Does Penn Presbyterian Medical Center have an emergency room?

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

Where is Penn Presbyterian Medical Center?

51 North 39th Street, Philadelphia, PA 19104, in Philadelphia County, Pennsylvania.

What is the phone number of Penn Presbyterian Medical Center?

(215) 662-8000, as listed by Medicare (CMS).

What is the Medicare star rating of Penn Presbyterian Medical Center?

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

Penn Presbyterian Medical Center

Quick answers

Does Penn Presbyterian Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Penn Presbyterian Medical Center. In a medical emergency, call 911.
Where is Penn Presbyterian Medical Center?: 51 North 39th Street, Philadelphia, PA 19104, in Philadelphia County, Pennsylvania.
What is the phone number of Penn Presbyterian Medical Center?: (215) 662-8000, as listed by Medicare (CMS).
What is the Medicare star rating of Penn Presbyterian Medical Center?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Anesthesiology
Cancer care
Endocrinology, diabetes, and metabolism
Gastroenterology and hepatology
Gynecology
Heart and vascular care
Infectious disease care
Neurology
Ophthalmology
Oral and maxillofacial surgery
Physical medicine and rehabilitation
Primary care
Pulmonary and respiratory care
Stroke care
Mental and behavioral health

Treatments^[4]

Radiation oncology

Procedures^[4]

Minimally invasive and robotic-assisted surgery

Programs and centers^[4]

Transplant Institute
Penn Medicine at Home
Imaging and radiology
Lab services
Pharmacy services

Emergency care (hospital website)^[4]

Emergency room	Yes
Trauma designation	Level I

Visiting and practical information

Visiting	Patient room visits 10 a.m. to 8 p.m. daily; passes at the Cupp Lobby information desk; under-18s need an adult^[5]
Parking	Garage between Filbert St and Powelton Ave (entrance on Filbert); first 30 minutes free, reduced patient rates; weekday valet^[6]
Patient portal	MyPennMedicine

Doctors and clinicians (2,327)

2,327 doctors and other clinicians list Penn Presbyterian Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Nurse Practitioner323
Internal Medicine241
Diagnostic Radiology136
Physician Assistant135
Family Practice127
Certified Registered Nurse Anesthetist (CRNA)117
Cardiovascular Disease (Cardiology)97
Anesthesiology86
Pathology77
Hospitalist71
Hematology/Oncology61
Emergency Medicine56

Doctors with a page on this site (2,327)

Aaron Balinski, MDInternal Medicine
Aaron J. Henderson, MDAnesthesiology
Aaron Richterman, MDInfectious Disease
Aba Y. Barden-Maja, MDHospitalist
Abass M. Noor, MDDiagnostic Radiology
Abbas Mulla, MDAnesthesiology
Abdallahsassine Geara, MDNephrology
Abigail Coombs, NPNurse Practitioner
Abigail Graeber, NPNurse Practitioner
Abigail H. McGee, NPNurse Practitioner
Abigail L. Withers, NPNurse Practitioner
Abigail Schmucker, MDInternal Medicine
Abraham S. Dubb, MDInternal Medicine
Achala Donuru, MDDiagnostic Radiology
Adam Cuker, MDHematology/Oncology
Adam D. Cohen, MDMedical Oncology
Adam Fredo, PAPhysician Assistant
Adam J. Gamse, MDEmergency Medicine
Adam J. Lyons, MDSports Medicine
Adam J. Seufert, CNACertified Registered Nurse Anesthetist (CRNA)
Adam Levin, MDOrthopedic Surgery
Adam M. Kruszewski, MDNeurology
Adam Waxman, MDHematology/Oncology
Adele M. Caruso, NPNurse Practitioner

And 2,303 more: the button below opens the full list.

Other emergency rooms nearby

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

Philadelphia VA Medical Center0.5 mi · Philadelphia, PA · Federal/VA Acute Care Hospital
Hospital of Univ of Pennsylvania0.6 mi · Philadelphia, PA · Acute Care Hospital
Children's Hospital of Philadelphia0.7 mi · Philadelphia, PA · Children's Hospital
Thomas Jefferson University Hospital2.2 mi · Philadelphia, PA · Acute Care Hospital
Wills Eye Hospital2.4 mi · Philadelphia, PA · Acute Care Hospital

Other hospitals nearby

Good Shepherd Penn Partners1.7 mi · Philadelphia, PA · Long-Term Acute Care Hospital
Magee Rehabilitation Hospital1.8 mi · Philadelphia, PA · Inpatient Rehabilitation 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

University City Rehabilitation and Healthcare Ctr0.2 mi · Philadelphia, PA · 3 of 5 stars
Rittenhouse Post Acute0.5 mi · Philadelphia, PA · 5 of 5 stars
West Park Rehabilitation and Nursing Center0.7 mi · Philadelphia, PA · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Immediate Homecare and Hospice0.1 mi · Philadelphia, PA
Echo Hospice of Pennsylvania, LLC2.9 mi · Philadelphia, PA
Heartland Hospice (Philadelphia)4.0 mi · Bala Cynwyd, PA

All hospice providers in the state →

Home health agencies

Immediate Homecare and Hospice0.1 mi · Philadelphia, PA · 2 of 5 stars
Bayada Home Health Care, Inc.1.4 mi · Philadelphia, PA
Always Best Care1.5 mi · Philadelphia, PA · 2 of 5 stars

All home health agencies in the state →

Dialysis facilities

Children's Hospital of Philadelphia0.1 mi · Philadelphia, PA
DaVita Market Street Dialysis0.1 mi · Philadelphia, PA · 5 of 5 stars
DaVita Philadelphia 42nd Street Dialysis0.1 mi · Philadelphia, 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.

ReVaMP Heart & Vascular Surgery Center1.5 mi · Philadelphia, PA
Metro Vascular Care2.2 mi · Philadelphia, PA
American Access Care of SP Asc, LLC3.0 mi · Philadelphia, PA

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

PEC Nursing Center/HopePHL0.4 mi · Philadelphia, PA · Community health center
Philadelphia District Health Center #40.7 mi · Philadelphia, PA · Community health center
FPCSN at Belmont Charter School0.7 mi · Philadelphia, PA · Community health center

Clinics and urgent care

Jefferson Acute Care Physicians, PC1.4 mi · Philadelphia, PA · Urgent care center
On Demand Urgent Care Group PC1.5 mi · Philadelphia, PA · Urgent care center
On Demand Urgent Care Group PC1.7 mi · Philadelphia, PA · Urgent care center

Pharmacies

Children's Hospital of Philadelphia0.1 mi · Philadelphia, PA · Community/retail pharmacy
My Pharmacy LLC0.1 mi · Philadelphia, PA · Community/retail pharmacy
New Girard Pharmacy0.1 mi · Philadelphia, PA · Community/retail pharmacy

Assisted living nearby

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

Divinity Manor0.1 mi · Philadelphia, PA
Robinson Personal Care Home0.1 mi · Philadelphia, PA
Atria Center City1.4 mi · Philadelphia, PA
Logan Square Enhanced Senior Living1.4 mi · Philadelphia, PA

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	70%National average: 72%
Would definitely recommend the hospital	70%National average: 71%
Nurses “always” communicated well	82%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	65%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	62%National average: 74%
Area around the room “always” quiet at night	47%National average: 60%
Completed surveys	443Response rate: 24%

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)	0.999No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.619No different from the national benchmark
Surgical site infections after colon surgery	1.052No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	1.451No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.425Better than 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	10.7%
Deaths within 30 days: heart failure patients	8.1%
Deaths within 30 days: pneumonia patients	11.5%
Deaths within 30 days: COPD patients	7.7%
Deaths within 30 days: stroke patients	7.6%
Deaths within 30 days: coronary bypass surgery (CABG)	1.4%
Serious complications (patient safety indicator PSI-90)	0.85No different from the national rate
Complications after hip or knee replacement	2.4%

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	13.9%
Readmitted within 30 days: heart failure	19%
Readmitted within 30 days: pneumonia	17.3%
Readmitted within 30 days: COPD	20.6%
Readmitted within 30 days: coronary bypass surgery	10.5%
Readmitted within 30 days: hip or knee replacement	4.7%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	326 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	5%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	42%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Philadelphia Best hospitals in Philadelphia

