONAL HMO: $104.13 BERGEN RISK — ALL PRODUCTS: $80.25
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS COMPLETE W/REFLEX TO CULTURE QST	$107	$3.17	$15.19 – $104.13
Urine test (automated, with microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $90.95 AETNA — ASA: $83.78 AETNA — HMO: $73.62 AETNA — MANAGED MEDICAID: $15.19 AETNA — MEDICARE ADVANTAGE: $3.46 AETNA — PPO: $73.62 AMERIGROUP — MANAGED MEDICAID: $3.17 AMERIHEALTH — LOCAL HMO: $91.93 AMERIHEALTH — REGIONAL HMO: $104.13 BERGEN RISK — ALL PRODUCTS: $80.25
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$45	$3.48	$6.39 – $43.79
Urine test (manual, without microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $38.25 AETNA — ASA: $35.24 AETNA — HMO: $30.96 AETNA — MANAGED MEDICAID: $6.39 AETNA — MEDICARE ADVANTAGE: $3.79 AETNA — PPO: $30.96 AMERIGROUP — MANAGED MEDICAID: $3.48 AMERIHEALTH — LOCAL HMO: $38.66 AMERIHEALTH — REGIONAL HMO: $43.79 BERGEN RISK — ALL PRODUCTS: $33.75
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS SING COMP	$80	$2.25	$11.36 – $77.86
Urine test (automated, without microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $68 AETNA — ASA: $62.64 AETNA — HMO: $55.04 AETNA — MANAGED MEDICAID: $11.36 AETNA — MEDICARE ADVANTAGE: $2.45 AETNA — PPO: $55.04 AMERIGROUP — MANAGED MEDICAID: $2.25 AMERIHEALTH — LOCAL HMO: $68.74 AMERIHEALTH — REGIONAL HMO: $77.86 BERGEN RISK — ALL PRODUCTS: $60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO MICRO	$80	$2.25	$11.36 – $77.86
Urine test (automated, without microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $68 AETNA — ASA: $62.64 AETNA — HMO: $55.04 AETNA — MANAGED MEDICAID: $11.36 AETNA — MEDICARE ADVANTAGE: $2.45 AETNA — PPO: $55.04 AMERIGROUP — MANAGED MEDICAID: $2.25 AMERIHEALTH — LOCAL HMO: $68.74 AMERIHEALTH — REGIONAL HMO: $77.86 BERGEN RISK — ALL PRODUCTS: $60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE PH	$80	$2.25	$11.36 – $77.86
Urine test (automated, without microscope): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $68 AETNA — ASA: $62.64 AETNA — HMO: $55.04 AETNA — MANAGED MEDICAID: $11.36 AETNA — MEDICARE ADVANTAGE: $2.45 AETNA — PPO: $55.04 AMERIGROUP — MANAGED MEDICAID: $2.25 AMERIHEALTH — LOCAL HMO: $68.74 AMERIHEALTH — REGIONAL HMO: $77.86 BERGEN RISK — ALL PRODUCTS: $60
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL	$328	$18.39	$46.58 – $319.21
PSA (prostate specific antigen) blood test: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $278.80 AETNA — ASA: $256.82 AETNA — HMO: $225.66 AETNA — MANAGED MEDICAID: $46.58 AETNA — MEDICARE ADVANTAGE: $20.05 AETNA — PPO: $225.66 AMERIGROUP — MANAGED MEDICAID: $18.39 AMERIHEALTH — LOCAL HMO: $281.82 AMERIHEALTH — REGIONAL HMO: $319.21 BERGEN RISK — ALL PRODUCTS: $246
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC	$328	$18.39	$46.58 – $319.21
PSA (prostate specific antigen) blood test: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $278.80 AETNA — ASA: $256.82 AETNA — HMO: $225.66 AETNA — MANAGED MEDICAID: $46.58 AETNA — MEDICARE ADVANTAGE: $20.05 AETNA — PPO: $225.66 AMERIGROUP — MANAGED MEDICAID: $18.39 AMERIHEALTH — LOCAL HMO: $281.82 AMERIHEALTH — REGIONAL HMO: $319.21 BERGEN RISK — ALL PRODUCTS: $246
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA ULTRASENSITIVE ARUP	$328	$18.39	$46.58 – $319.21
PSA (prostate specific antigen) blood test: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $278.80 AETNA — ASA: $256.82 AETNA — HMO: $225.66 AETNA — MANAGED MEDICAID: $46.58 AETNA — MEDICARE ADVANTAGE: $20.05 AETNA — PPO: $225.66 AMERIGROUP — MANAGED MEDICAID: $18.39 AMERIHEALTH — LOCAL HMO: $281.82 AMERIHEALTH — REGIONAL HMO: $319.21 BERGEN RISK — ALL PRODUCTS: $246
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE	$266	$16.80	$37.77 – $258.87
Thyroid stimulating hormone (TSH) test: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $226.10 AETNA — ASA: $208.28 AETNA — HMO: $183.01 AETNA — MANAGED MEDICAID: $37.77 AETNA — MEDICARE ADVANTAGE: $18.31 AETNA — PPO: $183.01 AMERIGROUP — MANAGED MEDICAID: $16.80 AMERIHEALTH — LOCAL HMO: $228.55 AMERIHEALTH — REGIONAL HMO: $258.87 BERGEN RISK — ALL PRODUCTS: $199.50
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH SENSITIVE	$72	$16.80	$10.22 – $70.07
Thyroid stimulating hormone (TSH) test: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $61.20 AETNA — ASA: $56.38 AETNA — HMO: $49.54 AETNA — MANAGED MEDICAID: $10.22 AETNA — MEDICARE ADVANTAGE: $18.31 AETNA — PPO: $49.54 AMERIGROUP — MANAGED MEDICAID: $16.80 AMERIHEALTH — LOCAL HMO: $61.86 AMERIHEALTH — REGIONAL HMO: $70.07 BERGEN RISK — ALL PRODUCTS: $54
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$266	$16.80	$37.77 – $258.87
Thyroid stimulating hormone (TSH) test: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $226.10 AETNA — ASA: $208.28 AETNA — HMO: $183.01 AETNA — MANAGED MEDICAID: $37.77 AETNA — MEDICARE ADVANTAGE: $18.31 AETNA — PPO: $183.01 AMERIGROUP — MANAGED MEDICAID: $16.80 AMERIHEALTH — LOCAL HMO: $228.55 AMERIHEALTH — REGIONAL HMO: $258.87 BERGEN RISK — ALL PRODUCTS: $199.50
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO WITH DIFF	$149	$7.77	$21.16 – $145.01
Complete blood count (CBC) with differential: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $126.65 AETNA — ASA: $116.67 AETNA — HMO: $102.51 AETNA — MANAGED MEDICAID: $21.16 AETNA — MEDICARE ADVANTAGE: $8.47 AETNA — PPO: $102.51 AMERIGROUP — MANAGED MEDICAID: $7.77 AMERIHEALTH — LOCAL HMO: $128.02 AMERIHEALTH — REGIONAL HMO: $145.01 BERGEN RISK — ALL PRODUCTS: $111.75
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITH DIFF	$165	$7.77	$23.43 – $160.58
Complete blood count (CBC) with differential: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $140.25 AETNA — ASA: $129.20 AETNA — HMO: $113.52 AETNA — MANAGED MEDICAID: $23.43 AETNA — MEDICARE ADVANTAGE: $8.47 AETNA — PPO: $113.52 AMERIGROUP — MANAGED MEDICAID: $7.77 AMERIHEALTH — LOCAL HMO: $141.77 AMERIHEALTH — REGIONAL HMO: $160.58 BERGEN RISK — ALL PRODUCTS: $123.75
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC INCLUDES DIFF AND PLT QST	$149	$7.77	$21.16 – $145.01
Complete blood count (CBC) with differential: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $126.65 AETNA — ASA: $116.67 AETNA — HMO: $102.51 AETNA — MANAGED MEDICAID: $21.16 AETNA — MEDICARE ADVANTAGE: $8.47 AETNA — PPO: $102.51 AMERIGROUP — MANAGED MEDICAID: $7.77 AMERIHEALTH — LOCAL HMO: $128.02 AMERIHEALTH — REGIONAL HMO: $145.01 BERGEN RISK — ALL PRODUCTS: $111.75
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO	$106	$6.47	$15.05 – $103.16
Complete blood count (CBC), automated: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $90.10 AETNA — ASA: $83 AETNA — HMO: $72.93 AETNA — MANAGED MEDICAID: $15.05 AETNA — MEDICARE ADVANTAGE: $7.05 AETNA — PPO: $72.93 AMERIGROUP — MANAGED MEDICAID: $6.47 AMERIHEALTH — LOCAL HMO: $91.08 AMERIHEALTH — REGIONAL HMO: $103.16 BERGEN RISK — ALL PRODUCTS: $79.50
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLD CNTHEMOGRAM PLT CT AUTO	$106	$6.47	$15.05 – $103.16
