Does Saratoga Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Saratoga Hospital. In a medical emergency, call 911.

Where is Saratoga Hospital?

211 Church Street, Saratoga Springs, NY 12866, in Saratoga County, New York.

What is the phone number of Saratoga Hospital?

(518) 587-3222, as listed by Medicare (CMS).

What is the Medicare star rating of Saratoga Hospital?

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

Saratoga Hospital — Saratoga Springs, NY

Quick answers

Does Saratoga Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Saratoga Hospital. In a medical emergency, call 911.
Where is Saratoga Hospital?: 211 Church Street, Saratoga Springs, NY 12866, in Saratoga County, New York.
What is the phone number of Saratoga Hospital?: (518) 587-3222, as listed by Medicare (CMS).
What is the Medicare star rating of Saratoga Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5]

Addiction Medicine
Allergy & Clinical Immunology
Bariatric Surgery
Behavioral & Mental Health
Breast Surgery
Cardiology & Vascular
Ear, Nose & Throat
Emergency Medicine
Endocrinology & Diabetes
Eye Care
Radiation Oncology
Digestive & Liver
General Surgery
Dentistry
ENT

Programs and centers^[4]

Primary Stroke Center

Emergency care (hospital website)^[4][6][8]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center

Visiting and practical information

Parking	Free parking at the main campus for patients, visitors and the Emergency Department^[7]

Recognition^[4][8]

Magnet Recognition (ANCC)
ACEP Accredited Emergency Department
New York State-designated Primary Stroke Center

Doctors and clinicians (904)

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

Main specialties

And 880 more: the button below opens the full list.

Other emergency rooms nearby

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

Glens Falls Hospital17 mi · Glens Falls, NY · Acute Care Hospital
Ellis Hospital19 mi · Schenectady, NY · Acute Care Hospital
St Marys Healthcare23 mi · Amsterdam, NY · Acute Care Hospital
Samaritan Hospital of Troy, New York25 mi · Troy, NY · Acute Care Hospital
Nathan Littauer Hospital27 mi · Gloversville, NY · Acute Care Hospital

Other hospitals nearby

Four Winds of Saratoga1.9 mi · Saratoga Springs, NY · Psychiatric Hospital
Sunnyview Hospital and Rehabilitation Center19 mi · Schenectady, NY · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Wesley Health Care Center Inc0.4 mi · Saratoga Springs, NY · 1 of 5 stars
Seton Health at Schuyler Ridge Residential H C15 mi · Clifton Park, NY · 1 of 5 stars
Glendale Home-Schdy Cnty Dept Social Services16 mi · Scotia, NY · 2 of 5 stars

All nursing homes in the state →

Hospice providers

High Peaks Hospice and Palliative Care, Inc22 mi · Hudson Falls, NY · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Centerwell Home Health11 mi · Ballston Lake, NY · 5 of 5 stars
Warren Co Hlth SVS Chha24 mi · Lake George, NY

All home health agencies in the state →

Dialysis facilities

DCI - Rubin Dialysis Centers - Saratoga Springs2.9 mi · Saratoga Springs, NY · 3 of 5 stars
DCI - Rubin Dialysis Centers - Clifton Park16 mi · Clifton Park, NY · 2 of 5 stars
FMC - Freedom Center of Clifton Park16 mi · Clifton Park, NY

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Center for Advanced Ambulatory Surgery6.8 mi · Malta, NY
Northeastern New York Surgical Center9.3 mi · Wilton, NY
Saratoga-Schenectady Endoscopy Center13 mi · Burnt Hills, NY

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

Moreau Family Health12 mi · Gansevoort, NY · Community health center
Hudson Headwaters Mobile Health Center 115 mi · Queensbury, NY · Community health center
Hudson Headwaters Mobile Health Center 215 mi · Queensbury, NY · Community health center

Clinics and urgent care

Saratoga Hospital2.9 mi · Saratoga Springs, NY · Urgent care center
Albany Medical College16 mi · Clifton Park, NY · Urgent care center
Ellis Hospital16 mi · Halfmoon, NY · Urgent care center

