Does Penn Highlands Huntingdon have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Penn Highlands Huntingdon. In a medical emergency, call 911.

Where is Penn Highlands Huntingdon?

1225 Warm Springs Ave, Huntingdon, PA 16652, in Huntingdon County, Pennsylvania.

What is the phone number of Penn Highlands Huntingdon?

(814) 643-2290, as listed by Medicare (CMS).

What is the Medicare star rating of Penn Highlands Huntingdon?

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

Penn Highlands Huntingdon — Huntingdon, PA

Quick answers

Does Penn Highlands Huntingdon have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Penn Highlands Huntingdon. In a medical emergency, call 911.
Where is Penn Highlands Huntingdon?: 1225 Warm Springs Ave, Huntingdon, PA 16652, in Huntingdon County, Pennsylvania.
What is the phone number of Penn Highlands Huntingdon?: (814) 643-2290, as listed by Medicare (CMS).
What is the Medicare star rating of Penn Highlands Huntingdon?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5]

Behavioral health services
Breast health
Heart care
Pulmonary care
Anesthesiology
Cancer care
Gastroenterology
General surgery
Orthopedic care
Orthopedic surgery
Non-surgical orthopedic care
Otorhinolaryngology (ear, nose, throat)
Sports medicine
Women's health services
Pediatrics
Wound care

Treatments^[4]

Cardiac rehabilitation
Pulmonary rehabilitation
Rehabilitation services
Infusion services
Carpal tunnel treatment
Diabetes and nutrition wellness

Procedures^[4][6]

Heart catheterization
Hip replacement surgery
Knee replacement surgery
Shoulder replacement surgery
Nuclear medicine
PET scan
EEG
Lung cancer screening

Programs and centers^[4][5]

Joint Replacement Program
Intensive care services
Urgent care
Occupational health
Imaging (radiology) services
Surgical services

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

Emergency room	Yes

Visiting and practical information

Patient portal	MyPennHighlands Patient Portal

Recognition^[6]

ACR accreditation - Nuclear Medicine (2026)

Doctors and clinicians (325)

325 doctors and other clinicians list Penn Highlands Huntingdon 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 301 more: the button below opens the full list.

Other emergency rooms nearby

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

Penn Highlands Tyrone18 mi · Tyrone, PA · Critical Access Hospital
UPMC Altoona20 mi · Altoona, PA · Acute Care Hospital
Conemaugh Nason Medical Center22 mi · Roaring Spring, PA · Acute Care Hospital
Mount Nittany Medical Center23 mi · State College, PA · Acute Care Hospital
Geisinger-Lewistown Hospital23 mi · Lewistown, PA · Acute Care Hospital

Other hospitals nearby

Encompass Health Rehabilitation Hospital of Altoon…20 mi · Altoona, PA · Inpatient Rehabilitation Hospital
James E. Van Zandt VA Medical Center (Altoona)20 mi · Altoona, PA · Federal/VA Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Embassy of Huntingdon Park0.0 mi · Huntingdon, PA · 2 of 5 stars
Westminster Woods at Huntingdo1.5 mi · Huntingdon, PA · 2 of 5 stars
Cedarwood Rehabilitation & Healthcare Center17 mi · Tyrone, PA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Family Hospice19 mi · Altoona, PA · 3 of 5 stars
Adoration Hospice20 mi · Altoona, PA · 4 of 5 stars
Aseracare Hospice20 mi · Altoona, PA · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Advantage Home Health Services, LLC19 mi · Altoona, PA
UPMC Home Healthcare of Central Pennsylvania19 mi · Altoona, PA
Grane Home Health Care20 mi · Altoona, PA

All home health agencies in the state →

Dialysis facilities

FKC Huntingdon3.6 mi · Huntingdon, PA · 3 of 5 stars
USRC Huntingdon3.6 mi · Huntingdon, PA · 3 of 5 stars
DaVita Tyrone Dialysis17 mi · Tyrone, PA · 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.

Allegheny Regional Endoscopy Center19 mi · Altoona, PA
Allegheny Surgery Center LLC19 mi · Altoona, PA
Center for the Surgical Arts, LLC19 mi · Altoona, PA

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

BTAMC Primary Care Center0.1 mi · Huntingdon, PA · Community health center
Btamc Family Wellness Center0.2 mi · Huntingdon, PA · Community health center
BTAMC Huntingdon Family Care Center0.5 mi · Huntingdon, PA · Community health center

Clinics and urgent care

Centre Urgentcare PC17 mi · Tyrone, PA · Urgent care center
Penn Highlands Tyrone Rural Health Clinic17 mi · Tyrone, PA · Rural health clinic
Medexpress Urgent Care, PC - Pennsylvania20 mi · Altoona, PA · Urgent care center

Pharmacies

The Giant Company, LLC3.6 mi · Huntingdon, PA · Community/retail pharmacy
Wal-Mart Stores East LP3.6 mi · Huntingdon, PA · Community/retail pharmacy

Assisted living nearby

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

Graystone Manor Huntingdon3.6 mi · Huntingdon, PA
Westminster Woods at Huntingdon3.6 mi · Huntingdon, PA

About the Medicare star rating

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

Medicare quality data

What Penn Highlands Huntingdon 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	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	5 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	61%National average: 72%
Would definitely recommend the hospital	59%National average: 71%
Nurses “always” communicated well	78%National average: 80%
Doctors “always” communicated well	80%National average: 80%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	83%National average: 74%
Area around the room “always” quiet at night	61%National average: 60%
Completed surveys	346Response rate: 30%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.615No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12%
Deaths within 30 days: heart failure patients	8.6%
Deaths within 30 days: pneumonia patients	15.5%
Deaths within 30 days: COPD patients	8.3%
Deaths within 30 days: stroke patients	10.8%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.95No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.2%
Readmitted within 30 days: heart failure	19.1%
Readmitted within 30 days: pneumonia	16.8%
Readmitted within 30 days: COPD	20.3%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	136 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)	60%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 85 common services exactly as Penn Highlands Huntingdon 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 →