Complete blood count (CBC), automated: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $90.10 AETNA — ASA: $83 AETNA — HMO: $72.93 AETNA — MANAGED MEDICAID: $15.05 AETNA — MEDICARE ADVANTAGE: $7.05 AETNA — PPO: $72.93 AMERIGROUP — MANAGED MEDICAID: $6.47 AMERIHEALTH — LOCAL HMO: $91.08 AMERIHEALTH — REGIONAL HMO: $103.16 BERGEN RISK — ALL PRODUCTS: $79.50
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC WITH PLATELET COUNT ARUP	$106	$6.47	$15.05 – $103.16
Complete blood count (CBC), automated: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $90.10 AETNA — ASA: $83 AETNA — HMO: $72.93 AETNA — MANAGED MEDICAID: $15.05 AETNA — MEDICARE ADVANTAGE: $7.05 AETNA — PPO: $72.93 AMERIGROUP — MANAGED MEDICAID: $6.47 AMERIHEALTH — LOCAL HMO: $91.08 AMERIHEALTH — REGIONAL HMO: $103.16 BERGEN RISK — ALL PRODUCTS: $79.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME- .	$97	$4.29	$13.77 – $94.40
Blood clotting time test (prothrombin time, PT): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $82.45 AETNA — ASA: $75.95 AETNA — HMO: $66.74 AETNA — MANAGED MEDICAID: $13.77 AETNA — MEDICARE ADVANTAGE: $4.68 AETNA — PPO: $66.74 AMERIGROUP — MANAGED MEDICAID: $4.29 AMERIHEALTH — LOCAL HMO: $83.34 AMERIHEALTH — REGIONAL HMO: $94.40 BERGEN RISK — ALL PRODUCTS: $72.75
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME-INR QST	$97	$4.29	$13.77 – $94.40
Blood clotting time test (prothrombin time, PT): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $82.45 AETNA — ASA: $75.95 AETNA — HMO: $66.74 AETNA — MANAGED MEDICAID: $13.77 AETNA — MEDICARE ADVANTAGE: $4.68 AETNA — PPO: $66.74 AMERIGROUP — MANAGED MEDICAID: $4.29 AMERIHEALTH — LOCAL HMO: $83.34 AMERIHEALTH — REGIONAL HMO: $94.40 BERGEN RISK — ALL PRODUCTS: $72.75
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$97	$4.29	$13.77 – $94.40
Blood clotting time test (prothrombin time, PT): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $82.45 AETNA — ASA: $75.95 AETNA — HMO: $66.74 AETNA — MANAGED MEDICAID: $13.77 AETNA — MEDICARE ADVANTAGE: $4.68 AETNA — PPO: $66.74 AMERIGROUP — MANAGED MEDICAID: $4.29 AMERIHEALTH — LOCAL HMO: $83.34 AMERIHEALTH — REGIONAL HMO: $94.40 BERGEN RISK — ALL PRODUCTS: $72.75
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBPLASTN TIME(PTT)POST HEP	$132	$6.01	$18.74 – $128.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $112.20 AETNA — ASA: $103.36 AETNA — HMO: $90.82 AETNA — MANAGED MEDICAID: $18.74 AETNA — MEDICARE ADVANTAGE: $6.55 AETNA — PPO: $90.82 AMERIGROUP — MANAGED MEDICAID: $6.01 AMERIHEALTH — LOCAL HMO: $113.41 AMERIHEALTH — REGIONAL HMO: $128.46 BERGEN RISK — ALL PRODUCTS: $99
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACTIVATED PARTIAL THROMBOPLASTIN TIME	$132	$6.01	$18.74 – $128.46
Blood clotting test (partial thromboplastin time, PTT): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $112.20 AETNA — ASA: $103.36 AETNA — HMO: $90.82 AETNA — MANAGED MEDICAID: $18.74 AETNA — MEDICARE ADVANTAGE: $6.55 AETNA — PPO: $90.82 AMERIGROUP — MANAGED MEDICAID: $6.01 AMERIHEALTH — LOCAL HMO: $113.41 AMERIHEALTH — REGIONAL HMO: $128.46 BERGEN RISK — ALL PRODUCTS: $99
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$46	$6.01	$6.53 – $44.77
Blood clotting test (partial thromboplastin time, PTT): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $39.10 AETNA — ASA: $36.02 AETNA — HMO: $31.65 AETNA — MANAGED MEDICAID: $6.53 AETNA — MEDICARE ADVANTAGE: $6.55 AETNA — PPO: $31.65 AMERIGROUP — MANAGED MEDICAID: $6.01 AMERIHEALTH — LOCAL HMO: $39.52 AMERIHEALTH — REGIONAL HMO: $44.77 BERGEN RISK — ALL PRODUCTS: $34.50

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL	$2,504	$116.22	$199.03 – $2,159.44
CT scan of the head or brain, without contrast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $650 AETNA — ASA: $1,960.63 AETNA — HMO: $205.42 AETNA — MANAGED MEDICAID: $355.57 AETNA — MEDICARE ADVANTAGE: $126.68 AETNA — PPO: $205.42 AMERIHEALTH — LOCAL HMO: $439.59 AMERIHEALTH — REGIONAL HMO: $447.19 BERGEN RISK — ALL PRODUCTS: $1,878 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $1,727.76
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 W/O DYE	Not listed in the file	$116.22	$128.36 – $265.07
CT scan of the head or brain, without contrast: rates for 5 insurance plans AETNA — HMO: $205.42 AETNA — PPO: $205.42 KARNA — MEDICARE ADVANTAGE: $128.36 OXFORD — ALL PRODUCTS: $265.07 UNITED HEALTHCARE — HMO: $265.07
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT HEAD/BRAIN W/O DYE	Not listed in the file	$116.22	$70.67
CT scan of the head or brain, without contrast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $70.67
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O &W/CONTRAST MATERIAL	$5,631	$390.30	$600.50 – $4,332
MRI of the brain, before and after contrast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $650 AETNA — ASA: $4,409.07 AETNA — HMO: $737.16 AETNA — MANAGED MEDICAID: $799.60 AETNA — MEDICARE ADVANTAGE: $425.43 AETNA — PPO: $737.16 AMERIHEALTH — LOCAL HMO: $1,531.59 AMERIHEALTH — REGIONAL HMO: $1,558.09 BERGEN RISK — ALL PRODUCTS: $4,332 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $3,885.39
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	$390.30	$409.88 – $895.45
MRI of the brain, before and after contrast: rates for 5 insurance plans AETNA — HMO: $737.16 AETNA — PPO: $737.16 KARNA — MEDICARE ADVANTAGE: $409.88 OXFORD — ALL PRODUCTS: $895.45 UNITED HEALTHCARE — HMO: $895.45
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	$390.30	$190.61
MRI of the brain, before and after contrast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $190.61
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$497	$96.23	$70.57 – $437.36
Chest X-ray, 2 views: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $422.45 AETNA — ASA: $389.15 AETNA — HMO: $54.81 AETNA — MANAGED MEDICAID: $70.57 AETNA — MEDICARE ADVANTAGE: $104.89 AETNA — PPO: $54.81 AMERIHEALTH — LOCAL HMO: $67.63 AMERIHEALTH — REGIONAL HMO: $68.80 BERGEN RISK — ALL PRODUCTS: $372.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $397.60
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NMDP RADIOLOGIC EXAM CHEST 2 VIEWS	$497	$96.23	$70.57 – $447.30
Chest X-ray, 2 views: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $422.45 AETNA — ASA: $389.15 AETNA — HMO: $54.81 AETNA — MANAGED MEDICAID: $70.57 AETNA — MEDICARE ADVANTAGE: $104.89 AETNA — PPO: $54.81 AMERIHEALTH — LOCAL HMO: $67.63 AMERIHEALTH — REGIONAL HMO: $68.80 BERGEN RISK — ALL PRODUCTS: $372.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $447.30
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM CHEST 2 VIEWS	Not listed in the file	$96.23	$43.39 – $219.04
Chest X-ray, 2 views: rates for 5 insurance plans AETNA — HMO: $54.81 AETNA — PPO: $54.81 KARNA — MEDICARE ADVANTAGE: $43.39 OXFORD — ALL PRODUCTS: $219.04 UNITED HEALTHCARE — HMO: $219.04
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$1,019	$116.22	$144.70 – $896.72
X-ray of the lower spine, at least 4 views: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $866.15 AETNA — ASA: $797.88 AETNA — HMO: $92.67 AETNA — MANAGED MEDICAID: $144.70 AETNA — MEDICARE ADVANTAGE: $126.68 AETNA — PPO: $92.67 AMERIHEALTH — LOCAL HMO: $99.45 AMERIHEALTH — REGIONAL HMO: $101.17 BERGEN RISK — ALL PRODUCTS: $764.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $815.20