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 54 common services exactly as Penn Presbyterian Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 1 amount is marked with “!”: it is 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. It is shown exactly as listed; ask the hospital before relying on it.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE VISIT NEW LEVL III	$448	$448	$54.21 – $448
New patient office visit (about 30–44 minutes): 10 of 71 insurance plan rates Aetna Commercial — Aetna Commercial: $123.20 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $123.20 Aetna Health Inc — Aetna HMO: $224 Centivo — Centivo: $448 Cigna — Cigna: $139.33 Cigna — Cigna New Business: $169.34 CIGNA — Cigna PPO: $155.46 Claims Watcher — Claim Watcher: $156.80 Claims Watcher — Claim Watcher Plus: $448 Clover Health Plan — Clover Health Plan: $448
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE VISIT NEW LEVL III	$448	$448	$75.71 – $448
New patient office visit (about 30–44 minutes): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $448 Commercial Other — Commercial Other: $448 Coventry — Coventry of Delaware: $228.48 Coventry — HealthAmerica/Coventry SEPA: $179.20 First Health Global — First Health Global: $224 Health America/CCN — First Health / Coventry National: $358.40 Health Net — Health Net: $268.80 Health Partners — Health Partners Medicaid: $448 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $219.52 Horizon NJ Health — Horizon NJ Health: $75.71
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPT VISIT NEW LEVL IV	$1,065	$1,065	$78.19 – $1,065
New patient office visit (about 45–59 minutes): 10 of 71 insurance plan rates Aetna Commercial — Aetna Commercial: $292.88 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $292.88 Aetna Health Inc — Aetna HMO: $532.50 Centivo — Centivo: $1,065 Cigna — Cigna: $331.21 Cigna — Cigna New Business: $402.57 CIGNA — Cigna PPO: $369.56 Claims Watcher — Claim Watcher: $372.75 Claims Watcher — Claim Watcher Plus: $1,065 Clover Health Plan — Clover Health Plan: $1,065
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPT VISIT NEW LEVL IV	$1,065	$1,065	$179.98 – $1,065
New patient office visit (about 45–59 minutes): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,065 Commercial Other — Commercial Other: $1,065 Coventry — Coventry of Delaware: $543.15 Coventry — HealthAmerica/Coventry SEPA: $426 First Health Global — First Health Global: $532.50 Health America/CCN — First Health / Coventry National: $852 Health Net — Health Net: $639 Health Partners — Health Partners Medicaid: $1,065 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $521.85 Horizon NJ Health — Horizon NJ Health: $179.98
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPT VISIT NEW LEVL V	$1,359	$1,359	$105.82 – $1,359
New patient office visit (about 60–74 minutes): 10 of 71 insurance plan rates Aetna Commercial — Aetna Commercial: $373.73 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $373.73 Aetna Health Inc — Aetna HMO: $679.50 Centivo — Centivo: $1,359 Cigna — Cigna: $422.65 Cigna — Cigna New Business: $513.70 CIGNA — Cigna PPO: $471.57 Claims Watcher — Claim Watcher: $475.65 Claims Watcher — Claim Watcher Plus: $1,359 Clover Health Plan — Clover Health Plan: $1,359
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/OUTPT VISIT NEW LEVL V	$1,359	$1,359	$229.67 – $1,359
New patient office visit (about 60–74 minutes): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,359 Commercial Other — Commercial Other: $1,359 Coventry — Coventry of Delaware: $693.09 Coventry — HealthAmerica/Coventry SEPA: $543.60 First Health Global — First Health Global: $679.50 Health America/CCN — First Health / Coventry National: $1,087.20 Health Net — Health Net: $815.40 Health Partners — Health Partners Medicaid: $1,359 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $665.91 Horizon NJ Health — Horizon NJ Health: $229.67
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUT/PT VISIT EST LEVL III	$857	$857	$43.24 – $857
Established patient office visit (about 20–29 minutes): 10 of 71 insurance plan rates Aetna Commercial — Aetna Commercial: $235.68 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $235.68 Aetna Health Inc — Aetna HMO: $428.50 Centivo — Centivo: $857 Cigna — Cigna: $266.53 Cigna — Cigna New Business: $323.95 CIGNA — Cigna PPO: $297.38 Claims Watcher — Claim Watcher: $299.95 Claims Watcher — Claim Watcher Plus: $857 Clover Health Plan — Clover Health Plan: $857
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE OUT/PT VISIT EST LEVL III	$857	$857	$144.83 – $857
Established patient office visit (about 20–29 minutes): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $857 Commercial Other — Commercial Other: $857 Coventry — Coventry of Delaware: $437.07 Coventry — HealthAmerica/Coventry SEPA: $342.80 First Health Global — First Health Global: $428.50 Health America/CCN — First Health / Coventry National: $685.60 Health Net — Health Net: $514.20 Health Partners — Health Partners Medicaid: $857 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $419.93 Horizon NJ Health — Horizon NJ Health: $144.83
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE/PUTPT VISIT EST LEVL IV	$1,065	$1,065	$57.03 – $1,065
Established patient office visit (about 30–39 minutes): 10 of 71 insurance plan rates Aetna Commercial — Aetna Commercial: $292.88 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $292.88 Aetna Health Inc — Aetna HMO: $532.50 Centivo — Centivo: $1,065 Cigna — Cigna: $331.21 Cigna — Cigna New Business: $402.57 CIGNA — Cigna PPO: $369.56 Claims Watcher — Claim Watcher: $372.75 Claims Watcher — Claim Watcher Plus: $1,065 Clover Health Plan — Clover Health Plan: $1,065
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OFFICE/PUTPT VISIT EST LEVL IV	$1,065	$1,065	$179.98 – $1,065
Established patient office visit (about 30–39 minutes): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,065 Commercial Other — Commercial Other: $1,065 Coventry — Coventry of Delaware: $543.15 Coventry — HealthAmerica/Coventry SEPA: $426 First Health Global — First Health Global: $532.50 Health America/CCN — First Health / Coventry National: $852 Health Net — Health Net: $639 Health Partners — Health Partners Medicaid: $1,065 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $521.85 Horizon NJ Health — Horizon NJ Health: $179.98
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEVEL 3 E.R.	$2,165	$2,165	$56.65 – $4,183
Emergency room visit (moderate): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $1,362 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $1,362 Aetna Health Inc — Aetna HMO: $1,197 Aetna Health Inc — Aetna Medicare HMO: $301.17 Centivo — Centivo: $513.94 Cigna — Cigna: $673.31 Cigna — Cigna New Business: $1,448 CIGNA — Cigna PPO: $751.26 Cigna HealthSpring — Cigna HealthSpring: $292.64 Claims Watcher — Claim Watcher: $513.94
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEVEL 3 E.R. WC	$2,061	$2,061	$56.65 – $4,183
Emergency room visit (moderate): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $1,362 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $1,362 Aetna Health Inc — Aetna HMO: $1,197 Aetna Health Inc — Aetna Medicare HMO: $301.17 Centivo — Centivo: $513.94 Cigna — Cigna: $640.97 Cigna — Cigna New Business: $1,448 CIGNA — Cigna PPO: $715.17 Cigna HealthSpring — Cigna HealthSpring: $292.64 Claims Watcher — Claim Watcher: $513.94
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEVEL 3 E.R.	$2,165	$2,165	$365.88 – $2,165
Emergency room visit (moderate): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $2,165 Commercial Other — Commercial Other: $2,165 Coventry — Coventry of Delaware: $1,104.15 Coventry — HealthAmerica/Coventry SEPA: $866 First Health Global — First Health Global: $1,082.50 Health America/CCN — First Health / Coventry National: $1,732 Health Net — Health Net: $1,299 Health Partners — Health Partners Medicaid: $2,165 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $1,060.85 Horizon NJ Health — Horizon NJ Health: $365.88
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEVEL 4 E.R.	$3,462	$3,462	$95.33 – $4,183
Emergency room visit (moderately high): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $1,733 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $1,733 Aetna Health Inc — Aetna HMO: $1,197 Aetna Health Inc — Aetna Medicare HMO: $460.35 Centivo — Centivo: $785.57 Cigna — Cigna: $1,076.68 Cigna — Cigna New Business: $1,855 CIGNA — Cigna PPO: $1,201.31 Cigna HealthSpring — Cigna HealthSpring: $447.32 Claims Watcher — Claim Watcher: $785.57
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEVEL 4 E.R.	$3,462	$3,462	$585.08 – $3,462
Emergency room visit (moderately high): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $3,462 Commercial Other — Commercial Other: $3,462 Coventry — Coventry of Delaware: $1,765.62 Coventry — HealthAmerica/Coventry SEPA: $1,384.80 First Health Global — First Health Global: $1,731 Health America/CCN — First Health / Coventry National: $2,769.60 Health Net — Health Net: $2,077.20 Health Partners — Health Partners Medicaid: $3,462 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $1,696.38 Horizon NJ Health — Horizon NJ Health: $585.08
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEVEL 5 E.R.	$5,201	$5,201	$138.74 – $5,201
Emergency room visit (high): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $2,105 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $2,105 Aetna Health Inc — Aetna HMO: $1,197 Aetna Health Inc — Aetna Medicare HMO: $657.02 Centivo — Centivo: $1,121.20 Cigna — Cigna: $1,617.51 Cigna — Cigna New Business: $2,256 CIGNA — Cigna PPO: $1,804.75 Cigna HealthSpring — Cigna HealthSpring: $638.42 Claims Watcher — Claim Watcher: $1,121.20
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEVEL 5 E.R.	$5,201	$5,201	$878.97 – $5,201
Emergency room visit (high): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $5,201 Commercial Other — Commercial Other: $5,201 Coventry — Coventry of Delaware: $2,652.51 Coventry — HealthAmerica/Coventry SEPA: $2,080.40 First Health Global — First Health Global: $2,600.50 Health America/CCN — First Health / Coventry National: $4,160.80 Health Net — Health Net: $3,120.60 Health Partners — Health Partners Medicaid: $5,201 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $2,548.49 Horizon NJ Health — Horizon NJ Health: $878.97