$ 20 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$1.64 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $215.40
New patient office visit (about 30–44 minutes): 10 of 18 insurance plan rates Aetna — All Commercial Plans: $144.65 Aetna — Better Health Medicaid Managed Care Plan: $54.25 Amerihealth — Caritas Medicaid Managed Care Plan: $60.76 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $54.25 Cigna — All Commercial Plans: $140.46 Devoted Health Plans — Medicare Managed Care Plan: $80.22 Geisinger Health Plan — All Commercial Plans: $130.05 Geisinger Health Plan — Medicare Managed Care Plan: $130.05 Highmark — All Commercial Plans: $150.78 Highmark — Medicare Managed Care Plan: $105.11
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: Q-CARE OV PROB DETAILED NEW L3	$146	$146	Not listed in the file
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC OV PROB DETAILED NEW L3	$526	$526	Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$0.62 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,145.25
New patient office visit (about 45–59 minutes): 10 of 18 insurance plan rates Aetna — All Commercial Plans: $216.02 Aetna — Better Health Medicaid Managed Care Plan: $90.37 Amerihealth — Caritas Medicaid Managed Care Plan: $101.21 Cigna — All Commercial Plans: $278.24 Devoted Health Plans — Medicare Managed Care Plan: $163.66 Geisinger Health Plan — All Commercial Plans: $179.40 Geisinger Health Plan — Medicare Managed Care Plan: $179.40 Highmark — All Commercial Plans: $190.60 Highmark — Medicare Managed Care Plan: $157.99 Humana — Medicare Managed Care: $159.03
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: Q-CARE OV PROB COMPREHEN NEW L4	$209	$209	Not listed in the file
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Hospital (facility) fee In the file: OV PROB COMPREHEN NEW L4	$1,527	$1,527	Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$21.90 – $1,145.25
New patient office visit (about 60–74 minutes): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $285.10 Cigna — All Commercial Plans: $175.36 Devoted Health Plans — Medicare Managed Care Plan: $177.69 Geisinger Health Plan — All Commercial Plans: $187.67 Geisinger Health Plan — Medicare Managed Care Plan: $207.67 Highmark — All Commercial Plans: $251.75 Highmark — Medicare Managed Care Plan: $204.08 Humana — Medicare Managed Care: $177.47 Pennsylvania Health & Wellness — Ambetter Exchange: $266.95 Unitedhealthcare — All Commercial Plans: $256.70
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: Q-CARE OV PROB COMPLEX NEW L5	$252	$252	Not listed in the file
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC OV PROB COMPLEX NEW L5	$760	$760	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit est	Not listed in the file	Not listed in the file	$0.31 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,145.25
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates Aetna — All Commercial Plans: $197.65 Aetna — Better Health Medicaid Managed Care Plan: $35 Amerihealth — Caritas Medicaid Managed Care Plan: $39.20 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $87.36 Cigna — All Commercial Plans: $394.80 Devoted Health Plans — Medicare Managed Care Plan: $88.84 Geisinger Health Plan — All Commercial Plans: $226.28 Geisinger Health Plan — Medicare Managed Care Plan: $226.28 Highmark — All Commercial Plans: $193 Highmark — Medicare Managed Care Plan: $226.58
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: Q-CARE OV PROB EXPANDED ESTAB L3	$106	$106	Not listed in the file
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: OV PROB EXPANDED ESTAB L3	$1,527	$1,527	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: Office/outpatient visit est	Not listed in the file	Not listed in the file	$0.21 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,145.25
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates Aetna — All Commercial Plans: $172.34 Aetna — Better Health Medicaid Managed Care Plan: $54.42 Amerihealth — Caritas Medicaid Managed Care Plan: $60.95 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $120.52 Cigna — All Commercial Plans: $456.85 Devoted Health Plans — Medicare Managed Care Plan: $125.24 Geisinger Health Plan — All Commercial Plans: $226.28 Geisinger Health Plan — Medicare Managed Care Plan: $226.28 Highmark — All Commercial Plans: $208.50 Highmark — Medicare Managed Care Plan: $226.58
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: Q-CARE OV PROB DETAILED ESTAB L4	$144	$144	Not listed in the file
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC OV PROB DETAILED ESTAB L4	$561	$561	Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Doctor (professional) fee In the file: Office consultation	Not listed in the file	Not listed in the file	$11.77 – $165
Office consultation with a specialist (moderate): rates for 3 insurance plans Aetna — All Commercial Plans: $165 Pennsylvania Health & Wellness — Ambetter Exchange: $151.99 Upmc — All Commercial Plans: $76.10
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC OV CONSULT PROB DETAILED L3	$185	$185	Not listed in the file
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · Hospital (facility) fee In the file: OV CONSULT PROB DETAILED L3	$185	$185	Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Doctor (professional) fee In the file: Office consultation	Not listed in the file	Not listed in the file	$42.85 – $230
Office consultation with a specialist (moderate to high): rates for 5 insurance plans Aetna — All Commercial Plans: $230 Amerihealth — Caritas Medicaid Managed Care Plan: $118.65 Pennsylvania Health & Wellness — Ambetter Exchange: $198.45 Unitedhealthcare — All Commercial Plans: $188.41 Upmc — All Commercial Plans: $116.53
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC OV CONSULT PROB COMPREHEN L4	$260	$260	Not listed in the file
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · Hospital (facility) fee In the file: OV CONSULT PROB COMPREHEN L4	$260	$260	Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: Prev visit new age 18-39	Not listed in the file	Not listed in the file	$22 – $220.40
Preventive checkup, new patient, age 18–39: rates for 6 insurance plans Aetna — All Commercial Plans: $171.21 Geisinger Health Plan — All Commercial Plans: $154.96 Highmark — All Commercial Plans: $147.20 Pennsylvania Health & Wellness — Ambetter Exchange: $220.40 Unitedhealthcare — All Commercial Plans: $149.08 Upmc — All Commercial Plans: $145.17
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC PREVENTIVE MED 18-39 YRS NEW	$247	$247	Not listed in the file
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: PREVENTIVE MED 18-39YRS NEW	$82	$82	Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: Prev visit new age 40-64	Not listed in the file	Not listed in the file	$22 – $198.88
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans Aetna — All Commercial Plans: $198.88 Geisinger Health Plan — All Commercial Plans: $182.47 Highmark — All Commercial Plans: $169.47 Unitedhealthcare — All Commercial Plans: $173.18 Upmc — All Commercial Plans: $167.44
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC PREVENTIVE MED 40-64 YRS NEW	$286	$286	Not listed in the file
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: PREVENTIVE MED 40-64YR NEW	$95	$95	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$2.03 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,514
Emergency room visit (moderate): 10 of 18 insurance plan rates Aetna — All Commercial Plans: $1,312.31 Amerihealth — Caritas Medicaid Managed Care Plan: $63.45 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $63.45 Cigna — All Commercial Plans: $80.85 Devoted Health Plans — Medicare Managed Care Plan: $69.64 Geisinger Health Plan — All Commercial Plans: $92.09 Geisinger Health Plan — Medicare Managed Care Plan: $92.09 Highmark — All Commercial Plans: $93.03 Highmark — Medicare Managed Care Plan: $73.07 Humana — Medicare Managed Care: $287.97
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT L3	$3,352	$3,352	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: 99283 EMERGENCY DEPARTMENT L3 ED TC	$3,352	$3,352	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$1.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,866.25
Emergency room visit (moderately high): 10 of 18 insurance plan rates Aetna — All Commercial Plans: $1,711.32 Amerihealth — Caritas Medicaid Managed Care Plan: $106.77 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $106.77 Cigna — All Commercial Plans: $153.30 Geisinger Health Plan — All Commercial Plans: $143.84 Geisinger Health Plan — Medicare Managed Care Plan: $146.78 Highmark — All Commercial Plans: $158.71 Highmark — Medicare Managed Care Plan: $127.99 Humana — Medicare Managed Care: $1,983.54 Jefferson Health Plans — Medicaid Managed Care Plan: $135.30
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT L4	$5,155	$5,155	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: 99284 EMERGENCY DEPARTMENT L4 ED TC	$5,155	$5,155	Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$4.12 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,566.50
Emergency room visit (high): 10 of 17 insurance plan rates Aetna — All Commercial Plans: $3,569.98 Amerihealth — Caritas Medicaid Managed Care Plan: $155.39 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $155.39 Cigna — All Commercial Plans: $228 Geisinger Health Plan — All Commercial Plans: $225.27 Geisinger Health Plan — Medicare Managed Care Plan: $225.27 Highmark — All Commercial Plans: $230.14 Highmark — Medicare Managed Care Plan: $191.77 Humana — Medicare Managed Care: $171.74 Jefferson Health Plans — Medicaid Managed Care Plan: $212.30
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT L5	$7,422	$7,422	Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: 99285 EMERGENCY DEPARTMENT L5 ED TC	$7,422	$7,422	Not listed in the file