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	$116.22	$73.78 – $295.04
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans AETNA — HMO: $92.67 AETNA — PPO: $92.67 KARNA — MEDICARE ADVANTAGE: $73.78 OXFORD — ALL PRODUCTS: $295.04 UNITED HEALTHCARE — HMO: $295.04
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: X-RAY EXAM L-2 SPINE 4/>VWS	Not listed in the file	$116.22	$21.99
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $21.99
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$4,439	$264.17	$360.39 – $4,332
MRI of the lower back (lumbar spine), without contrast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $650 AETNA — ASA: $3,475.74 AETNA — HMO: $417.98 AETNA — MANAGED MEDICAID: $630.34 AETNA — MEDICARE ADVANTAGE: $287.95 AETNA — PPO: $417.98 AMERIHEALTH — LOCAL HMO: $944.81 AMERIHEALTH — REGIONAL HMO: $961.16 BERGEN RISK — ALL PRODUCTS: $4,332 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $3,062.91
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	$264.17	$236.25 – $559.79
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans AETNA — HMO: $417.98 AETNA — PPO: $417.98 KARNA — MEDICARE ADVANTAGE: $236.25 OXFORD — ALL PRODUCTS: $559.79 UNITED HEALTHCARE — HMO: $559.79
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	$264.17	$124.14
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $124.14
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL	$3,245	$194.55	$432.90 – $2,917
CT scan of the pelvis, with contrast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $650 AETNA — ASA: $2,540.84 AETNA — HMO: $470.88 AETNA — MANAGED MEDICAID: $460.79 AETNA — MEDICARE ADVANTAGE: $212.06 AETNA — PPO: $470.88 AMERIHEALTH — LOCAL HMO: $618.61 AMERIHEALTH — REGIONAL HMO: $629.31 BERGEN RISK — ALL PRODUCTS: $2,433.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $2,239.05
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT PELVIS W/DYE	Not listed in the file	$194.55	$336.10 – $470.88
CT scan of the pelvis, with contrast: rates for 5 insurance plans AETNA — HMO: $470.88 AETNA — PPO: $470.88 KARNA — MEDICARE ADVANTAGE: $336.10 OXFORD — ALL PRODUCTS: $434.32 UNITED HEALTHCARE — HMO: $434.32
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT PELVIS W/DYE	Not listed in the file	$194.55	$96.80
CT scan of the pelvis, with contrast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $96.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$4,290	$264.17	$382.59 – $4,332
MRI of a leg joint (such as the knee), without contrast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $650 AETNA — ASA: $3,359.07 AETNA — HMO: $473.73 AETNA — MANAGED MEDICAID: $609.18 AETNA — MEDICARE ADVANTAGE: $287.95 AETNA — PPO: $473.73 AMERIHEALTH — LOCAL HMO: $944.81 AMERIHEALTH — REGIONAL HMO: $961.16 BERGEN RISK — ALL PRODUCTS: $4,332 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $2,960.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	$264.17	$269.12 – $559.79
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans AETNA — HMO: $473.73 AETNA — PPO: $473.73 KARNA — MEDICARE ADVANTAGE: $269.12 OXFORD — ALL PRODUCTS: $559.79 UNITED HEALTHCARE — HMO: $559.79
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	$264.17	$113.47
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $113.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS WITH CONTRAST MATERIAL	$4,650	$390.30	$572.50 – $2,917
CT scan of the abdomen and pelvis, with contrast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $650 AETNA — ASA: $3,640.95 AETNA — HMO: $617.56 AETNA — MANAGED MEDICAID: $660.30 AETNA — MEDICARE ADVANTAGE: $425.43 AETNA — PPO: $617.56 AMERIHEALTH — LOCAL HMO: $630.54 AMERIHEALTH — REGIONAL HMO: $641.45 BERGEN RISK — ALL PRODUCTS: $3,487.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $3,208.50
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	$390.30	$421.07 – $895.45
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans AETNA — HMO: $617.56 AETNA — PPO: $617.56 KARNA — MEDICARE ADVANTAGE: $421.07 OXFORD — ALL PRODUCTS: $895.45 UNITED HEALTHCARE — HMO: $895.45
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT ABD & PELVIS W/CONTRAST	Not listed in the file	$390.30	$151.43
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $151.43
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$1,362	$116.22	$193.40 – $1,225.80
Ultrasound of the abdomen, complete: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $1,157.70 AETNA — ASA: $1,066.45 AETNA — HMO: $232.38 AETNA — MANAGED MEDICAID: $193.40 AETNA — MEDICARE ADVANTAGE: $126.68 AETNA — PPO: $232.38 AMERIHEALTH — LOCAL HMO: $226.76 AMERIHEALTH — REGIONAL HMO: $230.68 BERGEN RISK — ALL PRODUCTS: $1,021.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $1,225.80
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: US EXAM ABDOM COMPLETE	Not listed in the file	$116.22	$146.32 – $295.04
Ultrasound of the abdomen, complete: rates for 5 insurance plans AETNA — HMO: $232.38 AETNA — PPO: $232.38 KARNA — MEDICARE ADVANTAGE: $146.32 OXFORD — ALL PRODUCTS: $295.04 UNITED HEALTHCARE — HMO: $295.04
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: US EXAM ABDOM COMPLETE	Not listed in the file	$116.22	$67.09
Ultrasound of the abdomen, complete: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $67.09
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$825	$116.22	$117.15 – $742.50
Pregnancy ultrasound (after the first trimester): 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $701.25 AETNA — ASA: $645.98 AETNA — HMO: $261.31 AETNA — MANAGED MEDICAID: $117.15 AETNA — MEDICARE ADVANTAGE: $126.68 AETNA — PPO: $261.31 AMERIHEALTH — LOCAL HMO: $198.91 AMERIHEALTH — REGIONAL HMO: $202.35 BERGEN RISK — ALL PRODUCTS: $618.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $742.50
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: OB US >= 14 WKS SNGL FETUS	Not listed in the file	$116.22	$165.55 – $295.04
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans AETNA — HMO: $261.31 AETNA — PPO: $261.31 KARNA — MEDICARE ADVANTAGE: $165.55 OXFORD — ALL PRODUCTS: $295.04 UNITED HEALTHCARE — HMO: $295.04
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: OB US >= 14 WKS SNGL FETUS	Not listed in the file	$116.22	$83.19
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $83.19
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND TRANSVAGINAL	$1,255	$116.22	$178.21 – $1,129.50
Transvaginal ultrasound: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $1,066.75 AETNA — ASA: $982.67 AETNA — HMO: $248.34 AETNA — MANAGED MEDICAID: $178.21 AETNA — MEDICARE ADVANTAGE: $126.68 AETNA — PPO: $248.34 AMERIHEALTH — LOCAL HMO: $184.98 AMERIHEALTH — REGIONAL HMO: $188.18 BERGEN RISK — ALL PRODUCTS: $941.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $1,129.50
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: TRANSVAGINAL US NON-OB	Not listed in the file	$116.22	$161.83 – $295.04
Transvaginal ultrasound: rates for 5 insurance plans AETNA — HMO: $248.34 AETNA — PPO: $248.34 KARNA — MEDICARE ADVANTAGE: $161.83 OXFORD — ALL PRODUCTS: $295.04 UNITED HEALTHCARE — HMO: $295.04