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL	$318	$318	$5.08 – $318
Basic metabolic panel (blood test): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $17.76 Aetna Health Inc — Aetna Medicare HMO: $8.97 Centivo — Centivo: $15.23 Cigna — Cigna: $98.90 Cigna — Cigna New Business: $13.03 CIGNA — Cigna PPO: $110.35 Cigna HealthSpring — Cigna HealthSpring: $5.08 Claims Watcher — Claim Watcher: $15.23 Claims Watcher — Claim Watcher Plus: $13.54 Clover Health Plan — Clover Health Plan: $9.14
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL	$318	$318	$53.74 – $318
Basic metabolic panel (blood test): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $318 Commercial Other — Commercial Other: $318 Coventry — Coventry of Delaware: $162.18 Coventry — HealthAmerica/Coventry SEPA: $127.20 First Health Global — First Health Global: $159 Health America/CCN — First Health / Coventry National: $254.40 Health Net — Health Net: $190.80 Health Partners — Health Partners Medicaid: $318 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $155.82 Horizon NJ Health — Horizon NJ Health: $53.74
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL	$446	$446	$6.34 – $446
Comprehensive metabolic panel (blood test): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $22.18 Aetna Health Inc — Aetna Medicare HMO: $11.19 Centivo — Centivo: $19.01 Cigna — Cigna: $138.71 Cigna — Cigna New Business: $16.83 CIGNA — Cigna PPO: $154.76 Cigna HealthSpring — Cigna HealthSpring: $6.34 Claims Watcher — Claim Watcher: $19.01 Claims Watcher — Claim Watcher Plus: $16.90 Clover Health Plan — Clover Health Plan: $11.40
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL	$446	$446	$75.37 – $446
Comprehensive metabolic panel (blood test): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $446 Commercial Other — Commercial Other: $446 Coventry — Coventry of Delaware: $227.46 Coventry — HealthAmerica/Coventry SEPA: $178.40 First Health Global — First Health Global: $223 Health America/CCN — First Health / Coventry National: $356.80 Health Net — Health Net: $267.60 Health Partners — Health Partners Medicaid: $446 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $218.54 Horizon NJ Health — Horizon NJ Health: $75.37
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$690	$690	$12 – $690
Obstetric blood test panel: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $100.38 Aetna Health Inc — Aetna Medicare HMO: $50.68 Centivo — Centivo: $86.06 Cigna — Cigna: $214.59 Cigna — Cigna New Business: $74.93 CIGNA — Cigna PPO: $239.43 Cigna HealthSpring — Cigna HealthSpring: $28.69 Claims Watcher — Claim Watcher: $86.06 Claims Watcher — Claim Watcher Plus: $76.50 Clover Health Plan — Clover Health Plan: $51.63
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL	$690	$690	$116.61 – $690
Obstetric blood test panel: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $690 Commercial Other — Commercial Other: $690 Coventry — Coventry of Delaware: $351.90 Coventry — HealthAmerica/Coventry SEPA: $276 First Health Global — First Health Global: $345 Health America/CCN — First Health / Coventry National: $552 Health Net — Health Net: $414 Health Partners — Health Partners Medicaid: $690 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $338.10 Horizon NJ Health — Horizon NJ Health: $116.61
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$582	$582	$8.03 – $582
Cholesterol panel (lipid panel): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $28.11 Aetna Health Inc — Aetna Medicare HMO: $14.19 Centivo — Centivo: $24.10 Cigna — Cigna: $181 Cigna — Cigna New Business: $21.17 CIGNA — Cigna PPO: $201.95 Cigna HealthSpring — Cigna HealthSpring: $8.03 Claims Watcher — Claim Watcher: $24.10 Claims Watcher — Claim Watcher Plus: $21.42 Clover Health Plan — Clover Health Plan: $14.46
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LIPID PANEL	$582	$582	$98.36 – $582
Cholesterol panel (lipid panel): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $582 Commercial Other — Commercial Other: $582 Coventry — Coventry of Delaware: $296.82 Coventry — HealthAmerica/Coventry SEPA: $232.80 First Health Global — First Health Global: $291 Health America/CCN — First Health / Coventry National: $465.60 Health Net — Health Net: $349.20 Health Partners — Health Partners Medicaid: $582 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $285.18 Horizon NJ Health — Horizon NJ Health: $98.36
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$120	$120	$5.21 – $120
Kidney function panel: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $18.23 Aetna Health Inc — Aetna Medicare HMO: $9.20 Centivo — Centivo: $15.62 Cigna — Cigna: $37.32 Cigna — Cigna New Business: $13.57 CIGNA — Cigna PPO: $41.64 Cigna HealthSpring — Cigna HealthSpring: $5.21 Claims Watcher — Claim Watcher: $15.62 Claims Watcher — Claim Watcher Plus: $13.89 Clover Health Plan — Clover Health Plan: $9.37
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL	$120	$120	$20.28 – $120
Kidney function panel: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $120 Commercial Other — Commercial Other: $120 Coventry — Coventry of Delaware: $61.20 Coventry — HealthAmerica/Coventry SEPA: $48 First Health Global — First Health Global: $60 Health America/CCN — First Health / Coventry National: $96 Health Net — Health Net: $72 Health Partners — Health Partners Medicaid: $120 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $58.80 Horizon NJ Health — Horizon NJ Health: $20.28
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$306	$306	$4.90 – $306
Liver function panel: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $17.14 Aetna Health Inc — Aetna Medicare HMO: $8.66 Centivo — Centivo: $14.71 Cigna — Cigna: $95.17 Cigna — Cigna New Business: $13.03 CIGNA — Cigna PPO: $106.18 Cigna HealthSpring — Cigna HealthSpring: $4.90 Claims Watcher — Claim Watcher: $14.71 Claims Watcher — Claim Watcher Plus: $13.07 Clover Health Plan — Clover Health Plan: $8.82
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL	$306	$306	$51.71 – $306
Liver function panel: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $306 Commercial Other — Commercial Other: $306 Coventry — Coventry of Delaware: $156.06 Coventry — HealthAmerica/Coventry SEPA: $122.40 First Health Global — First Health Global: $153 Health America/CCN — First Health / Coventry National: $244.80 Health Net — Health Net: $183.60 Health Partners — Health Partners Medicaid: $306 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $149.94 Horizon NJ Health — Horizon NJ Health: $51.71
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE	$152	$152	$1.90 – $152
Urine test (automated, with microscope): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $6.64 Aetna Health Inc — Aetna Medicare HMO: $3.36 Centivo — Centivo: $5.71 Cigna — Cigna: $47.27 Cigna — Cigna New Business: $4.88 CIGNA — Cigna PPO: $52.74 Cigna HealthSpring — Cigna HealthSpring: $1.90 Claims Watcher — Claim Watcher: $5.71 Claims Watcher — Claim Watcher Plus: $5.07 Clover Health Plan — Clover Health Plan: $3.42
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/SCOPE	$152	$152	$25.69 – $152
Urine test (automated, with microscope): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $152 Commercial Other — Commercial Other: $152 Coventry — Coventry of Delaware: $77.52 Coventry — HealthAmerica/Coventry SEPA: $60.80 First Health Global — First Health Global: $76 Health America/CCN — First Health / Coventry National: $121.60 Health Net — Health Net: $91.20 Health Partners — Health Partners Medicaid: $152 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $74.48 Horizon NJ Health — Horizon NJ Health: $25.69
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAPS URINALYSISNONAUTO W/O SCOP	$20	$20	$2.09 – $20
Urine test (manual, without microscope): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $7.31 Aetna Health Inc — Aetna Medicare HMO: $3.69 Centivo — Centivo: $6.26 Cigna — Cigna: $6.22 Cigna — Cigna New Business: $5.43 CIGNA — Cigna PPO: $6.94 Cigna HealthSpring — Cigna HealthSpring: $2.09 Claims Watcher — Claim Watcher: $6.26 Claims Watcher — Claim Watcher Plus: $5.57 Clover Health Plan — Clover Health Plan: $3.76
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEUKOCYTE ESTERASE (LE)	$38	$38	$2.09 – $38
Urine test (manual, without microscope): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $7.31 Aetna Health Inc — Aetna Medicare HMO: $3.69 Centivo — Centivo: $6.26 Cigna — Cigna: $11.82 Cigna — Cigna New Business: $5.43 CIGNA — Cigna PPO: $13.19 Cigna HealthSpring — Cigna HealthSpring: $2.09 Claims Watcher — Claim Watcher: $6.26 Claims Watcher — Claim Watcher Plus: $5.57 Clover Health Plan — Clover Health Plan: $3.76
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAPS URINALYSISNONAUTO W/O SCOP	$20	$20	$3.38 – $20
Urine test (manual, without microscope): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $20 Commercial Other — Commercial Other: $20 Coventry — Coventry of Delaware: $10.20 Coventry — HealthAmerica/Coventry SEPA: $8 First Health Global — First Health Global: $10 Health America/CCN — First Health / Coventry National: $16 Health Net — Health Net: $12 Health Partners — Health Partners Medicaid: $20 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $9.80 Horizon NJ Health — Horizon NJ Health: $3.38
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED WITHOUT MICROSCOPY	$132	$132	$1.35 – $132
Urine test (automated, without microscope): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $4.72 Aetna Health Inc — Aetna Medicare HMO: $2.39 Centivo — Centivo: $4.05 Cigna — Cigna: $41.05 Cigna — Cigna New Business: $3.79 CIGNA — Cigna PPO: $45.80 Cigna HealthSpring — Cigna HealthSpring: $1.35 Claims Watcher — Claim Watcher: $4.05 Claims Watcher — Claim Watcher Plus: $3.60 Clover Health Plan — Clover Health Plan: $2.43
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAPS URINALYSIS AUTO W/O SCOPE	$30	$30	$1.35 – $30
Urine test (automated, without microscope): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $4.72 Aetna Health Inc — Aetna Medicare HMO: $2.39 Centivo — Centivo: $4.05 Cigna — Cigna: $9.33 Cigna — Cigna New Business: $3.79 CIGNA — Cigna PPO: $10.41 Cigna HealthSpring — Cigna HealthSpring: $1.35 Claims Watcher — Claim Watcher: $4.05 Claims Watcher — Claim Watcher Plus: $3.60 Clover Health Plan — Clover Health Plan: $2.43
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED WITHOUT MICROSCOPY	$132	$132	$22.31 – $132
Urine test (automated, without microscope): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $132 Commercial Other — Commercial Other: $132 Coventry — Coventry of Delaware: $67.32 Coventry — HealthAmerica/Coventry SEPA: $52.80 First Health Global — First Health Global: $66 Health America/CCN — First Health / Coventry National: $105.60 Health Net — Health Net: $79.20 Health Partners — Health Partners Medicaid: $132 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $64.68 Horizon NJ Health — Horizon NJ Health: $22.31
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA TOTAL DIAGNOSTIC	$661	$661	$11.03 – $661
PSA (prostate specific antigen) blood test: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $38.61 Aetna Health Inc — Aetna Medicare HMO: $19.49 Centivo — Centivo: $33.10 Cigna — Cigna: $205.57 Cigna — Cigna New Business: $28.77 CIGNA — Cigna PPO: $229.37 Cigna HealthSpring — Cigna HealthSpring: $11.03 Claims Watcher — Claim Watcher: $33.10 Claims Watcher — Claim Watcher Plus: $29.42 Clover Health Plan — Clover Health Plan: $19.86
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA TOTAL SCREENING	$661	$661	$11.03 – $661
PSA (prostate specific antigen) blood test: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $38.61 Aetna Health Inc — Aetna Medicare HMO: $19.49 Centivo — Centivo: $33.10 Cigna — Cigna: $205.57 Cigna — Cigna New Business: $28.77 CIGNA — Cigna PPO: $229.37 Cigna HealthSpring — Cigna HealthSpring: $11.03 Claims Watcher — Claim Watcher: $33.10 Claims Watcher — Claim Watcher Plus: $29.42 Clover Health Plan — Clover Health Plan: $19.86
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA ULTRA SENSITIVE	$1,283	$1,283	$11.03 – $1,283
PSA (prostate specific antigen) blood test: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $38.61 Aetna Health Inc — Aetna Medicare HMO: $19.49 Centivo — Centivo: $33.10 Cigna — Cigna: $399.01 Cigna — Cigna New Business: $28.77 CIGNA — Cigna PPO: $445.20 Cigna HealthSpring — Cigna HealthSpring: $11.03 Claims Watcher — Claim Watcher: $33.10 Claims Watcher — Claim Watcher Plus: $29.42 Clover Health Plan — Clover Health Plan: $19.86
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE (TSH)	$656	$656	$10.08 – $656
Thyroid stimulating hormone (TSH) test: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $35.27 Aetna Health Inc — Aetna Medicare HMO: $17.81 Centivo — Centivo: $30.24 Cigna — Cigna: $204.02 Cigna — Cigna New Business: $26.60 CIGNA — Cigna PPO: $227.63 Cigna HealthSpring — Cigna HealthSpring: $10.08 Claims Watcher — Claim Watcher: $30.24 Claims Watcher — Claim Watcher Plus: $26.88 Clover Health Plan — Clover Health Plan: $18.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAPS THYROID STIMULTNG HORMONE(TSH)	$75	$75	$9.60 – $75
Thyroid stimulating hormone (TSH) test: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $35.27 Aetna Health Inc — Aetna Medicare HMO: $17.81 Centivo — Centivo: $30.24 Cigna — Cigna: $23.32 Cigna — Cigna New Business: $26.60 CIGNA — Cigna PPO: $26.03 Cigna HealthSpring — Cigna HealthSpring: $10.08 Claims Watcher — Claim Watcher: $30.24 Claims Watcher — Claim Watcher Plus: $26.88 Clover Health Plan — Clover Health Plan: $18.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE (TSH)	$656	$656	$110.86 – $656
Thyroid stimulating hormone (TSH) test: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $656 Commercial Other — Commercial Other: $656 Coventry — Coventry of Delaware: $334.56 Coventry — HealthAmerica/Coventry SEPA: $262.40 First Health Global — First Health Global: $328 Health America/CCN — First Health / Coventry National: $524.80 Health Net — Health Net: $393.60 Health Partners — Health Partners Medicaid: $656 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $321.44 Horizon NJ Health — Horizon NJ Health: $110.86
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC W/AUTO DIFF WBC	$311	$311	$4.66 – $311
Complete blood count (CBC) with differential: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $16.30 Aetna Health Inc — Aetna Medicare HMO: $8.24 Centivo — Centivo: $13.99 Cigna — Cigna: $96.72 Cigna — Cigna New Business: $11.95 CIGNA — Cigna PPO: $107.92 Cigna HealthSpring — Cigna HealthSpring: $4.66 Claims Watcher — Claim Watcher: $13.99 Claims Watcher — Claim Watcher Plus: $12.43 Clover Health Plan — Clover Health Plan: $8.39
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC W/AUTO DIFF WBC	$311	$311	$52.56 – $311
Complete blood count (CBC) with differential: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $311 Commercial Other — Commercial Other: $311 Coventry — Coventry of Delaware: $158.61 Coventry — HealthAmerica/Coventry SEPA: $124.40 First Health Global — First Health Global: $155.50 Health America/CCN — First Health / Coventry National: $248.80 Health Net — Health Net: $186.60 Health Partners — Health Partners Medicaid: $311 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $152.39 Horizon NJ Health — Horizon NJ Health: $52.56
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTOMATED	$278	$278	$3.88 – $278
Complete blood count (CBC), automated: 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $13.59 Aetna Health Inc — Aetna Medicare HMO: $6.86 Centivo — Centivo: $11.65 Cigna — Cigna: $86.46 Cigna — Cigna New Business: $10.31 CIGNA — Cigna PPO: $96.47 Cigna HealthSpring — Cigna HealthSpring: $3.88 Claims Watcher — Claim Watcher: $11.65 Claims Watcher — Claim Watcher Plus: $10.35 Clover Health Plan — Clover Health Plan: $6.99
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC AUTOMATED	$278	$278	$46.98 – $278
Complete blood count (CBC), automated: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $278 Commercial Other — Commercial Other: $278 Coventry — Coventry of Delaware: $141.78 Coventry — HealthAmerica/Coventry SEPA: $111.20 First Health Global — First Health Global: $139 Health America/CCN — First Health / Coventry National: $222.40 Health Net — Health Net: $166.80 Health Partners — Health Partners Medicaid: $278 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $136.22 Horizon NJ Health — Horizon NJ Health: $46.98
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$183	$183	$2.57 – $183
Blood clotting time test (prothrombin time, PT): 10 of 88 insurance plan rates Aetna Commercial — Aetna Commercial: $9.02 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $9.02 Aetna Health Inc — Aetna HMO: $7.12 Aetna Health Inc — Aetna Medicare HMO: $4.55 Centivo — Centivo: $7.72 Cigna — Cigna: $56.91 Cigna — Cigna New Business: $6.52 CIGNA — Cigna PPO: $63.50 Cigna HealthSpring — Cigna HealthSpring: $2.57 Claims Watcher — Claim Watcher: $7.72
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAPS PROTHROMBIN TIME	$174	$174	$2.57 – $174
Blood clotting time test (prothrombin time, PT): 10 of 88 insurance plan rates Aetna Commercial — Aetna Commercial: $9.02 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $9.02 Aetna Health Inc — Aetna HMO: $7.12 Aetna Health Inc — Aetna Medicare HMO: $4.55 Centivo — Centivo: $7.72 Cigna — Cigna: $54.11 Cigna — Cigna New Business: $6.52 CIGNA — Cigna PPO: $60.38 Cigna HealthSpring — Cigna HealthSpring: $2.57 Claims Watcher — Claim Watcher: $7.72
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME	$183	$183	$30.93 – $183
Blood clotting time test (prothrombin time, PT): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $183 Commercial Other — Commercial Other: $183 Coventry — Coventry of Delaware: $93.33 Coventry — HealthAmerica/Coventry SEPA: $73.20 First Health Global — First Health Global: $91.50 Health America/CCN — First Health / Coventry National: $146.40 Health Net — Health Net: $109.80 Health Partners — Health Partners Medicaid: $183 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $89.67 Horizon NJ Health — Horizon NJ Health: $30.93
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PARTIAL THROMBOPLASTIN TIME	$263	$263	$3.61 – $263
Blood clotting test (partial thromboplastin time, PTT): 10 of 86 insurance plan rates Aetna Commercial — Aetna Commercial: $12.62 Aetna Health Inc — Aetna Medicare HMO: $6.37 Centivo — Centivo: $10.82 Cigna — Cigna: $81.79 Cigna — Cigna New Business: $9.22 CIGNA — Cigna PPO: $91.26 Cigna HealthSpring — Cigna HealthSpring: $3.61 Claims Watcher — Claim Watcher: $10.82 Claims Watcher — Claim Watcher Plus: $9.62 Clover Health Plan — Clover Health Plan: $6.49
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PARTIAL THROMBOPLASTIN TIME	$263	$263	$44.45 – $263
Blood clotting test (partial thromboplastin time, PTT): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $263 Commercial Other — Commercial Other: $263 Coventry — Coventry of Delaware: $134.13 Coventry — HealthAmerica/Coventry SEPA: $105.20 First Health Global — First Health Global: $131.50 Health America/CCN — First Health / Coventry National: $210.40 Health Net — Health Net: $157.80 Health Partners — Health Partners Medicaid: $263 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $128.87 Horizon NJ Health — Horizon NJ Health: $44.45