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$1.33 – $95.06
Basic metabolic panel (blood test): rates for 7 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $10.30 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $20.41 Humana — Medicare Managed Care: $95.06 Jefferson Health Plans — Medicaid Managed Care Plan: $10.30 Unitedhealthcare — All Commercial Plans: $28.32 Unitedhealthcare — Medicare Managed Care Plan: $8.71 Upmc — All Commercial Plans: $92.25
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$5.50 – $10.65
Basic metabolic panel (blood test): rates for 2 insurance plans Cigna — All Commercial Plans: $5.50 Unitedhealthcare — All Commercial Plans: $10.65
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: Basic Metabolic Panel	$99	$99	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$1 – $309
Comprehensive metabolic panel (blood test): rates for 10 insurance plans Aetna — All Commercial Plans: $26.40 Aetna — Better Health Medicaid Managed Care Plan: $11.69 Amerihealth — Caritas Medicaid Managed Care Plan: $12.86 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $25.57 Cigna — All Commercial Plans: $37.14 Humana — Medicare Managed Care: $141.28 Jefferson Health Plans — Medicaid Managed Care Plan: $12.86 Unitedhealthcare — All Commercial Plans: $71.13 Unitedhealthcare — Medicare Managed Care Plan: $10.88 Upmc — All Commercial Plans: $309
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$6.86 – $13.29
Comprehensive metabolic panel (blood test): rates for 2 insurance plans Cigna — All Commercial Plans: $6.86 Unitedhealthcare — All Commercial Plans: $13.29
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: Comprehensive Metabolic Panel	$124	$124	Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$31.08 – $44.69
Obstetric blood test panel: rates for 2 insurance plans Cigna — All Commercial Plans: $31.08 Unitedhealthcare — All Commercial Plans: $44.69
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: Antibody Screen Gel	$562	$562	Not listed in the file
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: Hepatitis B Surface Antigen wRfx Conf	$562	$562	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$2.35 – $117.75
Cholesterol panel (lipid panel): rates for 9 insurance plans Aetna — All Commercial Plans: $33.48 Amerihealth — Caritas Medicaid Managed Care Plan: $15.40 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $15.40 Cigna — All Commercial Plans: $33.48 Humana — Medicare Managed Care: $63.48 Jefferson Health Plans — Medicaid Managed Care Plan: $15.40 Unitedhealthcare — All Commercial Plans: $32.97 Unitedhealthcare — Medicare Managed Care Plan: $13.79 Upmc — All Commercial Plans: $117.75
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$8.70 – $16.85
Cholesterol panel (lipid panel): rates for 2 insurance plans Cigna — All Commercial Plans: $8.70 Unitedhealthcare — All Commercial Plans: $16.85
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: Lipid Panel	$157	$157	Not listed in the file
Kidney function panel CPT 80069 · Inpatient or outpatient · Doctor (professional) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$7.01 – $76.50
Kidney function panel: rates for 4 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $10.56 Humana — Medicare Managed Care: $8.80 Unitedhealthcare — Medicare Managed Care Plan: $8.94 Upmc — All Commercial Plans: $76.50
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$5.64 – $10.92
Kidney function panel: rates for 2 insurance plans Cigna — All Commercial Plans: $5.64 Unitedhealthcare — All Commercial Plans: $10.92
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: Renal Function Panel	$102	$102	Not listed in the file
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$7.34 – $80.81
Liver function panel: rates for 7 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $9.93 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $19.80 Humana — Medicare Managed Care: $80.81 Jefferson Health Plans — Medicaid Managed Care Plan: $9.93 Unitedhealthcare — All Commercial Plans: $20.16 Unitedhealthcare — Medicare Managed Care Plan: $8.42 Upmc — All Commercial Plans: $72
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$5.31 – $10.28
Liver function panel: rates for 2 insurance plans Cigna — All Commercial Plans: $5.31 Unitedhealthcare — All Commercial Plans: $10.28
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: Hepatic Function Panel	$96	$96	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$2.45 – $55.51
Urine test (automated, with microscope): rates for 8 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $3.30 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $12.16 Cigna — All Commercial Plans: $17.67 Humana — Medicare Managed Care: $50.18 Jefferson Health Plans — Medicaid Managed Care Plan: $3.30 Unitedhealthcare — All Commercial Plans: $34.40 Unitedhealthcare — Medicare Managed Care Plan: $3.27 Upmc — All Commercial Plans: $55.51
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$2.06 – $3.99
Urine test (automated, with microscope): rates for 2 insurance plans Cigna — All Commercial Plans: $2.06 Unitedhealthcare — All Commercial Plans: $3.99
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: UA w/Micro	$59	$59	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$2.75 – $3.51
Urine test (manual, without microscope): rates for 3 insurance plans Highmark — All Commercial Plans: $2.75 Highmark — Medicare Managed Care Plan: $3.42 Humana — Medicare Managed Care: $3.51
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$2.26 – $3.21
Urine test (manual, without microscope): rates for 2 insurance plans Cigna — All Commercial Plans: $2.26 Unitedhealthcare — All Commercial Plans: $3.21
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: PH S/O Chrg Only	$41	$41	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$0.23 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $48.02
Urine test (automated, without microscope): 10 of 11 insurance plan rates Aetna — All Commercial Plans: $8.88 Amerihealth — Caritas Medicaid Managed Care Plan: $3.41 Devoted Health Plans — Medicare Managed Care Plan: $2.20 Highmark — All Commercial Plans: $2.21 Highmark — Medicare Managed Care Plan: $2.21 Humana — Medicare Managed Care: $48.02 Jefferson Health Plans — Medicaid Managed Care Plan: $3.41 Pennsylvania Health & Wellness — Ambetter Exchange: $3.26 Unitedhealthcare — All Commercial Plans: $3.77 Unitedhealthcare — Medicare Managed Care Plan: $2.32
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$1.46 – $2.83
Urine test (automated, without microscope): rates for 2 insurance plans Cigna — All Commercial Plans: $1.46 Unitedhealthcare — All Commercial Plans: $2.83
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALYSIS AUTO DIPSTICK W/O SCOPE	$16	$16	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Doctor (professional) fee In the file: Assay of psa total	Not listed in the file	Not listed in the file	$14.38 – $162
PSA (prostate specific antigen) blood test: rates for 6 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $26.80 Humana — Medicare Managed Care: $138.02 Jefferson Health Plans — Medicaid Managed Care Plan: $26.80 Unitedhealthcare — All Commercial Plans: $38.25 Unitedhealthcare — Medicare Managed Care Plan: $18.94 Upmc — All Commercial Plans: $162
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total	Not listed in the file	Not listed in the file	$11.95 – $23.13
PSA (prostate specific antigen) blood test: rates for 2 insurance plans Cigna — All Commercial Plans: $11.95 Unitedhealthcare — All Commercial Plans: $23.13
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: Prostate Specific Antigen Diagnostic	$216	$216	Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: Assay thyroid stim hormone	Not listed in the file	Not listed in the file	$0.25 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $193.06
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $25.53 Cigna — All Commercial Plans: $42 Humana — Medicare Managed Care: $193.06 Jefferson Health Plans — Medicaid Managed Care Plan: $25.53 Unitedhealthcare — All Commercial Plans: $41.37 Unitedhealthcare — Medicare Managed Care Plan: $17.30 Upmc — All Commercial Plans: $147.75
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone	Not listed in the file	Not listed in the file	$10.92 – $21.12
Thyroid stimulating hormone (TSH) test: rates for 2 insurance plans Cigna — All Commercial Plans: $10.92 Unitedhealthcare — All Commercial Plans: $21.12
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: TSH w/HAMA Treatment	$197	$197	Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$0.75 – $1,528.65
Complete blood count (CBC) with differential: rates for 10 insurance plans Aetna — All Commercial Plans: $19.43 Aetna — Better Health Medicaid Managed Care Plan: $6 Amerihealth — Caritas Medicaid Managed Care Plan: $6.60 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $18.77 Cigna — All Commercial Plans: $27.25 Humana — Medicare Managed Care: $68.60 Jefferson Health Plans — Medicaid Managed Care Plan: $6.60 Unitedhealthcare — All Commercial Plans: $40.81 Unitedhealthcare — Medicare Managed Care Plan: $8 Upmc — All Commercial Plans: $1,528.65
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$5.05 – $9.77
Complete blood count (CBC) with differential: rates for 2 insurance plans Cigna — All Commercial Plans: $5.05 Unitedhealthcare — All Commercial Plans: $9.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC w/ Auto Diff	$91	$91	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$1.40 – $74.48
Complete blood count (CBC), automated: rates for 6 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $8.27 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $15.67 Humana — Medicare Managed Care: $74.48 Jefferson Health Plans — Medicaid Managed Care Plan: $8.27 Unitedhealthcare — Medicare Managed Care Plan: $6.66 Upmc — All Commercial Plans: $57
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$4.21 – $8.14
Complete blood count (CBC), automated: rates for 2 insurance plans Cigna — All Commercial Plans: $4.21 Unitedhealthcare — All Commercial Plans: $8.14
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: Hemogram	$76	$76	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: Prothrombin time	Not listed in the file	Not listed in the file	$2.94 – $37.50
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans Aetna — All Commercial Plans: $10.73 Amerihealth — Caritas Medicaid Managed Care Plan: $4.40 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $10.31 Humana — Medicare Managed Care: $4.33 Jefferson Health Plans — Medicaid Managed Care Plan: $4.40 Unitedhealthcare — All Commercial Plans: $11.10 Unitedhealthcare — Medicare Managed Care Plan: $4.42 Upmc — All Commercial Plans: $37.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time	Not listed in the file	Not listed in the file	$2.79 – $4.94
Blood clotting time test (prothrombin time, PT): rates for 2 insurance plans Cigna — All Commercial Plans: $2.79 Unitedhealthcare — All Commercial Plans: $4.94
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC PT/INR	$35	$35	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: Thromboplastin time partial	Not listed in the file	Not listed in the file	$6.07 – $36.75
Blood clotting test (partial thromboplastin time, PTT): rates for 7 insurance plans Aetna — All Commercial Plans: $15.03 Amerihealth — Caritas Medicaid Managed Care Plan: $8.25 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $10.10 Humana — Medicare Managed Care: $6.07 Jefferson Health Plans — Medicaid Managed Care Plan: $8.25 Unitedhealthcare — Medicare Managed Care Plan: $6.19 Upmc — All Commercial Plans: $36.75
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial	Not listed in the file	Not listed in the file	$3.91 – $7.54
Blood clotting test (partial thromboplastin time, PTT): rates for 2 insurance plans Cigna — All Commercial Plans: $3.91 Unitedhealthcare — All Commercial Plans: $7.54
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: Partial Thromboplastin Time	$49	$49	Not listed in the file