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: TRANSVAGINAL US NON-OB	Not listed in the file	$116.22	$57.62
Transvaginal ultrasound: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $57.62
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$737	$164.52	$104.65 – $663.30
Diagnostic mammogram, one breast: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $626.45 AETNA — ASA: $577.07 AETNA — HMO: $264.30 AETNA — MANAGED MEDICAID: $104.65 AETNA — MEDICARE ADVANTAGE: $179.33 AETNA — PPO: $264.30 AMERIGROUP — MANAGED MEDICAID: $164.52 AMERIHEALTH — LOCAL HMO: $123.32 AMERIHEALTH — REGIONAL HMO: $125.46 BERGEN RISK — ALL PRODUCTS: $552.75
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DX MAMMO INCL CAD UNI	Not listed in the file	$164.52	$162.47 – $264.30
Diagnostic mammogram, one breast: rates for 5 insurance plans AETNA — HMO: $264.30 AETNA — PPO: $264.30 KARNA — MEDICARE ADVANTAGE: $162.47 OXFORD — ALL PRODUCTS: $247.52 UNITED HEALTHCARE — HMO: $247.52
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: DX MAMMO INCL CAD UNI	Not listed in the file	$164.52	$67.71
Diagnostic mammogram, one breast: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $67.71
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$1,045	$207.95	$148.39 – $940.50
Diagnostic mammogram, both breasts: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $888.25 AETNA — ASA: $818.24 AETNA — HMO: $338.14 AETNA — MANAGED MEDICAID: $148.39 AETNA — MEDICARE ADVANTAGE: $226.67 AETNA — PPO: $338.14 AMERIGROUP — MANAGED MEDICAID: $207.95 AMERIHEALTH — LOCAL HMO: $157.14 AMERIHEALTH — REGIONAL HMO: $159.86 BERGEN RISK — ALL PRODUCTS: $783.75
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DX MAMMO INCL CAD BI	Not listed in the file	$207.95	$208.34 – $338.14
Diagnostic mammogram, both breasts: rates for 5 insurance plans AETNA — HMO: $338.14 AETNA — PPO: $338.14 KARNA — MEDICARE ADVANTAGE: $208.34 OXFORD — ALL PRODUCTS: $316.48 UNITED HEALTHCARE — HMO: $316.48
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: DX MAMMO INCL CAD BI	Not listed in the file	$207.95	$83.13
Diagnostic mammogram, both breasts: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $83.13
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$748	$169.06	$106.22 – $673.20
Screening mammogram, both breasts: 10 of 35 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $635.80 AETNA — ASA: $585.68 AETNA — HMO: $279.28 AETNA — MANAGED MEDICAID: $106.22 AETNA — MEDICARE ADVANTAGE: $184.28 AETNA — PPO: $279.28 AMERIGROUP — MANAGED MEDICAID: $169.06 AMERIHEALTH — LOCAL HMO: $119.35 AMERIHEALTH — REGIONAL HMO: $121.41 BERGEN RISK — ALL PRODUCTS: $561
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: SCR MAMMO BI INCL CAD	Not listed in the file	$169.06	$171.77 – $279.28
Screening mammogram, both breasts: rates for 5 insurance plans AETNA — HMO: $279.28 AETNA — PPO: $279.28 KARNA — MEDICARE ADVANTAGE: $171.77 OXFORD — ALL PRODUCTS: $261.68 UNITED HEALTHCARE — HMO: $261.68
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: SCR MAMMO BI INCL CAD	Not listed in the file	$169.06	$63.55
Screening mammogram, both breasts: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $63.55

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$24.05 – $49.09
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans KARNA — MEDICARE ADVANTAGE: $24.05 UNITED HEALTHCARE — MANAGED MEDICAID: $49.09
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$15,597	$3,515.15	$2,214.77 – $13,725.36
Left heart catheterization (diagnostic): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $13,257.45 AETNA — ASA: $12,212.45 AETNA — HMO: $9,218 AETNA — MANAGED MEDICAID: $2,214.77 AETNA — MEDICARE ADVANTAGE: $3,831.51 AETNA — PPO: $9,218 AMERIHEALTH — LOCAL HMO: $19,565 AMERIHEALTH — REGIONAL HMO: $22,114 BERGEN RISK — ALL PRODUCTS: $11,697.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $11,920
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	$3,515.15	$378.50
Left heart catheterization (diagnostic): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $378.50
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	$3,515.15	$1,125.45
Left heart catheterization (diagnostic): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $1,125.45
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$13,433	$8,292.88	$1,907.49 – $13,073
Heart rhythm study (electrophysiology evaluation): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $11,418.05 AETNA — ASA: $10,518.04 AETNA — HMO: $12,089.70 AETNA — MANAGED MEDICAID: $1,907.49 AETNA — MEDICARE ADVANTAGE: $9,039.24 AETNA — PPO: $12,089.70 AMERIHEALTH — LOCAL HMO: $11,541.63 AMERIHEALTH — REGIONAL HMO: $13,073 BERGEN RISK — ALL PRODUCTS: $10,074.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $12,089.70
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	$8,292.88	$616.21
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $616.21
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	$8,292.88	$1,334.31
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $1,334.31
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 PULM VEIN ISOLATION	$42,264	$26,810.86	$6,001.49 – $41,131.32
Heart rhythm study with ablation for atrial fibrillation: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $35,924.40 AETNA — ASA: $33,092.71 AETNA — HMO: $38,037.60 AETNA — MANAGED MEDICAID: $6,001.49 AETNA — MEDICARE ADVANTAGE: $29,223.84 AETNA — PPO: $38,037.60 AMERIHEALTH — LOCAL HMO: $36,313.23 AMERIHEALTH — REGIONAL HMO: $41,131.32 BERGEN RISK — ALL PRODUCTS: $31,698 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $21,850
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY SLEEP STAGING 4/> ADDL PARAM	$9,011	$1,111.89	$1,279.56 – $8,617.22
Sleep study (overnight, in a sleep lab): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $7,659.35 AETNA — ASA: $7,055.61 AETNA — HMO: $6,832.14 AETNA — MANAGED MEDICAID: $1,279.56 AETNA — MEDICARE ADVANTAGE: $1,211.95 AETNA — PPO: $6,832.14 AMERIHEALTH — LOCAL HMO: $5,782.36 AMERIHEALTH — REGIONAL HMO: $6,438.36 BERGEN RISK — ALL PRODUCTS: $6,758.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $8,109.90
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	$1,111.89	$190.50
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $190.50
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	$1,111.89	$874.12
Sleep study (overnight, in a sleep lab): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $874.12

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$231	$37.06	$32.80 – $224.81
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $196.35 AETNA — ASA: $180.87 AETNA — HMO: $168.01 AETNA — MANAGED MEDICAID: $32.80 AETNA — MEDICARE ADVANTAGE: $40.40 AETNA — PPO: $168.01 AMERIGROUP — MANAGED MEDICAID: $37.06 AMERIHEALTH — LOCAL HMO: $198.48 AMERIHEALTH — REGIONAL HMO: $224.81 BERGEN RISK — ALL PRODUCTS: $291
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$396	$126.19	$80 – $517