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD UNENHANC EXT	$4,593	$4,593	$77.50 – $4,593
CT scan of the head or brain, without contrast: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $417.38 Aetna Health Inc — Aetna Medicare HMO: $115.34 Centivo — Centivo: $196.83 Cigna — Cigna: $198.59 Cigna — Cigna New Business: $192.82 CIGNA — Cigna PPO: $228.38 Cigna HealthSpring — Cigna HealthSpring: $112.07 Claims Watcher — Claim Watcher: $196.83 Claims Watcher — Claim Watcher Plus: $174.96 Clover Health Plan — Clover Health Plan: $118.10
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD UNENHANC EXT	$4,593	$4,593	$776.22 – $4,593
CT scan of the head or brain, without contrast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $4,593 Commercial Other — Commercial Other: $4,593 Coventry — Coventry of Delaware: $2,342.43 Coventry — HealthAmerica/Coventry SEPA: $1,837.20 First Health Global — First Health Global: $2,296.50 Health America/CCN — First Health / Coventry National: $3,674.40 Health Net — Health Net: $2,755.80 Health Partners — Health Partners Medicaid: $4,593 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $2,250.57 Horizon NJ Health — Horizon NJ Health: $776.22
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN WITH W/O CONTRAST	$11,890	$11,890	$269 – $11,890
MRI of the brain, before and after contrast: 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $2,161 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $2,161 Aetna Health Inc — Aetna HMO: $1,864 Aetna Health Inc — Aetna Medicare HMO: $384.90 Centivo — Centivo: $656.82 Cigna — Cigna: $648.31 Cigna — Cigna New Business: $629.47 CIGNA — Cigna PPO: $745.59 Cigna HealthSpring — Cigna HealthSpring: $374 Claims Watcher — Claim Watcher: $656.82
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN WITH W/O CONTRAST	$11,890	$11,890	$2,009.41 – $11,890
MRI of the brain, before and after contrast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $11,890 Commercial Other — Commercial Other: $11,890 Coventry — Coventry of Delaware: $6,063.90 Coventry — HealthAmerica/Coventry SEPA: $4,756 First Health Global — First Health Global: $5,945 Health America/CCN — First Health / Coventry National: $9,512 Health Net — Health Net: $7,134 Health Partners — Health Partners Medicaid: $11,890 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $5,826.10 Horizon NJ Health — Horizon NJ Health: $2,009.41
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CHEST 2 VIEWS	$953	$953	$14.85 – $953
Chest X-ray, 2 views: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $113.10 Aetna Health Inc — Aetna Medicare HMO: $96.01 Centivo — Centivo: $163.84 Cigna — Cigna: $296.38 Cigna — Cigna New Business: $64.02 CIGNA — Cigna PPO: $330.69 Cigna HealthSpring — Cigna HealthSpring: $93.30 Claims Watcher — Claim Watcher: $163.84 Claims Watcher — Claim Watcher Plus: $145.63 Clover Health Plan — Clover Health Plan: $98.30
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CHEST 2 VIEWS	$953	$953	$161.06 – $953
Chest X-ray, 2 views: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $953 Commercial Other — Commercial Other: $953 Coventry — Coventry of Delaware: $486.03 Coventry — HealthAmerica/Coventry SEPA: $381.20 First Health Global — First Health Global: $476.50 Health America/CCN — First Health / Coventry National: $762.40 Health Net — Health Net: $571.80 Health Partners — Health Partners Medicaid: $953 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $466.97 Horizon NJ Health — Horizon NJ Health: $161.06
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LUMBOSACRAL SPINE MIN 4 VWS	$2,015	$2,015	$22.50 – $2,015
X-ray of the lower spine, at least 4 views: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $173.36 Aetna Health Inc — Aetna Medicare HMO: $115.34 Centivo — Centivo: $196.83 Cigna — Cigna: $626.66 Cigna — Cigna New Business: $107.58 CIGNA — Cigna PPO: $699.21 Cigna HealthSpring — Cigna HealthSpring: $112.07 Claims Watcher — Claim Watcher: $196.83 Claims Watcher — Claim Watcher Plus: $174.96 Clover Health Plan — Clover Health Plan: $118.10
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LUMBOSACRAL SPINE MIN 4 VWS	$2,015	$2,015	$340.53 – $2,015
X-ray of the lower spine, at least 4 views: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $2,015 Commercial Other — Commercial Other: $2,015 Coventry — Coventry of Delaware: $1,027.65 Coventry — HealthAmerica/Coventry SEPA: $806 First Health Global — First Health Global: $1,007.50 Health America/CCN — First Health / Coventry National: $1,612 Health Net — Health Net: $1,209 Health Partners — Health Partners Medicaid: $2,015 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $987.35 Horizon NJ Health — Horizon NJ Health: $340.53
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE W/O CONTRAST	$7,501	$7,501	$187.20 – $7,501
MRI of the lower back (lumbar spine), without contrast: 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $2,161 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $2,161 Aetna Health Inc — Aetna HMO: $1,864 Aetna Health Inc — Aetna Medicare HMO: $263.24 Centivo — Centivo: $449.21 Cigna — Cigna: $372.35 Cigna — Cigna New Business: $361.53 CIGNA — Cigna PPO: $428.22 Cigna HealthSpring — Cigna HealthSpring: $255.79 Claims Watcher — Claim Watcher: $449.21
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE W/O CONTRAST	$7,501	$7,501	$1,267.67 – $7,501
MRI of the lower back (lumbar spine), without contrast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $7,501 Commercial Other — Commercial Other: $7,501 Coventry — Coventry of Delaware: $3,825.51 Coventry — HealthAmerica/Coventry SEPA: $3,000.40 First Health Global — First Health Global: $3,750.50 Health America/CCN — First Health / Coventry National: $6,000.80 Health Net — Health Net: $4,500.60 Health Partners — Health Partners Medicaid: $7,501 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $3,675.49 Horizon NJ Health — Horizon NJ Health: $1,267.67
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS WITH CONTRAST	$6,326	$6,326	$86.50 – $6,326
CT scan of the pelvis, with contrast: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $884.70 Aetna Health Inc — Aetna Medicare HMO: $193.51 Centivo — Centivo: $330.23 Cigna — Cigna: $538.28 Cigna — Cigna New Business: $522.63 CIGNA — Cigna PPO: $619.04 Cigna HealthSpring — Cigna HealthSpring: $188.04 Claims Watcher — Claim Watcher: $330.23 Claims Watcher — Claim Watcher Plus: $293.54 Clover Health Plan — Clover Health Plan: $198.14
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS WITH CONTRAST	$6,326	$6,326	$1,069.09 – $6,326
CT scan of the pelvis, with contrast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $6,326 Commercial Other — Commercial Other: $6,326 Coventry — Coventry of Delaware: $3,226.26 Coventry — HealthAmerica/Coventry SEPA: $2,530.40 First Health Global — First Health Global: $3,163 Health America/CCN — First Health / Coventry National: $5,060.80 Health Net — Health Net: $3,795.60 Health Partners — Health Partners Medicaid: $6,326 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $3,099.74 Horizon NJ Health — Horizon NJ Health: $1,069.09
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTRM JOINT W/O CONT	$7,241	$7,241	$202.88 – $7,241
MRI of a leg joint (such as the knee), without contrast: 10 of 88 insurance plan rates Aetna Commercial — Aetna Commercial: $2,161 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $2,161 Aetna Health Inc — Aetna HMO: $1,864 Aetna Health Inc — Aetna Medicare HMO: $263.24 Centivo — Centivo: $449.21 Cigna — Cigna: $420.06 Cigna — Cigna New Business: $407.86 CIGNA — Cigna PPO: $483.09 Cigna HealthSpring — Cigna HealthSpring: $255.79 Claims Watcher — Claim Watcher: $449.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI JNT OF KWR EXREM W/O DYE	$6,897	$6,897	$202.88 – $6,897
MRI of a leg joint (such as the knee), without contrast: 10 of 88 insurance plan rates Aetna Commercial — Aetna Commercial: $2,161 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $2,161 Aetna Health Inc — Aetna HMO: $1,864 Aetna Health Inc — Aetna Medicare HMO: $263.24 Centivo — Centivo: $449.21 Cigna — Cigna: $420.06 Cigna — Cigna New Business: $407.86 CIGNA — Cigna PPO: $483.09 Cigna HealthSpring — Cigna HealthSpring: $255.79 Claims Watcher — Claim Watcher: $449.21
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTRM JOINT W/O CONT	$7,241	$7,241	$1,223.73 – $7,241
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $7,241 Commercial Other — Commercial Other: $7,241 Coventry — Coventry of Delaware: $3,692.91 Coventry — HealthAmerica/Coventry SEPA: $2,896.40 First Health Global — First Health Global: $3,620.50 Health America/CCN — First Health / Coventry National: $5,792.80 Health Net — Health Net: $4,344.60 Health Partners — Health Partners Medicaid: $7,241 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $3,548.09 Horizon NJ Health — Horizon NJ Health: $1,223.73
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN PELVIS WITH CONTR	$12,464	$12,464	$192.73 – $12,464
CT scan of the abdomen and pelvis, with contrast: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $1,233.60 Aetna Health Inc — Aetna Medicare HMO: $384.90 Centivo — Centivo: $656.82 Cigna — Cigna: $673.88 Cigna — Cigna New Business: $654.29 CIGNA — Cigna PPO: $774.98 Cigna HealthSpring — Cigna HealthSpring: $374 Claims Watcher — Claim Watcher: $656.82 Claims Watcher — Claim Watcher Plus: $583.84 Clover Health Plan — Clover Health Plan: $394.09
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABDOMEN PELVIS WITH CONTR	$12,464	$12,464	$2,106.42 – $12,464
CT scan of the abdomen and pelvis, with contrast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $12,464 Commercial Other — Commercial Other: $12,464 Coventry — Coventry of Delaware: $6,356.64 Coventry — HealthAmerica/Coventry SEPA: $4,985.60 First Health Global — First Health Global: $6,232 Health America/CCN — First Health / Coventry National: $9,971.20 Health Net — Health Net: $7,478.40 Health Partners — Health Partners Medicaid: $12,464 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $6,107.36 Horizon NJ Health — Horizon NJ Health: $2,106.42
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ULTRASOUND ABDOMINAL B SCAN	$3,658	$3,658	$57.50 – $3,658
Ultrasound of the abdomen, complete: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $398.72 Aetna Health Inc — Aetna Medicare HMO: $115.34 Centivo — Centivo: $196.83 Cigna — Cigna: $1,137.64 Cigna — Cigna New Business: $221.52 CIGNA — Cigna PPO: $1,269.33 Cigna HealthSpring — Cigna HealthSpring: $112.07 Claims Watcher — Claim Watcher: $196.83 Claims Watcher — Claim Watcher Plus: $174.96 Clover Health Plan — Clover Health Plan: $118.10
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ULTRASOUND ABDOMINAL B SCAN	$3,658	$3,658	$618.20 – $3,658
Ultrasound of the abdomen, complete: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $3,658 Commercial Other — Commercial Other: $3,658 Coventry — Coventry of Delaware: $1,865.58 Coventry — HealthAmerica/Coventry SEPA: $1,463.20 First Health Global — First Health Global: $1,829 Health America/CCN — First Health / Coventry National: $2,926.40 Health Net — Health Net: $2,194.80 Health Partners — Health Partners Medicaid: $3,658 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $1,792.42 Horizon NJ Health — Horizon NJ Health: $618.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US PREG >/ 14 WKS SINGL GEST	$2,078	$2,078	$46.50 – $2,078
Pregnancy ultrasound (after the first trimester): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $456.97 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $456.97 Aetna Health Inc — Aetna HMO: $421.51 Aetna Health Inc — Aetna Medicare HMO: $115.34 Centivo — Centivo: $196.83 Cigna — Cigna: $646.26 Cigna — Cigna New Business: $245.62 CIGNA — Cigna PPO: $721.07 Cigna HealthSpring — Cigna HealthSpring: $112.07 Claims Watcher — Claim Watcher: $196.83
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US PREG >/ 14 WKS SINGL GEST	$2,078	$2,078	$351.18 – $2,078
Pregnancy ultrasound (after the first trimester): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $2,078 Commercial Other — Commercial Other: $2,078 Coventry — Coventry of Delaware: $1,059.78 Coventry — HealthAmerica/Coventry SEPA: $831.20 First Health Global — First Health Global: $1,039 Health America/CCN — First Health / Coventry National: $1,662.40 Health Net — Health Net: $1,246.80 Health Partners — Health Partners Medicaid: $2,078 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $1,018.22 Horizon NJ Health — Horizon NJ Health: $351.18
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ULTRASOUND TRANSVAGINAL	$1,977	$1,977	$46.50 – $1,977
Transvaginal ultrasound: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $408.63 Aetna Health Inc — Aetna Medicare HMO: $115.34 Centivo — Centivo: $196.83 Cigna — Cigna: $614.85 Cigna — Cigna New Business: $243.76 CIGNA — Cigna PPO: $686.02 Cigna HealthSpring — Cigna HealthSpring: $112.07 Claims Watcher — Claim Watcher: $196.83 Claims Watcher — Claim Watcher Plus: $174.96 Clover Health Plan — Clover Health Plan: $118.10
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAPS ULTRASOUND TRANSVAGINAL	$370	$370	$46.50 – $370
Transvaginal ultrasound: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $370 Aetna Health Inc — Aetna Medicare HMO: $115.34 Centivo — Centivo: $196.83 Cigna — Cigna: $115.07 Cigna — Cigna New Business: $243.76 CIGNA — Cigna PPO: $128.39 Cigna HealthSpring — Cigna HealthSpring: $112.07 Claims Watcher — Claim Watcher: $196.83 Claims Watcher — Claim Watcher Plus: $174.96 Clover Health Plan — Clover Health Plan: $118.10
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ULTRASOUND TRANSVAGINAL	$1,977	$1,977	$334.11 – $1,977
Transvaginal ultrasound: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,977 Commercial Other — Commercial Other: $1,977 Coventry — Coventry of Delaware: $1,008.27 Coventry — HealthAmerica/Coventry SEPA: $790.80 First Health Global — First Health Global: $988.50 Health America/CCN — First Health / Coventry National: $1,581.60 Health Net — Health Net: $1,186.20 Health Partners — Health Partners Medicaid: $1,977 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $968.73 Horizon NJ Health — Horizon NJ Health: $334.11
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNI	$1,166	$1,166	$71.01 – $1,166
Diagnostic mammogram, one breast: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $424.98 Aetna Health Inc — Aetna Medicare HMO: $95.15 Centivo — Centivo: $161.57 Cigna — Cigna: $362.63 Cigna — Cigna New Business: $242.82 CIGNA — Cigna PPO: $404.60 Cigna HealthSpring — Cigna HealthSpring: $92.45 Claims Watcher — Claim Watcher: $161.57 Claims Watcher — Claim Watcher Plus: $143.62 Clover Health Plan — Clover Health Plan: $96.94
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNI	$1,166	$1,166	$197.05 – $1,166
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,166 Commercial Other — Commercial Other: $1,166 Coventry — Coventry of Delaware: $594.66 Coventry — HealthAmerica/Coventry SEPA: $466.40 First Health Global — First Health Global: $583 Health America/CCN — First Health / Coventry National: $932.80 Health Net — Health Net: $699.60 Health Partners — Health Partners Medicaid: $1,166 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $571.34 Horizon NJ Health — Horizon NJ Health: $197.05
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMOGRAM DIAG BILATERAL	$1,166	$1,166	$90.83 – $1,166
Diagnostic mammogram, both breasts: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $537.01 Aetna Health Inc — Aetna Medicare HMO: $122.10 Centivo — Centivo: $207.34 Cigna — Cigna: $362.63 Cigna — Cigna New Business: $309.54 CIGNA — Cigna PPO: $404.60 Cigna HealthSpring — Cigna HealthSpring: $118.65 Claims Watcher — Claim Watcher: $207.34 Claims Watcher — Claim Watcher Plus: $184.30 Clover Health Plan — Clover Health Plan: $124.41
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMMOGRAM DIAG BILATERAL	$1,166	$1,166	$197.05 – $1,166
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,166 Commercial Other — Commercial Other: $1,166 Coventry — Coventry of Delaware: $594.66 Coventry — HealthAmerica/Coventry SEPA: $466.40 First Health Global — First Health Global: $583 Health America/CCN — First Health / Coventry National: $932.80 Health Net — Health Net: $699.60 Health Partners — Health Partners Medicaid: $1,166 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $571.34 Horizon NJ Health — Horizon NJ Health: $197.05
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SCR MAMMO BI INCL CAD	$1,166	$1,166	$71.20 – $1,166
Screening mammogram, both breasts: 10 of 87 insurance plan rates Aetna Commercial — Aetna Commercial: $433.32 Aetna Health Inc — Aetna Medicare HMO: $100.67 Centivo — Centivo: $170.95 Cigna — Cigna: $362.63 Cigna — Cigna New Business: $255.80 CIGNA — Cigna PPO: $404.60 Cigna HealthSpring — Cigna HealthSpring: $97.82 Claims Watcher — Claim Watcher: $170.95 Claims Watcher — Claim Watcher Plus: $151.95 Clover Health Plan — Clover Health Plan: $102.57
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC SCR MAMMO BI INCL CAD	$1,166	$1,166	$197.05 – $1,166
Screening mammogram, both breasts: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $1,166 Commercial Other — Commercial Other: $1,166 Coventry — Coventry of Delaware: $594.66 Coventry — HealthAmerica/Coventry SEPA: $466.40 First Health Global — First Health Global: $583 Health America/CCN — First Health / Coventry National: $932.80 Health Net — Health Net: $699.60 Health Partners — Health Partners Medicaid: $1,166 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $571.34 Horizon NJ Health — Horizon NJ Health: $197.05