Pharmacies

Martins Foods of South Burlington LLC2.9 mi · Saratoga Springs, NY · Community/retail pharmacy
Menges & Curtis LLC2.9 mi · Saratoga Springs, NY · Community/retail pharmacy
Saratoga Hospital2.9 mi · Saratoga Springs, NY · Community/retail pharmacy

Assisted living nearby

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

Home of the Good Shepherd2.9 mi · Saratoga Springs, NY
Home of the Good Shepherd Saratoga2.9 mi · Saratoga Springs, NY
Woodlawn Commons2.9 mi · Saratoga Springs, NY
Home of the Good Shepherd at Highpointe6.8 mi · Malta, NY

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 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	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	73%National average: 72%
Would definitely recommend the hospital	77%National average: 71%
Nurses “always” communicated well	84%National average: 80%
Doctors “always” communicated well	82%National average: 80%
Staff “always” explained medicines before giving them	69%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	77%National average: 74%
Area around the room “always” quiet at night	49%National average: 60%
Completed surveys	522Response rate: 26%

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)	0Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.336No different from the national benchmark
Surgical site infections after colon surgery	0Better than the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.944No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.643No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.7%
Deaths within 30 days: heart failure patients	12.6%
Deaths within 30 days: pneumonia patients	13.7%
Deaths within 30 days: COPD patients	9.2%
Deaths within 30 days: stroke patients	10.2%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.08No different from the national rate
Complications after hip or knee replacement	4.6%

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	20.7%
Readmitted within 30 days: pneumonia	16.5%
Readmitted within 30 days: COPD	19.7%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	5.6%