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$26.86 – $490.35
CT scan of the head or brain, without contrast: rates for 5 insurance plans Aetna — All Commercial Plans: $50.91 Highmark — All Commercial Plans: $37.24 Jefferson Health Plans — Medicaid Managed Care Plan: $85.25 Unitedhealthcare — All Commercial Plans: $490.35 Upmc — All Commercial Plans: $149.28
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$97.27 – $362.09
CT scan of the head or brain, without contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $362.09 Cigna — All Commercial Plans: $97.27
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Brain wo Contrast w Stealth Protocol	$1,287	$1,287	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Doctor (professional) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$156.35 – $371.90
MRI of the brain, before and after contrast: rates for 4 insurance plans Aetna — All Commercial Plans: $156.35 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $223.23 Jefferson Health Plans — Medicaid Managed Care Plan: $295.90 Upmc — All Commercial Plans: $371.90
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$335.32 – $525.53
MRI of the brain, before and after contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $525.53 Cigna — All Commercial Plans: $335.32
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI Brain w/ + w/o Contrast	$4,324	$4,324	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$5.68 – $474.27
Chest X-ray, 2 views: rates for 5 insurance plans Aetna — All Commercial Plans: $59.40 Cigna — All Commercial Plans: $144.62 Jefferson Health Plans — Medicaid Managed Care Plan: $16.34 Unitedhealthcare — All Commercial Plans: $382.69 Upmc — All Commercial Plans: $474.27
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$79.07 – $1,640.49
Chest X-ray, 2 views: rates for 2 insurance plans Aetna — All Commercial Plans: $1,640.49 Cigna — All Commercial Plans: $79.07
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: OCCHLTH CHEST XRAY 2 VIEW	$137	$137	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$14.48 – $965.25
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans Aetna — All Commercial Plans: $47.79 Cigna — All Commercial Plans: $71.57 Jefferson Health Plans — Medicaid Managed Care Plan: $24.75 Unitedhealthcare — All Commercial Plans: $33.58 Upmc — All Commercial Plans: $965.25
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$97.27 – $2,827.99
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans Aetna — All Commercial Plans: $2,827.99 Cigna — All Commercial Plans: $97.27
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: OCCHLTH LS XRAY 4 VIEW	$213	$213	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$79.79 – $205.92
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans Aetna — All Commercial Plans: $88.65 Jefferson Health Plans — Medicaid Managed Care Plan: $205.92 Upmc — All Commercial Plans: $198
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$212.53 – $1,202.30
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $1,202.30 Cigna — All Commercial Plans: $212.53
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI Spine Lumbar w/o Contrast	$2,926	$2,926	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye	Not listed in the file	Not listed in the file	$48.76 – $164.13
CT scan of the pelvis, with contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $48.76 Cigna — All Commercial Plans: $164.13
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Cystogram	$2,155	$2,155	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT Pelvis w/ Contrast	$2,155	$2,155	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$212.53 – $2,416.34
MRI of a leg joint (such as the knee), without contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $2,416.34 Cigna — All Commercial Plans: $212.53
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$45.79 – $175
MRI of a leg joint (such as the knee), without contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $91.19 Upmc — All Commercial Plans: $175
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee · modifier 26\|LT In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$6.12 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $97.90
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans Aetna — All Commercial Plans: $91.19 Geisinger Health Plan — All Commercial Plans: $68.63 Geisinger Health Plan — Medicare Managed Care Plan: $62.36 Highmark — All Commercial Plans: $81.99 Highmark — Medicare Managed Care Plan: $73 Humana — Medicare Managed Care: $62.80 Pennsylvania Health & Wellness — Medicaid Managed Care Plan: $68.63 Unitedhealthcare — All Commercial Plans: $61.25 Upmc — All Commercial Plans: $97.90 Va Ccn — Optum Government: $62.21
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: Ct abd & pelv w/contrast	Not listed in the file	Not listed in the file	$82.84 – $609.64
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans Aetna — All Commercial Plans: $576.18 Jefferson Health Plans — Medicaid Managed Care Plan: $212 Unitedhealthcare — Medicare Managed Care Plan: $362.02 Upmc — All Commercial Plans: $609.64
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast	Not listed in the file	Not listed in the file	$335.32 – $1,504
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans Aetna — All Commercial Plans: $1,504 Cigna — All Commercial Plans: $335.32
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: zzCT Abdomen w/ Pelvis w/ contrast	$4,324	$4,324	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$34.43 – $109.56
Ultrasound of the abdomen, complete: rates for 3 insurance plans Aetna — All Commercial Plans: $53.56 Cigna — All Commercial Plans: $109.56 Jefferson Health Plans — Medicaid Managed Care Plan: $63.25
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$97.27 – $1,238.24
Ultrasound of the abdomen, complete: rates for 2 insurance plans Aetna — All Commercial Plans: $1,238.24 Cigna — All Commercial Plans: $97.27
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: US Abdomen Complete	$1,287	$1,287	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$97.27 – $1,806.64
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans Aetna — All Commercial Plans: $1,806.64 Cigna — All Commercial Plans: $97.27
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: Ob us >/= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$59.78 – $61.56
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan Aetna — All Commercial Plans: $61.56
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: PC Pel OB Compl > 14 Wks	$1,287	$1,287	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob	Not listed in the file	Not listed in the file	$97.27 – $1,437.81
Transvaginal ultrasound: rates for 2 insurance plans Aetna — All Commercial Plans: $1,437.81 Cigna — All Commercial Plans: $97.27
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: Transvaginal us non-ob	Not listed in the file	Not listed in the file	$29.58 – $57.08
Transvaginal ultrasound: rates for 2 insurance plans Aetna — All Commercial Plans: $57.08 Jefferson Health Plans — Medicaid Managed Care Plan: $51.15
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: US Transvaginal Non-OB	$1,287	$1,287	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$82.83 – $1,225.10
Diagnostic mammogram, one breast: rates for 2 insurance plans Aetna — All Commercial Plans: $1,225.10 Cigna — All Commercial Plans: $82.83
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$44.79 – $48.36
Diagnostic mammogram, one breast: rates for 1 insurance plan Aetna — All Commercial Plans: $48.36
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MA Diag Digital Mammo+Tomo RT	$927	$927	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$105.59 – $1,389.74
Diagnostic mammogram, both breasts: rates for 2 insurance plans Aetna — All Commercial Plans: $1,389.74 Cigna — All Commercial Plans: $105.59
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$43.88 – $64.26
Diagnostic mammogram, both breasts: rates for 1 insurance plan Aetna — All Commercial Plans: $64.26
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: MA Mammogram Digital Diagnostic Bilat	$1,180	$1,180	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$27.04 – $235.04
Screening mammogram, both breasts: rates for 4 insurance plans Aetna — All Commercial Plans: $235.04 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $83.03 Unitedhealthcare — Medicare Managed Care Plan: $86.27 Upmc — All Commercial Plans: $103
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$87.57 – $750.26
Screening mammogram, both breasts: rates for 2 insurance plans Aetna — All Commercial Plans: $750.26 Cigna — All Commercial Plans: $87.57
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MA Mammogram Digital Screening	$976	$976	Not listed in the file

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: Electrocardiogram complete	Not listed in the file	Not listed in the file	$12.87 – $16.69
Electrocardiogram (ECG/EKG) with reading: rates for 2 insurance plans Aetna — All Commercial Plans: $13.15 Highmark — All Commercial Plans: $16.69
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Hospital (facility) fee In the file: OCCHLTH EKG W/INTERPRETATION	$65	$65	Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: EPS WO ATTEMPTED INDUCTION	$91,864	$91,864	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: TX ATRIAL FIB PULM VEIN ISOL	$296,995	$296,995	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$164.68 – $1,582.80
Sleep study (overnight, in a sleep lab): rates for 2 insurance plans Aetna — All Commercial Plans: $164.68 Upmc — All Commercial Plans: $1,582.80
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: Polysomnography	$3,145	$3,145	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$4.63 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $219.45
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans Aetna — All Commercial Plans: $147.33 Amerihealth — Caritas Medicaid Managed Care Plan: $85.39 Devoted Health Plans — Medicare Managed Care Plan: $114.22 Highmark — All Commercial Plans: $146.01 Highmark — Medicare Managed Care Plan: $123.32 Humana — Medicare Managed Care: $114.20 Unitedhealthcare — All Commercial Plans: $150.25 Upmc — All Commercial Plans: $219.45 Va Ccn — Optum Government: $113.14