Physical therapy evaluation (low complexity): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $80 AETNA — ASA: $310.07 AETNA — HMO: $288.01 AETNA — MANAGED MEDICAID: $56.23 AETNA — MEDICARE ADVANTAGE: $137.55 AETNA — PPO: $288.01 AMERIGROUP — MANAGED MEDICAID: $126.19 AMERIHEALTH — LOCAL HMO: $340.24 AMERIHEALTH — REGIONAL HMO: $385.39 BERGEN RISK — ALL PRODUCTS: $349
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$453	$126.19	$80 – $517
Physical therapy evaluation (moderate complexity): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $80 AETNA — ASA: $354.70 AETNA — HMO: $329.47 AETNA — MANAGED MEDICAID: $64.33 AETNA — MEDICARE ADVANTAGE: $137.55 AETNA — PPO: $329.47 AMERIGROUP — MANAGED MEDICAID: $126.19 AMERIHEALTH — LOCAL HMO: $389.22 AMERIHEALTH — REGIONAL HMO: $440.86 BERGEN RISK — ALL PRODUCTS: $349
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$611	$126.19	$80 – $517
Physical therapy evaluation (high complexity): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $80 AETNA — ASA: $478.41 AETNA — HMO: $444.38 AETNA — MANAGED MEDICAID: $86.76 AETNA — MEDICARE ADVANTAGE: $137.55 AETNA — PPO: $444.38 AMERIGROUP — MANAGED MEDICAID: $126.19 AMERIHEALTH — LOCAL HMO: $524.97 AMERIHEALTH — REGIONAL HMO: $594.63 BERGEN RISK — ALL PRODUCTS: $349
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 30 MINUTES	$452	$175.59	$64.18 – $439.89
Psychotherapy, 30 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $384.20 AETNA — ASA: $353.92 AETNA — HMO: $406.80 AETNA — MANAGED MEDICAID: $64.18 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $406.80 AMERIHEALTH — LOCAL HMO: $388.36 AMERIHEALTH — REGIONAL HMO: $439.89 BERGEN RISK — ALL PRODUCTS: $339 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $406.80
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DOC PSYCHOTHERAPY W/PATIENT 30 MINUTES	$452	$175.59	$64.18 – $439.89
Psychotherapy, 30 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $384.20 AETNA — ASA: $353.92 AETNA — HMO: $406.80 AETNA — MANAGED MEDICAID: $64.18 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $406.80 AMERIHEALTH — LOCAL HMO: $388.36 AMERIHEALTH — REGIONAL HMO: $439.89 BERGEN RISK — ALL PRODUCTS: $339 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $406.80
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MS PSYCHOTHERAPY W/PATIENT 30 MINUTES	$452	$175.59	$64.18 – $439.89
Psychotherapy, 30 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $384.20 AETNA — ASA: $353.92 AETNA — HMO: $406.80 AETNA — MANAGED MEDICAID: $64.18 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $406.80 AMERIHEALTH — LOCAL HMO: $388.36 AMERIHEALTH — REGIONAL HMO: $439.89 BERGEN RISK — ALL PRODUCTS: $339 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $406.80
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 45 MINUTES	$539	$175.59	$76.54 – $524.55
Psychotherapy, 45 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $458.15 AETNA — ASA: $422.04 AETNA — HMO: $485.10 AETNA — MANAGED MEDICAID: $76.54 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $485.10 AMERIHEALTH — LOCAL HMO: $463.11 AMERIHEALTH — REGIONAL HMO: $524.55 BERGEN RISK — ALL PRODUCTS: $404.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $485.10
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DOC PSYCHOTHERAPY W/PATIENT 45 MINUTES	$539	$175.59	$76.54 – $524.55
Psychotherapy, 45 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $458.15 AETNA — ASA: $422.04 AETNA — HMO: $485.10 AETNA — MANAGED MEDICAID: $76.54 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $485.10 AMERIHEALTH — LOCAL HMO: $463.11 AMERIHEALTH — REGIONAL HMO: $524.55 BERGEN RISK — ALL PRODUCTS: $404.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $485.10
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MS PSYCHOTHERAPY W/PATIENT 45 MINUTES	$539	$175.59	$76.54 – $524.55
Psychotherapy, 45 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $458.15 AETNA — ASA: $422.04 AETNA — HMO: $485.10 AETNA — MANAGED MEDICAID: $76.54 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $485.10 AMERIHEALTH — LOCAL HMO: $463.11 AMERIHEALTH — REGIONAL HMO: $524.55 BERGEN RISK — ALL PRODUCTS: $404.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $485.10
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 60 MINUTES	$605	$175.59	$85.91 – $588.79
Psychotherapy, 60 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $514.25 AETNA — ASA: $473.72 AETNA — HMO: $544.50 AETNA — MANAGED MEDICAID: $85.91 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $544.50 AMERIHEALTH — LOCAL HMO: $519.82 AMERIHEALTH — REGIONAL HMO: $588.79 BERGEN RISK — ALL PRODUCTS: $453.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $544.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DOC PSYCHOTHERAPY W/PATIENT 60 MINUTES	$605	$175.59	$85.91 – $588.79
Psychotherapy, 60 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $514.25 AETNA — ASA: $473.72 AETNA — HMO: $544.50 AETNA — MANAGED MEDICAID: $85.91 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $544.50 AMERIHEALTH — LOCAL HMO: $519.82 AMERIHEALTH — REGIONAL HMO: $588.79 BERGEN RISK — ALL PRODUCTS: $453.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $544.50
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MS PSYCHOTHERAPY W/PATIENT 60 MINUTES	$605	$175.59	$85.91 – $588.79
Psychotherapy, 60 minutes: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $514.25 AETNA — ASA: $473.72 AETNA — HMO: $544.50 AETNA — MANAGED MEDICAID: $85.91 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $544.50 AMERIHEALTH — LOCAL HMO: $519.82 AMERIHEALTH — REGIONAL HMO: $588.79 BERGEN RISK — ALL PRODUCTS: $453.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $544.50
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$385	$175.59	$54.67 – $374.68
Family psychotherapy, without the patient: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $327.25 AETNA — ASA: $301.46 AETNA — HMO: $346.50 AETNA — MANAGED MEDICAID: $54.67 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $346.50 AMERIHEALTH — LOCAL HMO: $330.79 AMERIHEALTH — REGIONAL HMO: $374.68 BERGEN RISK — ALL PRODUCTS: $288.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $346.50
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$497	$175.59	$70.57 – $483.68
Family psychotherapy, with the patient: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $422.45 AETNA — ASA: $389.15 AETNA — HMO: $447.30 AETNA — MANAGED MEDICAID: $70.57 AETNA — MEDICARE ADVANTAGE: $191.40 AETNA — PPO: $447.30 AMERIHEALTH — LOCAL HMO: $427.02 AMERIHEALTH — REGIONAL HMO: $483.68 BERGEN RISK — ALL PRODUCTS: $372.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $447.30
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	$413	$101.09	$58.65 – $401.93
Group psychotherapy: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $351.05 AETNA — ASA: $323.38 AETNA — HMO: $371.70 AETNA — MANAGED MEDICAID: $58.65 AETNA — MEDICARE ADVANTAGE: $110.19 AETNA — PPO: $371.70 AMERIHEALTH — LOCAL HMO: $354.85 AMERIHEALTH — REGIONAL HMO: $401.93 BERGEN RISK — ALL PRODUCTS: $309.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $371.70
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DOC GROUP PSYCHOTHERAPY	$413	$101.09	$58.65 – $401.93