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$19,063	$19,063	$776 – $35,215.20
Left heart catheterization (diagnostic): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $10,509 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $10,509 Aetna Health Inc — Aetna HMO: $8,486 Aetna Health Inc — Aetna Medicare HMO: $3,576.68 Centivo — Centivo: $6,103.53 Cigna — Cigna: $5,928.59 Cigna — Cigna New Business: $14,483 CIGNA — Cigna PPO: $6,614.86 Cigna HealthSpring — Cigna HealthSpring: $3,475.46 Claims Watcher — Claim Watcher: $6,103.53
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$19,063	$19,063	$3,221.65 – $19,063
Left heart catheterization (diagnostic): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $19,063 Commercial Other — Commercial Other: $19,063 Coventry — Coventry of Delaware: $9,722.13 Coventry — HealthAmerica/Coventry SEPA: $7,625.20 First Health Global — First Health Global: $9,531.50 Health America/CCN — First Health / Coventry National: $15,250.40 Health Net — Health Net: $11,437.80 Health Partners — Health Partners Medicaid: $19,063 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $9,340.87 Horizon NJ Health — Horizon NJ Health: $3,221.65
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ELECTROPHYSIOLOGY EVALUATION W/O INDUCTION	$15,685	$15,685	$776 – $49,282
Heart rhythm study (electrophysiology evaluation): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $32,881 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $32,881 Aetna Health Inc — Aetna HMO: $26,096 Aetna Health Inc — Aetna Medicare HMO: $8,605.04 Centivo — Centivo: $14,684.27 Cigna — Cigna: $4,878.03 Cigna — Cigna New Business: $14,483 CIGNA — Cigna PPO: $5,442.70 Cigna HealthSpring — Cigna HealthSpring: $8,361.50 Claims Watcher — Claim Watcher: $14,684.27
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ELECTROPHYSIOLOGY EVALUATION W/O INDUCTION	$15,685	$15,685	$2,650.76 – $15,685
Heart rhythm study (electrophysiology evaluation): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $15,685 Commercial Other — Commercial Other: $15,685 Coventry — Coventry of Delaware: $7,999.35 Coventry — HealthAmerica/Coventry SEPA: $6,274 First Health Global — First Health Global: $7,842.50 Health America/CCN — First Health / Coventry National: $12,548 Health Net — Health Net: $9,411 Health Partners — Health Partners Medicaid: $15,685 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $7,685.65 Horizon NJ Health — Horizon NJ Health: $2,650.76
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC TX ATRIAL FIB PULM VEIN ISOL	$72,487	$72,487	$776 – $76,422
Heart rhythm study with ablation for atrial fibrillation: 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $32,881 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $32,881 Aetna Health Inc — Aetna HMO: $26,096 Aetna Health Inc — Aetna Medicare HMO: $28,836.79 Centivo — Centivo: $49,209.26 Cigna — Cigna: $22,543.46 Cigna — Cigna New Business: $14,483 CIGNA — Cigna PPO: $25,152.99 Cigna HealthSpring — Cigna HealthSpring: $28,020.66 Claims Watcher — Claim Watcher: $49,209.26
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC TX ATRIAL FIB PULM VEIN ISOL	$72,487	$72,487	$12,250.30 – $72,487
Heart rhythm study with ablation for atrial fibrillation: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $72,487 Commercial Other — Commercial Other: $72,487 Coventry — Coventry of Delaware: $36,968.37 Coventry — HealthAmerica/Coventry SEPA: $28,994.80 First Health Global — First Health Global: $36,243.50 Health America/CCN — First Health / Coventry National: $57,989.60 Health Net — Health Net: $43,492.20 Health Partners — Health Partners Medicaid: $72,487 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $35,518.63 Horizon NJ Health — Horizon NJ Health: $12,250.30