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Doctor (professional) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$6.13 – $88.58
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans Aetna — All Commercial Plans: $88.58 Highmark — All Commercial Plans: $27.12 Upmc — All Commercial Plans: $9.22
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: PT GE THERAPEUTIC EXERC STRENGTH 15 MIN	$167	$167	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: OT GE THERAPEUTIC EXERCISE 15 MIN	$167	$167	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$44.52 – $101.66
Physical therapy evaluation (low complexity): rates for 2 insurance plans Aetna — All Commercial Plans: $101.66 Jefferson Health Plans — Medicaid Managed Care Plan: $69.97
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: PT GE EVAL LOW COMPLEX 20 MINS	$567	$567	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee · modifier GP In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$14.37 – $425.25
Physical therapy evaluation (low complexity): rates for 7 insurance plans Aetna — All Commercial Plans: $126.62 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $47.28 Highmark — All Commercial Plans: $89.37 Highmark — Medicare Managed Care Plan: $89.79 Humana — Medicare Managed Care: $73.43 Unitedhealthcare — All Commercial Plans: $76.28 Upmc — All Commercial Plans: $425.25
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$44.52 – $69.97
Physical therapy evaluation (moderate complexity): rates for 2 insurance plans Aetna — All Commercial Plans: $44.52 Jefferson Health Plans — Medicaid Managed Care Plan: $69.97
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: PT GE EVAL MOD COMPLEX 30 MINS	$567	$567	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee · modifier GP In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$25.33 – $425.25
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Aetna — All Commercial Plans: $101.30 Geisinger Health Plan — All Commercial Plans: $25.33 Highmark — All Commercial Plans: $89.37 Highmark — Medicare Managed Care Plan: $75.09 Humana — Medicare Managed Care: $95.37 Upmc — All Commercial Plans: $425.25
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: PT GE EVAL HIGH COMPLEX 45 MINS	$567	$567	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee · modifier GP In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$76.30 – $425.25
Physical therapy evaluation (high complexity): rates for 3 insurance plans Humana — Medicare Managed Care: $95.37 Unitedhealthcare — Medicare Managed Care Plan: $78.03 Upmc — All Commercial Plans: $425.25
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee · modifier U8\|GP In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$67.97 – $69.97
Physical therapy evaluation (high complexity): rates for 1 insurance plan Upmc — All Commercial Plans: $69.97
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: Psytx w pt 30 minutes	Not listed in the file	Not listed in the file	$5.90 – $86.72
Psychotherapy, 30 minutes: rates for 6 insurance plans Aetna — All Commercial Plans: $60.79 Highmark — All Commercial Plans: $86.72 Highmark — Medicare Managed Care Plan: $66.90 Humana — Medicare Managed Care: $68.90 Unitedhealthcare — All Commercial Plans: $56.68 Upmc — All Commercial Plans: $59.13
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: PSYTX PT FAMILY 30 MINUTES	$828	$828	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC PSYTX W PT 30 MINUTES	$1,061	$1,061	Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: Psytx w pt 45 minutes	Not listed in the file	Not listed in the file	$20.30 – $114.41
Psychotherapy, 45 minutes: rates for 7 insurance plans Aetna — All Commercial Plans: $84.09 Geisinger Health Plan — All Commercial Plans: $76.02 Highmark — All Commercial Plans: $114.41 Highmark — Medicare Managed Care Plan: $88.24 Humana — Medicare Managed Care: $90.89 Unitedhealthcare — All Commercial Plans: $75.79 Upmc — All Commercial Plans: $97.47
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC PSYTX W PT 45 MINUTES	$1,135	$1,135	Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: PSYTX PT FAMILY 45 MINUTES	$828	$828	Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: Psytx w pt 60 minutes	Not listed in the file	Not listed in the file	$12.73 – $153.56
Psychotherapy, 60 minutes: rates for 8 insurance plans Aetna — All Commercial Plans: $153.56 Geisinger Health Plan — All Commercial Plans: $131.60 Geisinger Health Plan — Medicare Managed Care Plan: $88.90 Highmark — All Commercial Plans: $147.74 Highmark — Medicare Managed Care Plan: $72.23 Humana — Medicare Managed Care: $134.55 Unitedhealthcare — All Commercial Plans: $147.07 Upmc — All Commercial Plans: $142
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC PSYTX W PT 60 MINUTES	$1,283	$1,283	Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: PSYTX W PT 60 MINUTES	$828	$828	Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: Family psytx w/o pt 50 min	Not listed in the file	Not listed in the file	$56.73 – $74.48
Family psychotherapy, without the patient: rates for 1 insurance plan Upmc — All Commercial Plans: $74.48
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: FAMILY MED RX WO PATIENT	$828	$828	Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC FAMILY PSYTX W/O PT 50 MIN	$1,121	$1,121	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: Family psytx w/pt 50 min	Not listed in the file	Not listed in the file	$6.57 – $121.96
Family psychotherapy, with the patient: rates for 5 insurance plans Aetna — All Commercial Plans: $65.62 Highmark — All Commercial Plans: $121.96 Highmark — Medicare Managed Care Plan: $99.49 Humana — Medicare Managed Care: $102.48 Upmc — All Commercial Plans: $101.52
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC FAMILY PSYTX W/PT 50 MIN	$1,133	$1,133	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: FAMILY CONJOINT THERAPY	$828	$828	Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: GROUP THERAPY	$477	$477	Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: RHC GROUP PSYCHOTHERAPY	$560	$560	Not listed in the file
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: 90853 Group Psychotherapy	$477	$477	Not listed in the file