Group psychotherapy: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $351.05 AETNA — ASA: $323.38 AETNA — HMO: $371.70 AETNA — MANAGED MEDICAID: $58.65 AETNA — MEDICARE ADVANTAGE: $110.19 AETNA — PPO: $371.70 AMERIHEALTH — LOCAL HMO: $354.85 AMERIHEALTH — REGIONAL HMO: $401.93 BERGEN RISK — ALL PRODUCTS: $309.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $371.70
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MS GROUP PSYCHOTHERAPY	$413	$101.09	$58.65 – $401.93
Group psychotherapy: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $351.05 AETNA — ASA: $323.38 AETNA — HMO: $371.70 AETNA — MANAGED MEDICAID: $58.65 AETNA — MEDICARE ADVANTAGE: $110.19 AETNA — PPO: $371.70 AMERIHEALTH — LOCAL HMO: $354.85 AMERIHEALTH — REGIONAL HMO: $401.93 BERGEN RISK — ALL PRODUCTS: $309.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $371.70

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	$4,184.94	$4,184.94 – $5,021.93
Removal of breast growth (open surgery): rates for 8 insurance plans AETNA — MEDICARE ADVANTAGE: $4,561.59 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $4,184.94 KARNA — MEDICARE ADVANTAGE: $874.93 UNITED COMMUNITY/AMERICHOICE — MEDICARE ADVANTAGE: $4,394.19 UNITED HEALTHCARE — DSNP: $5,021.93 VACCN — ALL PRODUCTS: $4,184.94 WELLCARE — MANAGED MEDICAID: $4,184.94 WELLCARE — MEDICARE ADVANTAGE: $4,184.94
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESIONS	$7,014	Not listed in the file	$995.99 – $6,826.02
Removal of breast growth (open surgery): 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $5,961.90 AETNA — ASA: $5,491.96 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $995.99 AETNA — MEDICARE ADVANTAGE: $1,430.86 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $6,026.43 AMERIHEALTH — REGIONAL HMO: $6,826.02 BERGEN RISK — ALL PRODUCTS: $5,260.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	$14,061.89	$14,061.89 – $16,874.27
Total hip replacement: rates for 8 insurance plans AETNA — MEDICARE ADVANTAGE: $15,327.46 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $14,061.89 KARNA — MEDICARE ADVANTAGE: $2,664.47 UNITED COMMUNITY/AMERICHOICE — MEDICARE ADVANTAGE: $14,764.98 UNITED HEALTHCARE — DSNP: $16,874.27 VACCN — ALL PRODUCTS: $14,061.89 WELLCARE — MANAGED MEDICAID: $14,061.89 WELLCARE — MEDICARE ADVANTAGE: $14,061.89
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$16,225	Not listed in the file	$2,303.95 – $15,790.17
Total hip replacement: 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $13,791.25 AETNA — ASA: $12,704.18 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $2,303.95 AETNA — MEDICARE ADVANTAGE: $3,309.90 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $13,940.52 AMERIHEALTH — REGIONAL HMO: $15,790.17 BERGEN RISK — ALL PRODUCTS: $12,168.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	$14,061.89	$14,061.89 – $16,874.27
Total knee replacement: rates for 8 insurance plans AETNA — MEDICARE ADVANTAGE: $15,327.46 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $14,061.89 KARNA — MEDICARE ADVANTAGE: $2,660.24 UNITED COMMUNITY/AMERICHOICE — MEDICARE ADVANTAGE: $14,764.98 UNITED HEALTHCARE — DSNP: $16,874.27 VACCN — ALL PRODUCTS: $14,061.89 WELLCARE — MANAGED MEDICAID: $14,061.89 WELLCARE — MEDICARE ADVANTAGE: $14,061.89
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$17,531	Not listed in the file	$2,489.40 – $15,795
Total knee replacement: 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $14,901.35 AETNA — ASA: $13,726.77 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $2,489.40 AETNA — MEDICARE ADVANTAGE: $3,576.32 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $13,972 AMERIHEALTH — REGIONAL HMO: $15,795 BERGEN RISK — ALL PRODUCTS: $13,148.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$349.95
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $349.95
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: SHOULDER SCOPE BONE SHAVING	$5,304	Not listed in the file	$753.17 – $5,161.85
Shoulder arthroscopy: shaving of shoulder bone: 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $4,508.40 AETNA — ASA: $4,153.03 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $753.17 AETNA — MEDICARE ADVANTAGE: $1,082.02 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $4,557.20 AMERIHEALTH — REGIONAL HMO: $5,161.85 BERGEN RISK — ALL PRODUCTS: $3,978 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $15,984
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY	Not listed in the file	$3,545.97	$3,545.97 – $4,255.16
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans AETNA — MEDICARE ADVANTAGE: $3,865.11 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $3,545.97 KARNA — MEDICARE ADVANTAGE: $1,144.38 UNITED COMMUNITY/AMERICHOICE — MEDICARE ADVANTAGE: $3,723.27 UNITED HEALTHCARE — DSNP: $4,255.16 VACCN — ALL PRODUCTS: $3,545.97 WELLCARE — MANAGED MEDICAID: $3,545.97 WELLCARE — MEDICARE ADVANTAGE: $3,545.97
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$7,673	Not listed in the file	$1,089.57 – $7,467.36
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $6,522.05 AETNA — ASA: $6,007.96 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $1,089.57 AETNA — MEDICARE ADVANTAGE: $1,565.29 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $6,592.64 AMERIHEALTH — REGIONAL HMO: $7,467.36 BERGEN RISK — ALL PRODUCTS: $5,754.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $15,984
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$9,176	$6,465.11	$1,302.99 – $8,930.08
Removal of tonsils and adenoids (under age 12): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $7,799.60 AETNA — ASA: $7,184.81 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $1,302.99 AETNA — MEDICARE ADVANTAGE: $7,046.97 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $7,884.02 AMERIHEALTH — REGIONAL HMO: $8,930.08 BERGEN RISK — ALL PRODUCTS: $6,882 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$4,476	$1,024.64	$635.59 – $4,356.04
Upper GI endoscopy (diagnostic): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,804.60 AETNA — ASA: $3,504.71 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $635.59 AETNA — MEDICARE ADVANTAGE: $1,116.86 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,845.78 AMERIHEALTH — REGIONAL HMO: $4,356.04 BERGEN RISK — ALL PRODUCTS: $3,357 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UPPER NDSC BIOPSY SINGLE/MULTIPLE	$4,106	$1,024.64	$583.05 – $3,995.96
Upper GI endoscopy with biopsy: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,490.10 AETNA — ASA: $3,215 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $583.05 AETNA — MEDICARE ADVANTAGE: $1,116.86 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,527.88 AMERIHEALTH — REGIONAL HMO: $3,995.96 BERGEN RISK — ALL PRODUCTS: $3,079.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$4,235	$996.39	$601.37 – $4,121.50
Colonoscopy (diagnostic): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,599.75 AETNA — ASA: $3,316.01 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $601.37 AETNA — MEDICARE ADVANTAGE: $1,086.06 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,638.71 AMERIHEALTH — REGIONAL HMO: $4,121.50 BERGEN RISK — ALL PRODUCTS: $3,176.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	$996.39	$187.47