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THERAPEUTIC EXERCISES	$478	$478	$16.51 – $478
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $198.37 Aetna Health Inc — Aetna Medicare HMO: $31.76 Centivo — Centivo: $53.93 Cigna — Cigna: $148.66 Cigna — Cigna New Business: $139 CIGNA — Cigna PPO: $165.87 Cigna HealthSpring — Cigna HealthSpring: $30.86 Claims Watcher — Claim Watcher: $53.93 Claims Watcher — Claim Watcher Plus: $47.94 Clover Health Plan — Clover Health Plan: $32.36
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THERAPEUTIC EXERCISES	$478	$478	$80.78 – $478
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $478 Commercial Other — Commercial Other: $478 Coventry — Coventry of Delaware: $243.78 Coventry — HealthAmerica/Coventry SEPA: $191.20 First Health Global — First Health Global: $239 Health America/CCN — First Health / Coventry National: $382.40 Health Net — Health Net: $286.80 Health Partners — Health Partners Medicaid: $478 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $234.22 Horizon NJ Health — Horizon NJ Health: $80.78
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX 20 MIN	$744	$744	$63.61 – $744
Physical therapy evaluation (low complexity): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $308.76 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $308.76 Aetna Health Inc — Aetna HMO: $372 Aetna Health Inc — Aetna Medicare HMO: $106.78 Centivo — Centivo: $181.33 Cigna — Cigna: $231.38 Cigna — Cigna New Business: $139 CIGNA — Cigna PPO: $258.17 Cigna HealthSpring — Cigna HealthSpring: $103.76 Claims Watcher — Claim Watcher: $181.33
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL LOW COMPLEX 20 MIN	$744	$744	$125.74 – $744
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $744 Commercial Other — Commercial Other: $744 Coventry — Coventry of Delaware: $379.44 Coventry — HealthAmerica/Coventry SEPA: $297.60 First Health Global — First Health Global: $372 Health America/CCN — First Health / Coventry National: $595.20 Health Net — Health Net: $446.40 Health Partners — Health Partners Medicaid: $744 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $364.56 Horizon NJ Health — Horizon NJ Health: $125.74
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL MODERATE COMPLEX 30 MIN	$744	$744	$49.90 – $744
Physical therapy evaluation (moderate complexity): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $308.76 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $308.76 Aetna Health Inc — Aetna HMO: $372 Aetna Health Inc — Aetna Medicare HMO: $106.78 Centivo — Centivo: $181.33 Cigna — Cigna: $231.38 Cigna — Cigna New Business: $139 CIGNA — Cigna PPO: $258.17 Cigna HealthSpring — Cigna HealthSpring: $103.76 Claims Watcher — Claim Watcher: $181.33
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL MODERATE COMPLEX 30 MIN	$744	$744	$125.74 – $744
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $744 Commercial Other — Commercial Other: $744 Coventry — Coventry of Delaware: $379.44 Coventry — HealthAmerica/Coventry SEPA: $297.60 First Health Global — First Health Global: $372 Health America/CCN — First Health / Coventry National: $595.20 Health Net — Health Net: $446.40 Health Partners — Health Partners Medicaid: $744 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $364.56 Horizon NJ Health — Horizon NJ Health: $125.74
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX 45 MIN	$744	$744	$63.61 – $744
Physical therapy evaluation (high complexity): 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $308.76 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $308.76 Aetna Health Inc — Aetna HMO: $372 Aetna Health Inc — Aetna Medicare HMO: $106.78 Centivo — Centivo: $181.33 Cigna — Cigna: $231.38 Cigna — Cigna New Business: $139 CIGNA — Cigna PPO: $258.17 Cigna HealthSpring — Cigna HealthSpring: $103.76 Claims Watcher — Claim Watcher: $181.33
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT EVAL HIGH COMPLEX 45 MIN	$744	$744	$125.74 – $744
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $744 Commercial Other — Commercial Other: $744 Coventry — Coventry of Delaware: $379.44 Coventry — HealthAmerica/Coventry SEPA: $297.60 First Health Global — First Health Global: $372 Health America/CCN — First Health / Coventry National: $595.20 Health Net — Health Net: $446.40 Health Partners — Health Partners Medicaid: $744 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $364.56 Horizon NJ Health — Horizon NJ Health: $125.74
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX PT /FAMILY 30 MINUTES	$580	$580	$51.22 – $580
Psychotherapy, 30 minutes: 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $159.50 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $159.50 Aetna Health Inc — Aetna HMO: $290 Aetna Health Inc — Aetna Medicare HMO: $195.82 Centivo — Centivo: $334.17 Cigna — Cigna: $180.38 Cigna — Cigna New Business: $219.24 CIGNA — Cigna PPO: $201.26 Cigna HealthSpring — Cigna HealthSpring: $190.28 Claims Watcher — Claim Watcher: $334.17
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OUTPATIENT D A INDIVIDUAL THERAPY - CBT	$147	$147	$22.05 – $214.54
Psychotherapy, 30 minutes: 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $40.42 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $40.42 Aetna Health Inc — Aetna HMO: $73.50 Aetna Health Inc — Aetna Medicare HMO: $195.82 Centivo — Centivo: $334.17 Cigna — Cigna: $45.72 Cigna — Cigna New Business: $55.57 CIGNA — Cigna PPO: $51.01 Cigna HealthSpring — Cigna HealthSpring: $190.28 Claims Watcher — Claim Watcher: $334.17
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSYTX PT /FAMILY 30 MINUTES	$580	$580	$98.02 – $580
Psychotherapy, 30 minutes: 10 of 28 insurance plan rates Aetna Health Inc — Aetna HMO: $580 Commercial Other — Commercial Other: $580 Coventry — Coventry of Delaware: $295.80 Coventry — HealthAmerica/Coventry SEPA: $232 First Health Global — First Health Global: $290 Health America/CCN — First Health / Coventry National: $464 Health Net — Health Net: $348 Health Partners — Health Partners Medicaid: $580 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $284.20 Horizon NJ Health — Horizon NJ Health: $98.02
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYTX W/PATIENT	$596	$596	$25.61 – $596
Family psychotherapy, with the patient: 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $163.90 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $163.90 Aetna Health Inc — Aetna HMO: $298 Aetna Health Inc — Aetna Medicare HMO: $195.82 Centivo — Centivo: $334.17 Cigna — Cigna: $185.36 Cigna — Cigna New Business: $225.29 CIGNA — Cigna PPO: $206.81 Cigna HealthSpring — Cigna HealthSpring: $190.28 Claims Watcher — Claim Watcher: $334.17
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OUTPATIENT D A FAMILY THERAPY - CBT	$75	$75	$11.25 – $214.54
Family psychotherapy, with the patient: 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $20.63 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $20.63 Aetna Health Inc — Aetna HMO: $37.50 Aetna Health Inc — Aetna Medicare HMO: $195.82 Centivo — Centivo: $334.17 Cigna — Cigna: $23.32 Cigna — Cigna New Business: $28.35 CIGNA — Cigna PPO: $26.03 Cigna HealthSpring — Cigna HealthSpring: $190.28 Claims Watcher — Claim Watcher: $334.17
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY PSYTX W/PATIENT	$596	$596	$100.72 – $596
Family psychotherapy, with the patient: 10 of 28 insurance plan rates Aetna Health Inc — Aetna HMO: $596 Commercial Other — Commercial Other: $596 Coventry — Coventry of Delaware: $303.96 Coventry — HealthAmerica/Coventry SEPA: $238.40 First Health Global — First Health Global: $298 Health America/CCN — First Health / Coventry National: $476.80 Health Net — Health Net: $357.60 Health Partners — Health Partners Medicaid: $596 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $292.04 Horizon NJ Health — Horizon NJ Health: $100.72
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY	$285	$285	$40 – $285
Group psychotherapy: 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $78.38 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $78.38 Aetna Health Inc — Aetna HMO: $142.50 Aetna Health Inc — Aetna Medicare HMO: $112.08 Centivo — Centivo: $191.27 Cigna — Cigna: $88.64 Cigna — Cigna New Business: $107.73 CIGNA — Cigna PPO: $98.90 Cigna HealthSpring — Cigna HealthSpring: $108.91 Claims Watcher — Claim Watcher: $191.27
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OUTPATIENT D A GROUP THERAPY - CBT	$27	$27	$4.05 – $122.80
Group psychotherapy: 10 of 84 insurance plan rates Aetna Commercial — Aetna Commercial: $7.42 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $7.42 Aetna Health Inc — Aetna HMO: $13.50 Aetna Health Inc — Aetna Medicare HMO: $112.08 Centivo — Centivo: $191.27 Cigna — Cigna: $8.40 Cigna — Cigna New Business: $10.21 CIGNA — Cigna PPO: $9.37 Cigna HealthSpring — Cigna HealthSpring: $108.91 Claims Watcher — Claim Watcher: $191.27
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY	$285	$285	$48.16 – $285
Group psychotherapy: 10 of 28 insurance plan rates Aetna Health Inc — Aetna HMO: $285 Commercial Other — Commercial Other: $285 Coventry — Coventry of Delaware: $145.35 Coventry — HealthAmerica/Coventry SEPA: $114 First Health Global — First Health Global: $142.50 Health America/CCN — First Health / Coventry National: $228 Health Net — Health Net: $171 Health Partners — Health Partners Medicaid: $285 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $139.65 Horizon NJ Health — Horizon NJ Health: $48.16