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$190.30
Removal of breast growth (open surgery): rates for 1 insurance plan Upmc — All Commercial Plans: $190.30
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: EXCIS CYST FIBR LESION BREAST	$46,358	$46,358	Not listed in the file
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$190.30 – $533.08
Removal of breast growth (open surgery): rates for 3 insurance plans Aetna — All Commercial Plans: $531.31 Highmark — All Commercial Plans: $533.08 Upmc — All Commercial Plans: $190.30
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$1,189.08 – $1,625.89
Total hip replacement: rates for 2 insurance plans Aetna — All Commercial Plans: $1,625.89 Upmc — All Commercial Plans: $1,214.60
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$504.45 – $1,957.22
Total hip replacement: rates for 7 insurance plans Aetna — All Commercial Plans: $1,957.22 Geisinger Health Plan — All Commercial Plans: $1,213.35 Geisinger Health Plan — Medicare Managed Care Plan: $989.39 Highmark — All Commercial Plans: $1,723.92 Highmark — Medicare Managed Care Plan: $1,214.61 Unitedhealthcare — All Commercial Plans: $1,200.98 Upmc — All Commercial Plans: $1,913.72
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$15.34 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,913.72
Total hip replacement: rates for 6 insurance plans Aetna — All Commercial Plans: $1,226.74 Amerihealth — Caritas Medicaid Managed Care Plan: $1,120 Highmark — All Commercial Plans: $1,723.92 Highmark — Medicare Managed Care Plan: $1,310.42 Unitedhealthcare — All Commercial Plans: $1,200.98 Upmc — All Commercial Plans: $1,913.72
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$1,100
Total knee replacement: rates for 1 insurance plan Upmc — All Commercial Plans: $1,100
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$896.77 – $13,381.60
Total knee replacement: rates for 9 insurance plans Aetna — All Commercial Plans: $2,090.63 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $7,423.91 Geisinger Health Plan — All Commercial Plans: $1,204.24 Highmark — All Commercial Plans: $1,721.71 Highmark — Medicare Managed Care Plan: $1,212.79 Humana — Medicare Managed Care: $13,381.60 Unitedhealthcare — All Commercial Plans: $1,199.50 Upmc — All Commercial Plans: $2,249.58 Va Ccn — Optum Government: $1,211.85
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$906.85 – $12,989.60
Total knee replacement: rates for 8 insurance plans Aetna — All Commercial Plans: $1,224.92 Geisinger Health Plan — Medicare Managed Care Plan: $1,920.99 Highmark — All Commercial Plans: $1,721.71 Highmark — Medicare Managed Care Plan: $1,212.79 Humana — Medicare Managed Care: $12,989.60 Unitedhealthcare — All Commercial Plans: $2,126.43 Upmc — All Commercial Plans: $2,249.58 Va Ccn — Optum Government: $1,211.85
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: Shoulder arthroscopy/surgery	Not listed in the file	Not listed in the file	$30.88 – $149.46
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans Aetna — All Commercial Plans: $30.88 Upmc — All Commercial Plans: $149.46
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Shoulder arthroscopy/surgery	Not listed in the file	Not listed in the file	$76.18 – $761
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans Aetna — All Commercial Plans: $220.59 Geisinger Health Plan — All Commercial Plans: $161.47 Highmark — All Commercial Plans: $228.06 Highmark — Medicare Managed Care Plan: $540.50 Unitedhealthcare — All Commercial Plans: $142.45 Upmc — All Commercial Plans: $761
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: Shoulder arthroscopy/surgery	Not listed in the file	Not listed in the file	$126.60 – $921.94
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans Aetna — All Commercial Plans: $216.37 Highmark — All Commercial Plans: $228.06 Highmark — Medicare Managed Care Plan: $158.25 Upmc — All Commercial Plans: $921.94 Va Ccn — Optum Government: $161.47
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$160.94
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan Aetna — All Commercial Plans: $160.94
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$120.26 – $734.24
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 5 insurance plans Aetna — All Commercial Plans: $690.72 Highmark — All Commercial Plans: $734.24 Highmark — Medicare Managed Care Plan: $505.16 Unitedhealthcare — All Commercial Plans: $120.26 Upmc — All Commercial Plans: $597.85
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$137.46 – $1,096.76
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 5 insurance plans Aetna — All Commercial Plans: $690.72 Amerihealth — Caritas Medicaid Managed Care Plan: $1,096.76 Highmark — All Commercial Plans: $736.87 Highmark — Medicare Managed Care Plan: $594.85 Upmc — All Commercial Plans: $762.48
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$184 – $7,824.10
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans Geisinger Health Plan — All Commercial Plans: $202.40 Highmark — All Commercial Plans: $332.56 Highmark — Medicare Managed Care Plan: $184 Unitedhealthcare — All Commercial Plans: $315.48 Upmc — All Commercial Plans: $7,824.10
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$34.43 – $5,710.50
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — All Commercial Plans: $200.43 Amerihealth — Caritas Medicaid Managed Care Plan: $140.25 Devoted Health Plans — Medicare Managed Care Plan: $118.80 Geisinger Health Plan — All Commercial Plans: $91.49 Geisinger Health Plan — Medicare Managed Care Plan: $114.36 Highmark — All Commercial Plans: $159.94 Highmark — Medicare Managed Care Plan: $114.73 Humana — Medicare Managed Care: $622.27 Pennsylvania Health & Wellness — Allwell Medicare Managed Care Plan: $123.98 Unitedhealthcare — All Commercial Plans: $191.26
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	$8,100	$8,100	Not listed in the file
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee · modifier XS In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$34.43 – $77.65
Upper GI endoscopy (diagnostic): rates for 3 insurance plans Highmark — All Commercial Plans: $77.65 Humana — Medicare Managed Care: $57.72 Upmc — All Commercial Plans: $59.40
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$0.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,710.50
Upper GI endoscopy with biopsy: 10 of 15 insurance plan rates Aetna — All Commercial Plans: $325.49 Amerihealth — Caritas Medicaid Managed Care Plan: $166.41 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $166.41 Devoted Health Plans — Medicare Managed Care Plan: $133.54 Geisinger Health Plan — All Commercial Plans: $128.56 Geisinger Health Plan — Medicare Managed Care Plan: $128.56 Highmark — All Commercial Plans: $180.18 Highmark — Medicare Managed Care Plan: $129.66 Humana — Medicare Managed Care: $133.54 Pennsylvania Health & Wellness — Allwell Medicare Managed Care Plan: $139.38
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	$8,100	$8,100	Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee · modifier XS In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$13.92 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,316.50
Upper GI endoscopy with biopsy: rates for 7 insurance plans Aetna — All Commercial Plans: $162.75 Highmark — All Commercial Plans: $175.40 Highmark — Medicare Managed Care Plan: $125.99 Humana — Medicare Managed Care: $487.54 Unitedhealthcare — All Commercial Plans: $116.69 Upmc — All Commercial Plans: $2,316.50 Va Ccn — Optum Government: $15.23
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$40.13 – $2,315.60
Colonoscopy (diagnostic): 10 of 11 insurance plan rates Aetna — All Commercial Plans: $299.49 Amerihealth — Caritas Medicaid Managed Care Plan: $519.74 Geisinger Health Plan — All Commercial Plans: $267.93 Geisinger Health Plan — Medicare Managed Care Plan: $151.99 Highmark — All Commercial Plans: $240.13 Highmark — Medicare Managed Care Plan: $172.55 Humana — Medicare Managed Care: $474.09 Pennsylvania Health & Wellness — Ambetter Exchange: $199.51 Unitedhealthcare — All Commercial Plans: $285.80 Upmc — All Commercial Plans: $2,315.60
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$34.05 – $233.14
Colonoscopy (diagnostic): rates for 6 insurance plans Aetna — All Commercial Plans: $34.05 Geisinger Health Plan — All Commercial Plans: $75.27 Highmark — All Commercial Plans: $233.14 Unitedhealthcare — All Commercial Plans: $85.13 Upmc — All Commercial Plans: $198.55 Va Ccn — Optum Government: $43.15
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee · modifier PT In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$198.55 – $226.40
Colonoscopy (diagnostic): rates for 3 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $202.16 Unitedhealthcare — All Commercial Plans: $226.40 Upmc — All Commercial Plans: $198.55
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$2.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,045.98
Colonoscopy with biopsy: 10 of 12 insurance plan rates Aetna — All Commercial Plans: $1,843.50 Amerihealth — Caritas Medicaid Managed Care Plan: $252.47 Geisinger Health Plan — All Commercial Plans: $231.99 Geisinger Health Plan — Medicare Managed Care Plan: $319.68 Highmark — All Commercial Plans: $261.16 Highmark — Medicare Managed Care Plan: $202.06 Humana — Medicare Managed Care: $1,226.24 Pennsylvania Health & Wellness — Allwell Medicare Managed Care Plan: $199.85 Unitedhealthcare — All Commercial Plans: $341.54 Unitedhealthcare — Medicare Managed Care Plan: $1,226.24
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee · modifier PT In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$14.80 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,468.73
Colonoscopy with biopsy: 10 of 11 insurance plan rates Aetna — All Commercial Plans: $577.01 Amerihealth — Caritas Medicaid Managed Care Plan: $225.42 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $110 Geisinger Health Plan — All Commercial Plans: $319.68 Geisinger Health Plan — Medicare Managed Care Plan: $319.68 Highmark — All Commercial Plans: $261.16 Highmark — Medicare Managed Care Plan: $202.06 Humana — Medicare Managed Care: $193.10 Unitedhealthcare — All Commercial Plans: $234.86 Upmc — All Commercial Plans: $3,468.73
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee · modifier 33 In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$14.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,298.97
Colonoscopy with biopsy: rates for 7 insurance plans Aetna — All Commercial Plans: $357.91 Amerihealth — Caritas Medicaid Managed Care Plan: $252.47 Highmark — All Commercial Plans: $261.16 Highmark — Medicare Managed Care Plan: $183.35 Unitedhealthcare — All Commercial Plans: $341.54 Upmc — All Commercial Plans: $2,298.97 Va Ccn — Optum Government: $191.30
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$24.97 – $3,045.98
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans Aetna — All Commercial Plans: $718.97 Amerihealth — Caritas Medicaid Managed Care Plan: $300.25 Geisinger Health Plan — All Commercial Plans: $380.68 Highmark — All Commercial Plans: $329.16 Highmark — Medicare Managed Care Plan: $237.35 Humana — Medicare Managed Care: $244.47 Pennsylvania Health & Wellness — Allwell Medicare Managed Care Plan: $252.03 Unitedhealthcare — All Commercial Plans: $405.23 Upmc — All Commercial Plans: $3,045.98 Va Ccn — Optum Government: $242.19
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee · modifier PT In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$115.61 – $5,346
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna — All Commercial Plans: $316.16 Amerihealth — Caritas Medicaid Managed Care Plan: $268.08 Amerihealth — Caritas Medicare/Medicaid Managed Care Plan: $156.49 Geisinger Health Plan — All Commercial Plans: $235.94 Geisinger Health Plan — Medicare Managed Care Plan: $235.94 Highmark — All Commercial Plans: $329.16 Highmark — Medicare Managed Care Plan: $257.17 Humana — Medicare Managed Care: $244.47 Unitedhealthcare — All Commercial Plans: $298.28 Unitedhealthcare — Medicare Managed Care Plan: $1,226.24
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee · modifier 33 In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$153.68 – $5,346
Colonoscopy with removal of polyps (snare): rates for 9 insurance plans Aetna — All Commercial Plans: $424.64 Amerihealth — Caritas Medicaid Managed Care Plan: $300.25 Cigna — All Commercial Plans: $316.16 Highmark — All Commercial Plans: $329.16 Highmark — Medicare Managed Care Plan: $231.23 Pennsylvania Health & Wellness — Ambetter Exchange: $342.11 Unitedhealthcare — All Commercial Plans: $405.23 Upmc — All Commercial Plans: $5,346 Va Ccn — Optum Government: $242.19
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$60.30
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan Upmc — All Commercial Plans: $60.30
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$86.24 – $5,710.50
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $299.49 Cigna — All Commercial Plans: $230.87 Devoted Health Plans — Medicare Managed Care Plan: $168.84 Geisinger Health Plan — All Commercial Plans: $267.93 Geisinger Health Plan — Medicare Managed Care Plan: $172.29 Highmark — All Commercial Plans: $240.57 Highmark — Medicare Managed Care Plan: $172.86 Humana — Medicare Managed Care: $178.04 Pennsylvania Health & Wellness — Allwell Medicare Managed Care Plan: $184.04 Pennsylvania Health & Wellness — Ambetter Exchange: $249.82
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier KX In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$85.27 – $3,468.73
Screening colonoscopy (not high risk): rates for 8 insurance plans Aetna — All Commercial Plans: $236.35 Devoted Health Plans — Medicare Managed Care Plan: $168.84 Highmark — All Commercial Plans: $240.57 Highmark — Medicare Managed Care Plan: $172.86 Humana — Medicare Managed Care: $173.91 Unitedhealthcare — All Commercial Plans: $170.53 Upmc — All Commercial Plans: $3,468.73 Va Ccn — Optum Government: $172.29
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$34.10 – $240.57
Screening colonoscopy (not high risk): rates for 6 insurance plans Aetna — All Commercial Plans: $34.10 Highmark — All Commercial Plans: $240.57 Highmark — Medicare Managed Care Plan: $168.85 Pennsylvania Health & Wellness — Ambetter Exchange: $125.12 Upmc — All Commercial Plans: $42.28 Va Ccn — Optum Government: $88.50
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$120.75 – $4,529.54
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates Aetna — All Commercial Plans: $1,011.92 Amerihealth — Caritas Medicaid Managed Care Plan: $660.07 Geisinger Health Plan — All Commercial Plans: $852.47 Geisinger Health Plan — Medicare Managed Care Plan: $639.95 Highmark — All Commercial Plans: $782.44 Highmark — Medicare Managed Care Plan: $627.16 Humana — Medicare Managed Care: $627.84 Pennsylvania Health & Wellness — Ambetter Exchange: $680.84 Unitedhealthcare — All Commercial Plans: $869.09 Unitedhealthcare — Medicare Managed Care Plan: $4,529.54
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee · modifier 80 In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$78.54 – $170.49
Gallbladder removal by laparoscope: rates for 6 insurance plans Aetna — All Commercial Plans: $143.93 Geisinger Health Plan — All Commercial Plans: $170.49 Highmark — All Commercial Plans: $125.19 Highmark — Medicare Managed Care Plan: $98.17 Unitedhealthcare — Medicare Managed Care Plan: $81.09 Upmc — All Commercial Plans: $103.73
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee · modifier 22 In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$393.23 – $964.76
Gallbladder removal by laparoscope: rates for 3 insurance plans Aetna — All Commercial Plans: $964.76 Highmark — All Commercial Plans: $393.23 Upmc — All Commercial Plans: $627.15
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$349.25 – $596.37
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans Aetna — All Commercial Plans: $491.57 Highmark — All Commercial Plans: $596.37 Upmc — All Commercial Plans: $515.90
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$349.25 – $612.63
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans Highmark — All Commercial Plans: $612.63 Highmark — Medicare Managed Care Plan: $486.70 Upmc — All Commercial Plans: $486.70
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee · modifier 80\|LT In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$77.88
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan Highmark — Medicare Managed Care Plan: $77.88
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$45.28 – $1,210.35
Prostate biopsy: 10 of 11 insurance plan rates Aetna — All Commercial Plans: $162.98 Amerihealth — Caritas Medicaid Managed Care Plan: $100.24 Devoted Health Plans — Medicare Managed Care Plan: $126.35 Geisinger Health Plan — All Commercial Plans: $121.63 Geisinger Health Plan — Medicare Managed Care Plan: $121.63 Highmark — All Commercial Plans: $180.06 Highmark — Medicare Managed Care Plan: $122.66 Humana — Medicare Managed Care: $122.77 Unitedhealthcare — All Commercial Plans: $189.91 Upmc — All Commercial Plans: $1,210.35
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee · modifier SG In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$850.60
Prostate biopsy: rates for 2 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $850.60 Upmc — All Commercial Plans: $850.60
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee · modifier XS In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$60.20
Prostate biopsy: rates for 1 insurance plan Aetna — All Commercial Plans: $60.20
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: Laparo radical prostatectomy	Not listed in the file	Not listed in the file	$1,100 – $1,613.35
Prostate removal by laparoscope (radical prostatectomy): rates for 5 insurance plans Aetna — All Commercial Plans: $1,127.74 Highmark — All Commercial Plans: $1,613.35 Highmark — Medicare Managed Care Plan: $1,102.63 Upmc — All Commercial Plans: $1,168.79 Va Ccn — Optum Government: $1,150.76
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee · modifier 22 In the file: Laparo radical prostatectomy	Not listed in the file	Not listed in the file	$1,102.63 – $2,097.36
Prostate removal by laparoscope (radical prostatectomy): rates for 2 insurance plans Highmark — All Commercial Plans: $2,097.36 Highmark — Medicare Managed Care Plan: $1,102.63
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$6.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $8,295.75
Hysteroscopy with biopsy of the uterus lining: rates for 8 insurance plans Aetna — All Commercial Plans: $462.36 Amerihealth — Caritas Medicaid Managed Care Plan: $262.65 Geisinger Health Plan — All Commercial Plans: $223.62 Highmark — All Commercial Plans: $518.40 Highmark — Medicare Managed Care Plan: $219.15 Pennsylvania Health & Wellness — Allwell Medicare Managed Care Plan: $186.21 Unitedhealthcare — All Commercial Plans: $299.57 Upmc — All Commercial Plans: $8,295.75
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee · modifier 59 In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$65.66 – $233.51
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans Aetna — All Commercial Plans: $146.33 Highmark — All Commercial Plans: $233.51 Upmc — All Commercial Plans: $65.66
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee · modifier SG In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$850.60
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans Amerihealth — Caritas Medicaid Managed Care Plan: $850.60 Upmc — All Commercial Plans: $850.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$2.53 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,288
Spinal injection, lower back (epidural), with imaging guidance: rates for 9 insurance plans Aetna — All Commercial Plans: $705.13 Amerihealth — Caritas Medicaid Managed Care Plan: $91.08 Highmark — All Commercial Plans: $292.97 Highmark — Medicare Managed Care Plan: $228.37 Humana — Medicare Managed Care: $93.79 Jefferson Health Plans — Medicaid Managed Care Plan: $89.45 Unitedhealthcare — All Commercial Plans: $308.43 Upmc — All Commercial Plans: $6,288 Va Ccn — Optum Government: $95.70
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: XR Lumbar/Sacral Epidural inc. Fluoro	$8,384	$8,384	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: Lumbar Spine Injection Single	$8,384	$8,384	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: Inj foramen epidural l/s	Not listed in the file	Not listed in the file	$82.61 – $864.53
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans Aetna — All Commercial Plans: $299.32 Highmark — All Commercial Plans: $271.96 Unitedhealthcare — All Commercial Plans: $864.53 Upmc — All Commercial Plans: $104.54
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: FACET BLOCK LUMBAR SACR SINGLE	$10,778	$10,778	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Inj foramen epidural l/s	Not listed in the file	Not listed in the file	$52.46 – $906.50
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans Aetna — All Commercial Plans: $906.50 Amerihealth — Caritas Medicaid Managed Care Plan: $112.15 Highmark — All Commercial Plans: $279.37 Highmark — Medicare Managed Care Plan: $228.30 Unitedhealthcare — All Commercial Plans: $82.62 Upmc — All Commercial Plans: $224
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$411.92 – $507.57
Carpal tunnel release: rates for 1 insurance plan Aetna — All Commercial Plans: $507.57
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$23,641	$23,641	Not listed in the file
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$43.13 – $3,155.25
Carpal tunnel release: rates for 10 insurance plans Aetna — All Commercial Plans: $568.92 Geisinger Health Plan — All Commercial Plans: $332.94 Geisinger Health Plan — Medicare Managed Care Plan: $174.57 Highmark — All Commercial Plans: $564.91 Highmark — Medicare Managed Care Plan: $416.08 Humana — Medicare Managed Care: $424.57 Pennsylvania Health & Wellness — Ambetter Exchange: $301.72 Unitedhealthcare — All Commercial Plans: $558.48 Upmc — All Commercial Plans: $3,155.25 Va Ccn — Optum Government: $424.57
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier 79\|LT In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$223.54 – $444.28
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans Aetna — All Commercial Plans: $421.04 Highmark — All Commercial Plans: $444.28 Highmark — Medicare Managed Care Plan: $298.52 Humana — Medicare Managed Care: $297.73 Unitedhealthcare — All Commercial Plans: $298.52 Upmc — All Commercial Plans: $337.93 Va Ccn — Optum Government: $304.61
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$66.22 – $458.55
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans Aetna — All Commercial Plans: $421.04 Highmark — All Commercial Plans: $458.55 Highmark — Medicare Managed Care Plan: $298.52 Humana — Medicare Managed Care: $297.73 Unitedhealthcare — All Commercial Plans: $298.52 Upmc — All Commercial Plans: $296.19 Va Ccn — Optum Government: $304.61
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$152.89 – $458.55
Laser treatment of clouding after cataract surgery: rates for 7 insurance plans Aetna — All Commercial Plans: $420.36 Highmark — All Commercial Plans: $458.55 Highmark — Medicare Managed Care Plan: $309.93 Humana — Medicare Managed Care: $287.80 Unitedhealthcare — All Commercial Plans: $282.22 Upmc — All Commercial Plans: $296.19 Va Ccn — Optum Government: $304.61
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: Cataract surg w/iol 1 stage	Not listed in the file	Not listed in the file	$462.54 – $1,819.40
Cataract removal with lens implant: rates for 2 insurance plans Aetna — All Commercial Plans: $671.31 Jefferson Health Plans — Medicaid Managed Care Plan: $1,819.40
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee · modifier RT In the file: Cataract surg w/iol 1 stage	Not listed in the file	Not listed in the file	$118.28 – $8,295.75
Cataract removal with lens implant: rates for 10 insurance plans Aetna — All Commercial Plans: $732.59 Amerihealth — Caritas Medicaid Managed Care Plan: $674.83 Geisinger Health Plan — All Commercial Plans: $300.98 Geisinger Health Plan — Medicare Managed Care Plan: $195.98 Highmark — All Commercial Plans: $747.85 Highmark — Medicare Managed Care Plan: $505.55 Humana — Medicare Managed Care: $4,826.18 Unitedhealthcare — All Commercial Plans: $495.88 Upmc — All Commercial Plans: $8,295.75 Va Ccn — Optum Government: $515.86
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee · modifier LT In the file: Cataract surg w/iol 1 stage	Not listed in the file	Not listed in the file	$7.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,100.64
Cataract removal with lens implant: rates for 9 insurance plans Aetna — All Commercial Plans: $510.60 Amerihealth — Caritas Medicaid Managed Care Plan: $674.83 Cigna — All Commercial Plans: $4,682.71 Highmark — All Commercial Plans: $747.85 Highmark — Medicare Managed Care Plan: $516.06 Humana — Medicare Managed Care: $5,100.64 Unitedhealthcare — All Commercial Plans: $868.18 Upmc — All Commercial Plans: $3,045.98 Va Ccn — Optum Government: $515.86