Colonoscopy (diagnostic): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $187.47
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$4,294	$1,288.59	$609.75 – $4,178.92
Colonoscopy with biopsy: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,649.90 AETNA — ASA: $3,362.20 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $609.75 AETNA — MEDICARE ADVANTAGE: $1,404.57 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,689.40 AMERIHEALTH — REGIONAL HMO: $4,178.92 BERGEN RISK — ALL PRODUCTS: $3,220.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$4,235	$1,288.59	$601.37 – $4,121.50
Colonoscopy with removal of polyps (snare): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,599.75 AETNA — ASA: $3,316.01 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $601.37 AETNA — MEDICARE ADVANTAGE: $1,404.57 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,638.71 AMERIHEALTH — REGIONAL HMO: $4,121.50 BERGEN RISK — ALL PRODUCTS: $3,176.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$4,490	$1,288.59	$637.58 – $4,369.67
Ultrasound of the lower bowel by endoscope: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,816.50 AETNA — ASA: $3,515.67 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $637.58 AETNA — MEDICARE ADVANTAGE: $1,404.57 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,857.81 AMERIHEALTH — REGIONAL HMO: $4,369.67 BERGEN RISK — ALL PRODUCTS: $3,367.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING COLONOSCOPY	$4,023	$996.39	$571.27 – $3,915.18
Screening colonoscopy (not high risk): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,419.55 AETNA — ASA: $3,150.01 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $571.27 AETNA — MEDICARE ADVANTAGE: $1,086.06 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,456.56 AMERIHEALTH — REGIONAL HMO: $3,915.18 BERGEN RISK — ALL PRODUCTS: $3,017.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	$996.39	$158.85
Screening colonoscopy (not high risk): rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $158.85
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY SURG CHOLECYSTECTOMY	$10,973	$6,376.26	$1,558.17 – $9,863.63
Gallbladder removal by laparoscope: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $9,327.05 AETNA — ASA: $8,591.86 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $1,558.17 AETNA — MEDICARE ADVANTAGE: $6,950.12 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $21,245 AMERIHEALTH — REGIONAL HMO: $24,016 BERGEN RISK — ALL PRODUCTS: $8,229.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $15,984
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	$3,856.84	$3,856.84 – $4,628.21
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans AETNA — MEDICARE ADVANTAGE: $4,203.95 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $3,856.84 KARNA — MEDICARE ADVANTAGE: $1,090.59 UNITED COMMUNITY/AMERICHOICE — MEDICARE ADVANTAGE: $4,049.68 UNITED HEALTHCARE — DSNP: $4,628.21 VACCN — ALL PRODUCTS: $3,856.84 WELLCARE — MANAGED MEDICAID: $3,856.84 WELLCARE — MEDICARE ADVANTAGE: $3,856.84
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$9,680	Not listed in the file	$1,374.56 – $9,420.58
Groin (inguinal) hernia repair, age 5 or older: 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $8,228 AETNA — ASA: $7,579.44 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $1,374.56 AETNA — MEDICARE ADVANTAGE: $1,974.72 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $8,317.06 AMERIHEALTH — REGIONAL HMO: $9,420.58 BERGEN RISK — ALL PRODUCTS: $7,260 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROSTATE NEEDLE BIOPSY ANY APPROACH	$6,930	$2,238.78	$984.06 – $6,744.28
Prostate biopsy: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $5,890.50 AETNA — ASA: $5,426.19 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $984.06 AETNA — MEDICARE ADVANTAGE: $2,440.27 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $5,954.26 AMERIHEALTH — REGIONAL HMO: $6,744.28 BERGEN RISK — ALL PRODUCTS: $5,197.50 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT	$14,441	$11,378.21	$2,050.62 – $14,053.98
Prostate removal by laparoscope (radical prostatectomy): 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $12,274.85 AETNA — ASA: $11,307.30 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $2,050.62 AETNA — MEDICARE ADVANTAGE: $12,402.25 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $12,407.71 AMERIHEALTH — REGIONAL HMO: $14,053.98 BERGEN RISK — ALL PRODUCTS: $10,830.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$7,159	$3,474.84	$1,016.58 – $6,967.14
Hysteroscopy with biopsy of the uterus lining: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $6,085.15 AETNA — ASA: $5,605.50 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $1,016.58 AETNA — MEDICARE ADVANTAGE: $3,787.58 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $6,151.01 AMERIHEALTH — REGIONAL HMO: $6,967.14 BERGEN RISK — ALL PRODUCTS: $5,369.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$4,620	$756.84	$656.04 – $4,496.18
Spinal injection, lower back (epidural), with imaging guidance: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,927 AETNA — ASA: $3,617.46 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $656.04 AETNA — MEDICARE ADVANTAGE: $824.96 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,969.50 AMERIHEALTH — REGIONAL HMO: $4,496.18 BERGEN RISK — ALL PRODUCTS: $3,465 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	$972.98	$972.98 – $1,167.58
Nerve root injection, lower back, with imaging guidance: rates for 8 insurance plans AETNA — MEDICARE ADVANTAGE: $1,060.55 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $972.98 KARNA — MEDICARE ADVANTAGE: $228.50 UNITED COMMUNITY/AMERICHOICE — MEDICARE ADVANTAGE: $1,021.63 UNITED HEALTHCARE — DSNP: $1,167.58 VACCN — ALL PRODUCTS: $972.98 WELLCARE — MANAGED MEDICAID: $972.98 WELLCARE — MEDICARE ADVANTAGE: $972.98
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$4,349	Not listed in the file	$617.56 – $4,232.45
Nerve root injection, lower back, with imaging guidance: 10 of 29 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $3,696.65 AETNA — ASA: $3,405.27 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $617.56 AETNA — MEDICARE ADVANTAGE: $887.20 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $3,736.66 AMERIHEALTH — REGIONAL HMO: $4,232.45 BERGEN RISK — ALL PRODUCTS: $3,261.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNEL	$5,972	$2,134.14	$848.02 – $5,811.95
Carpal tunnel release: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $5,076.20 AETNA — ASA: $4,676.08 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $848.02 AETNA — MEDICARE ADVANTAGE: $2,326.22 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $5,131.14 AMERIHEALTH — REGIONAL HMO: $5,811.95 BERGEN RISK — ALL PRODUCTS: $4,479 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST-CATARACT LASER SURGERY	$2,869	$599.55	$407.40 – $2,792.11