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BX PROSTATE	$3,964	$3,964	$97.56 – $6,558
Prostate biopsy: 10 of 76 insurance plan rates Aetna Commercial — Aetna Commercial: $3,964 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $3,964 Aetna Health Inc — Aetna HMO: $6,558 Centivo — Centivo: $3,964 Cigna — Cigna: $1,232.80 Cigna — Cigna New Business: $4,456 CIGNA — Cigna PPO: $1,375.51 Claims Watcher — Claim Watcher: $1,387.40 Claims Watcher — Claim Watcher Plus: $3,964 Clover Health Plan — Clover Health Plan: $3,964
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BX PROSTATE	$3,964	$3,964	$669.92 – $3,964
Prostate biopsy: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $3,964 Commercial Other — Commercial Other: $3,964 Coventry — Coventry of Delaware: $2,021.64 Coventry — HealthAmerica/Coventry SEPA: $1,585.60 First Health Global — First Health Global: $1,982 Health America/CCN — First Health / Coventry National: $3,171.20 Health Net — Health Net: $2,378.40 Health Partners — Health Partners Medicaid: $3,964 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $1,942.36 Horizon NJ Health — Horizon NJ Health: $669.92
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAPS AFTER CATARACT LASER SURGERY	$960	$960	$168.77 – $4,456
Laser treatment of clouding after cataract surgery: 10 of 89 insurance plan rates Aetna Commercial — Aetna Commercial: $264 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $264 Aetna Health Inc — Aetna HMO: $480 Aetna Health Inc — Aetna Medicare HMO: $606.79 Centivo — Centivo: $1,035.47 Cigna — Cigna: $298.56 Cigna — Cigna New Business: $4,456 CIGNA — Cigna PPO: $333.12 Cigna HealthSpring — Cigna HealthSpring: $589.61 Claims Watcher — Claim Watcher: $1,035.47
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAPS AFTER CATARACT LASER SURGERY	$960	$960	$162.24 – $960
Laser treatment of clouding after cataract surgery: 10 of 29 insurance plan rates Aetna Health Inc — Aetna HMO: $960 Commercial Other — Commercial Other: $960 Coventry — Coventry of Delaware: $489.60 Coventry — HealthAmerica/Coventry SEPA: $384 First Health Global — First Health Global: $480 Health America/CCN — First Health / Coventry National: $768 Health Net — Health Net: $576 Health Partners — Health Partners Medicaid: $960 HealthAmerica/Coventry — HealthAmerica/HealthAssurance: $470.40 Horizon NJ Health — Horizon NJ Health: $162.24