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$55.11 – $3,185.33
Vaginal delivery, with care before and after: rates for 7 insurance plans Aetna — All Commercial Plans: $3,042.12 Geisinger Health Plan — All Commercial Plans: $1,964.60 Highmark — All Commercial Plans: $3,185.33 Pennsylvania Health & Wellness — Ambetter Exchange: $2,633.48 Unitedhealthcare — All Commercial Plans: $3,153.64 Upmc — All Commercial Plans: $2,996.72 Va Ccn — Optum Government: $2,341.83
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Hospital (facility) fee In the file: 3RD TRI MATERNITY CARE VAG	$3,815	$3,815	Not listed in the file
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee · modifier U8\|59\|HD In the file: Obstetrical care	Not listed in the file	Not listed in the file	$2,283.60
Vaginal delivery, with care before and after: rates for 1 insurance plan Upmc — All Commercial Plans: $2,283.60
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$868.46 – $3,379
Cesarean delivery (C-section), with care before and after: rates for 5 insurance plans Aetna — All Commercial Plans: $3,379 Geisinger Health Plan — All Commercial Plans: $1,964.60 Highmark — All Commercial Plans: $3,185.33 Unitedhealthcare — All Commercial Plans: $3,216.71 Upmc — All Commercial Plans: $3,328.56
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Hospital (facility) fee In the file: 3RD TRI MATERNITY CARE C-SECT	$3,815	$3,815	Not listed in the file
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee · modifier 22 In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$1,964.60 – $3,185.33
Cesarean delivery (C-section), with care before and after: rates for 2 insurance plans Highmark — All Commercial Plans: $3,185.33 Upmc — All Commercial Plans: $1,964.60
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$2,056 – $3,185.33
Vaginal delivery after a previous C-section, with care before and after: rates for 2 insurance plans Aetna — All Commercial Plans: $3,048.90 Highmark — All Commercial Plans: $3,185.33
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee · modifier TG\|HD In the file: Vbac delivery	Not listed in the file	Not listed in the file	$2,283.60
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan Upmc — All Commercial Plans: $2,283.60
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Hospital (facility) fee · modifier U9 In the file: 3RD TRI MATERNITY VAG AFT C-SECT	$3,815	$3,815	Not listed in the file