Laser treatment of clouding after cataract surgery: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $2,438.65 AETNA — ASA: $2,246.43 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $407.40 AETNA — MEDICARE ADVANTAGE: $653.51 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $2,465.04 AMERIHEALTH — REGIONAL HMO: $2,792.11 BERGEN RISK — ALL PRODUCTS: $2,151.75 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $2,582.10
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CATARACT REMOVAL INSERTION OF LENS	$7,351	$2,492.56	$1,043.84 – $7,153.99
Cataract removal with lens implant: 10 of 36 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $6,248.35 AETNA — ASA: $5,755.83 AETNA — HMO: $8,419 AETNA — MANAGED MEDICAID: $1,043.84 AETNA — MEDICARE ADVANTAGE: $2,716.89 AETNA — PPO: $8,419 AMERIHEALTH — LOCAL HMO: $6,315.98 AMERIHEALTH — REGIONAL HMO: $7,153.99 BERGEN RISK — ALL PRODUCTS: $5,513.25 BRIGHTON HEALTH PLAN — ALL PRODUCTS: $9,933

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$5,834	Not listed in the file	$828.43 – $5,133.92
Vaginal delivery, with care before and after: 10 of 15 insurance plan rates ACTIVECARE FIRST MCO — ALL PRODUCTS: $4,958.90 AETNA — ASA: $4,568.02 AETNA — MANAGED MEDICAID: $828.43 AETNA — MEDICARE ADVANTAGE: $1,190.14 CLOVER — MEDICARE ADVANTAGE: $1,050.12 HORIZON — PIP: $4,509.68 HORIZON — WORKERS COMP: $3,349 KARNA — MEDICARE ADVANTAGE: $5,029.10 MULTIPLAN - PHCS — ALL PRODUCTS: $4,958.90 OXFORD — ALL PRODUCTS: $3,836.44
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$5,589.58
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $5,589.58
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$5,269.74
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan KARNA — MEDICARE ADVANTAGE: $5,269.74

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	$79,657.38	$15,110 – $369,646.78
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 25 insurance plan rates AETNA — HMO: $269,217.43 AETNA — MANAGED MEDICAID: $87,949.11 AETNA — MEDICARE ADVANTAGE: $95,864.53 AETNA — PPO: $269,217.43 AMERIGROUP — MANAGED MEDICAID: $87,949.11 AMERIHEALTH — LOCAL HMO: $79,198.36 AMERIHEALTH — REGIONAL HMO: $79,198.36 CIGNA — HMO: $288,056.38 CIGNA — PPO: $324,228.70 CLOVER — MEDICARE ADVANTAGE: $96,744.02
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC	Not listed in the file	$79,657.38	$15,110 – $369,646.78
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 7 insurance plans BRIGHTON HEALTH PLAN — ALL PRODUCTS: $333,940.06 HORIZON — HMO: $241,800 HORIZON — INDEMNITY: $285,670 HORIZON — MANAGED MEDICAID: $80,247 HORIZON — OMNIA: $195,858 HORIZON — PPO: $285,012 HORIZON — SHP: $229,632
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$29,861.97
Spinal fusion (not neck), without major complications: rates for 2 insurance plans AMERIHEALTH — LOCAL HMO: $29,861.97 AMERIHEALTH — REGIONAL HMO: $29,861.97
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	$15,562.37	$14,426.42 – $72,216.53
Hip or knee replacement (major joint of the leg), without major complications: 10 of 17 insurance plan rates AETNA — HMO: $52,596.02 AETNA — MANAGED MEDICAID: $17,182.29 AETNA — MEDICARE ADVANTAGE: $18,728.70 AETNA — PPO: $52,596.02 AMERIGROUP — MANAGED MEDICAID: $17,182.29 CIGNA — HMO: $56,276.52 CIGNA — PPO: $63,343.37 CLOVER — MEDICARE ADVANTAGE: $18,900.52 HORIZON BCBS BRAVEN — MEDICARE ADVANTAGE: $17,182.29 KARNA — MEDICARE ADVANTAGE: $24,585.67
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	$15,562.37	$14,426.42 – $72,216.53
Hip or knee replacement (major joint of the leg), without major complications: rates for 7 insurance plans AMERIHEALTH — LOCAL HMO: $14,426.42 AMERIHEALTH — REGIONAL HMO: $14,426.42 HORIZON — WORKERS COMP: $15,110 VACCN — ALL PRODUCTS: $15,562.37 ACTIVECARE FIRST MCO — ALL PRODUCTS: 85% (a percentage in the contract, not a dollar amount) HORIZON — PIP: 77.3% (a percentage in the contract, not a dollar amount) MULTIPLAN - PHCS — ALL PRODUCTS: 85% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC	Not listed in the file	$15,562.37	$14,426.42 – $72,216.53
Hip or knee replacement (major joint of the leg), without major complications: rates for 7 insurance plans BRIGHTON HEALTH PLAN — ALL PRODUCTS: $67,659.17 HORIZON — HMO: $48,991 HORIZON — INDEMNITY: $57,879 HORIZON — MANAGED MEDICAID: $15,729 HORIZON — OMNIA: $39,683 HORIZON — PPO: $57,746 HORIZON — SHP: $46,526
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	$19,539.83	$15,110 – $90,673.78
Neck (cervical) spinal fusion, without complications: 10 of 24 insurance plan rates AETNA — HMO: $66,038.62 AETNA — MANAGED MEDICAID: $21,573.78 AETNA — MEDICARE ADVANTAGE: $23,515.42 AETNA — PPO: $66,038.62 AMERIGROUP — MANAGED MEDICAID: $21,573.78 AMERIHEALTH — LOCAL HMO: $19,288.37 AMERIHEALTH — REGIONAL HMO: $19,288.37 CIGNA — HMO: $70,659.79 CIGNA — PPO: $79,532.80 CLOVER — MEDICARE ADVANTAGE: $23,731.16
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION W/O CC/MCC	Not listed in the file	$19,539.83	$15,110 – $90,673.78
Neck (cervical) spinal fusion, without complications: rates for 7 insurance plans BRIGHTON HEALTH PLAN — ALL PRODUCTS: $80,685.72 HORIZON — HMO: $58,423 HORIZON — INDEMNITY: $69,023 HORIZON — MANAGED MEDICAID: $20,076 HORIZON — OMNIA: $47,323 HORIZON — PPO: $68,864 HORIZON — SHP: $55,483
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	$9,893.72	$8,597.84 – $45,911.40
Uterus and ovary surgery (not for cancer), without complications: 10 of 24 insurance plan rates AETNA — HMO: $33,437.74 AETNA — MANAGED MEDICAID: $10,923.58 AETNA — MEDICARE ADVANTAGE: $11,906.70 AETNA — PPO: $33,437.74 AMERIGROUP — MANAGED MEDICAID: $10,923.58 AMERIHEALTH — LOCAL HMO: $8,597.84 AMERIHEALTH — REGIONAL HMO: $8,597.84 CIGNA — HMO: $35,777.60 CIGNA — PPO: $40,270.33 CLOVER — MEDICARE ADVANTAGE: $12,015.94
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC	Not listed in the file	$9,893.72	$8,597.84 – $45,911.40
Uterus and ovary surgery (not for cancer), without complications: rates for 7 insurance plans BRIGHTON HEALTH PLAN — ALL PRODUCTS: $37,933.75 HORIZON — HMO: $27,467 HORIZON — INDEMNITY: $32,451 HORIZON — MANAGED MEDICAID: $9,177 HORIZON — OMNIA: $22,248 HORIZON — PPO: $32,376 HORIZON — SHP: $26,085

Source: Ocean Medical Center’s standard charges file (hackensackmeridianhealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on December 31, 2025; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	425 Jack Martin Blvd, Brick, NJ 08724
County	Ocean County
State	New Jersey
Phone	(732) 840‑2200
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	310052
Name in Medicare records	OCEAN MEDICAL CENTER
Profile level	Medicare data + hospital website
Name on the hospital’s website	Ocean University Medical Center
Official website	hackensackmeridianhealth.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Ocean University Medical Center | Hackensack Meridian Health — hackensackmeridianhealth.org
Ocean University Medical Center | Hackensack Meridian Health — hackensackmeridianhealth.org
About Ocean University Medical Center | Hackensack Meridian Health — hackensackmeridianhealth.org

Ocean Medical Center

Summary

Profile from official sources

At a glance