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	$544.94 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $303,808.65
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 78 insurance plan rates Aetna Commercial — Aetna Commercial: $181,475.32 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $181,475.32 Aetna Health Inc — Aetna HMO: $172,023 Aetna Health Inc — Aetna Medicare HMO: $86,156.32 Centivo — Centivo: $181,209.94 Cigna — Cigna: $214,584.04 Cigna — Cigna New Business: $202,259.69 CIGNA — Cigna PPO: $246,773.62 Cigna HealthSpring — Cigna HealthSpring: $83,717.93 Claims Watcher — Claim Watcher: $181,209.94
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$544.94 – $105,373
Spinal fusion (not neck), without major complications: 10 of 76 insurance plan rates Aetna Commercial — Aetna Commercial: $79,728.89 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $79,728.89 Aetna Health Inc — Aetna HMO: $72,247 Aetna Health Inc — Aetna Medicare HMO: $32,409.74 Centivo — Centivo: $67,954.84 Cigna — Cigna: $79,728.89 CIGNA — Cigna PPO: $79,728.89 Cigna HealthSpring — Cigna HealthSpring: $31,492.48 Claims Watcher — Claim Watcher: $67,954.84 Claims Watcher — Claim Watcher Plus: $60,404.30
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	$544.94 – $54,469.45
Hip or knee replacement (major joint of the leg), without major complications: 10 of 78 insurance plan rates Aetna Commercial — Aetna Commercial: $35,921.58 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $35,921.58 Aetna Health Inc — Aetna HMO: $38,178 Aetna Health Inc — Aetna Medicare HMO: $17,718.84 Centivo — Centivo: $36,998.12 Cigna — Cigna: $42,475.19 Cigna — Cigna New Business: $40,035.68 CIGNA — Cigna PPO: $48,846.85 Cigna HealthSpring — Cigna HealthSpring: $17,217.37 Claims Watcher — Claim Watcher: $36,998.12
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	$544.94 – $70,883
Neck (cervical) spinal fusion, without complications: 10 of 78 insurance plan rates Aetna Commercial — Aetna Commercial: $45,019.95 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $45,019.95 Aetna Health Inc — Aetna HMO: $40,920 Aetna Health Inc — Aetna Medicare HMO: $21,996.78 Centivo — Centivo: $46,012.59 Cigna — Cigna: $53,233.48 Cigna — Cigna New Business: $50,176.09 CIGNA — Cigna PPO: $61,218.99 Cigna HealthSpring — Cigna HealthSpring: $21,374.23 Claims Watcher — Claim Watcher: $46,012.59
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	$544.94 – $51,987.52
Uterus and ovary surgery (not for cancer), without complications: 10 of 78 insurance plan rates Aetna Commercial — Aetna Commercial: $23,822.86 Aetna Commercial HMO with Capitation — Aetna Commercial HMO with Capitation: $23,822.86 Aetna Health Inc — Aetna HMO: $17,979 Aetna Health Inc — Aetna Medicare HMO: $12,030.18 Centivo — Centivo: $25,010.94 Cigna — Cigna: $28,169.15 Cigna — Cigna New Business: $26,551.29 CIGNA — Cigna PPO: $32,394.78 Cigna HealthSpring — Cigna HealthSpring: $11,689.71 Claims Watcher — Claim Watcher: $25,010.94

Source: Penn Presbyterian Medical Center’s standard charges file (tupa-q-001.sitecorecontenthub.cloud, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 21, 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	51 North 39th Street, Philadelphia, PA 19104
County	Philadelphia County
State	Pennsylvania
Phone	(215) 662‑8000
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	4 of 5 stars
CMS Certification Number	390223
Name in Medicare records	PENN PRESBYTERIAN MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	pennmedicine.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 Presbyterian Medical Center | Penn Medicine — pennmedicine.org
Penn Presbyterian Medical Center visitor policies and hours | Penn Medicine — pennmedicine.org
Penn Presbyterian Medical Center directions and parking | Penn Medicine — pennmedicine.org