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	Not listed in the file	$59,530.10 – $163,134.45
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 6 insurance plans Aetna — All Commercial Plans: $140,872.32 Cigna — All Commercial Plans: $114,717.22 Geisinger Health Plan — All Commercial Plans: $86,489.73 Highmark — All Commercial Plans: $163,134.45 Unitedhealthcare — All Commercial Plans: $147,925.72 Upmc — All Commercial Plans: $59,530.10
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc	Not listed in the file	Not listed in the file	$11,737.70 – $32,165.64
Hip or knee replacement (major joint of the leg), without major complications: rates for 6 insurance plans Aetna — All Commercial Plans: $27,776.16 Cigna — All Commercial Plans: $22,619.09 Geisinger Health Plan — All Commercial Plans: $17,053.40 Highmark — All Commercial Plans: $32,165.64 Unitedhealthcare — All Commercial Plans: $29,166.90 Upmc — All Commercial Plans: $11,737.70
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc	Not listed in the file	Not listed in the file	$14,855.75 – $40,710.24
Neck (cervical) spinal fusion, without complications: rates for 6 insurance plans Aetna — All Commercial Plans: $35,154.72 Cigna — All Commercial Plans: $28,627.71 Geisinger Health Plan — All Commercial Plans: $21,583.53 Highmark — All Commercial Plans: $40,710.24 Unitedhealthcare — All Commercial Plans: $36,914.90 Upmc — All Commercial Plans: $14,855.75
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc	Not listed in the file	Not listed in the file	$7,549.88 – $20,689.47
Uterus and ovary surgery (not for cancer), without complications: rates for 6 insurance plans Aetna — All Commercial Plans: $17,866.08 Cigna — All Commercial Plans: $14,548.97 Geisinger Health Plan — All Commercial Plans: $10,969.03 Highmark — All Commercial Plans: $20,689.47 Unitedhealthcare — All Commercial Plans: $18,760.62 Upmc — All Commercial Plans: $7,549.88

Source: Penn Highlands Huntingdon’s standard charges file (phhealthcare.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1225 Warm Springs Ave, Huntingdon, PA 16652
County	Huntingdon County
State	Pennsylvania
Phone	(814) 643‑2290
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
CMS Certification Number	390056
Name in Medicare records	PENN HIGHLANDS HUNTINGDON
Profile level	Medicare data + hospital website
Official website	phhealthcare.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Penn Highlands Huntingdon About | Penn Highlands Healthcare — phhealthcare.org
About Us | Penn Highlands Healthcare (Penn Highlands Huntingdon) — phhealthcare.org
Awards and Accreditations | Penn Highlands Healthcare (Penn Highlands Huntingdon) — phhealthcare.org

Penn Highlands Huntingdon

Summary

Profile from official sources

At a glance