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)	296 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)	79%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in New York Best hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Saratoga Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 30 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$211	$105.50	$8.08 – $178.93
New patient office visit (about 30–44 minutes): 10 of 120 insurance plan rates Aetna — All Products_FAC: $88.47 Aetna — All Products_NONFAC: $119.70 Aetna — Medicare_FAC: $78.25 Aetna — Medicare_NONFAC: $107.06 Blue Cross — Blue Access_FAC: $94.49 Blue Cross — Blue Access_NONFAC: $129.44 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $65.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $89.22 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $76.72 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $104.96
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUTPATIENT NEW 30 MINUTES	$557	$278.50	$75.03 – $374.34
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $75.03 BCBS_Empire HealthChoice — Medicare Advantage: $110.06 Blue Shield — All Products: $374.34 CDPHP — Medicare Advantage: $104.82 Emblem — Commercial_All Products: $445.60 Emblem — Medicare Advantage: $116.35 Empire Plan NYSHIP — All Products: $473.45 MagnaCare — All Products: $501.30 Multiplan — PPO: $417.75 MVP Commercial — CIGNA All Products: $389.90
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$120	$60	$75.03 – $120
New patient office visit (about 30–44 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $75.03 BCBS_Empire HealthChoice — Medicare Advantage: $110.06 Blue Shield — All Products: $120 CDPHP — Medicare Advantage: $104.82 Emblem — Commercial_All Products: $96 Emblem — Medicare Advantage: $116.35 Empire Plan NYSHIP — All Products: $102 MagnaCare — All Products: $108 Multiplan — PPO: $90 MVP Commercial — CIGNA All Products: $84
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$375	$187.50	$8.08 – $273.82
New patient office visit (about 45–59 minutes): 10 of 117 insurance plan rates Aetna — All Products_FAC: $142.67 Aetna — All Products_NONFAC: $178.16 Aetna — Medicare_FAC: $127.58 Aetna — Medicare_NONFAC: $160.77 Blue Cross — Blue Access_FAC: $157.42 Blue Cross — Blue Access_NONFAC: $199.26 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $106.32 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $133.98 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $125.08 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $157.62
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUTPATIENT NEW 45 MINUTES	$666	$333	$127.27 – $572.73
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $127.27 BCBS_Empire HealthChoice — Medicare Advantage: $179.51 Blue Shield — All Products: $572.73 CDPHP — Medicare Advantage: $170.96 Emblem — Commercial_All Products: $532.80 Emblem — Medicare Advantage: $189.77 Empire Plan NYSHIP — All Products: $566.10 MagnaCare — All Products: $599.40 Multiplan — PPO: $499.50 MVP Commercial — CIGNA All Products: $466.20
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$120	$60	$120 – $127.27
New patient office visit (about 45–59 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $127.27 BCBS_Empire HealthChoice — Medicare Advantage: $179.51 Blue Shield — All Products: $120 CDPHP — Medicare Advantage: $170.96 Emblem — Commercial_All Products: $96 Emblem — Medicare Advantage: $189.77 Empire Plan NYSHIP — All Products: $102 MagnaCare — All Products: $108 Multiplan — PPO: $90 MVP Commercial — CIGNA All Products: $84
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$533	$266.50	$8.08 – $346.22
New patient office visit (about 60–74 minutes): 10 of 117 insurance plan rates Aetna — All Products_FAC: $193.69 Aetna — All Products_NONFAC: $235.21 Aetna — Medicare_FAC: $173.47 Aetna — Medicare_NONFAC: $212.30 Blue Cross — Blue Access_FAC: $204 Blue Cross — Blue Access_NONFAC: $248.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $144.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $176.92 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $170.07 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $208.14
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUTPATIENT NEW 60 MINUTES	$763	$381.50	$165.73 – $724.07
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $165.73 BCBS_Empire HealthChoice — Medicare Advantage: $243.53 Blue Shield — All Products: $724.07 CDPHP — Medicare Advantage: $231.93 Emblem — Commercial_All Products: $610.40 Emblem — Medicare Advantage: $257.44 Empire Plan NYSHIP — All Products: $648.55 MagnaCare — All Products: $686.70 Multiplan — PPO: $572.25 MVP Commercial — CIGNA All Products: $534.10
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$120	$60	$120 – $165.73
New patient office visit (about 60–74 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $165.73 BCBS_Empire HealthChoice — Medicare Advantage: $243.53 Blue Shield — All Products: $120 CDPHP — Medicare Advantage: $231.93 Emblem — Commercial_All Products: $96 Emblem — Medicare Advantage: $257.44 Empire Plan NYSHIP — All Products: $102 MagnaCare — All Products: $108 Multiplan — PPO: $90 MVP Commercial — CIGNA All Products: $84
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$151	$75.50	$5.05 – $139.76
Established patient office visit (about 20–29 minutes): 10 of 120 insurance plan rates Aetna — All Products_FAC: $70.74 Aetna — All Products_NONFAC: $96.65 Aetna — Medicare_FAC: $63.16 Aetna — Medicare_NONFAC: $87.58 Blue Cross — Blue Access_FAC: $63.14 Blue Cross — Blue Access_NONFAC: $87.69 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $52.63 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $72.98 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $61.92 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $85.86
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LABOR TRIAGE LEVEL THREE	$557	$278.50	$50.12 – $258.66
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates Aetna Government Program — Medicare Advantage: $50.12 BCBS_Empire HealthChoice — Blue Access Large Group: $334.20 BCBS_Empire HealthChoice — Blue Access Small Group: $311.92 BCBS_Empire HealthChoice — Commercial All Products: $389.90 BCBS_Empire HealthChoice — Medicare Advantage: $89.17 Blue Shield — All Products: $258.66 CDPHP — Medicare Advantage: $84.92 Emblem — Commercial_All Products: $445.60 Emblem — Medicare Advantage: $94.26 Empire Plan NYSHIP — All Products: $389.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUTPATIENT VISIT 20 MINUTES	$557	$278.50	$50.12 – $258.66
Established patient office visit (about 20–29 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $50.12 BCBS_Empire HealthChoice — Medicare Advantage: $89.17 Blue Shield — All Products: $258.66 CDPHP — Medicare Advantage: $84.92 Emblem — Commercial_All Products: $445.60 Emblem — Medicare Advantage: $94.26 Empire Plan NYSHIP — All Products: $473.45 MagnaCare — All Products: $501.30 Multiplan — PPO: $417.75 MVP Commercial — CIGNA All Products: $389.90
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$262	$131	$5.05 – $196.82
Established patient office visit (about 30–39 minutes): 10 of 117 insurance plan rates Aetna — All Products_FAC: $104.54 Aetna — All Products_NONFAC: $136.83 Aetna — Medicare_FAC: $92.96 Aetna — Medicare_NONFAC: $123.33 Blue Cross — Blue Access_FAC: $97.20 Blue Cross — Blue Access_NONFAC: $129.60 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $77.47 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $102.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $91.14 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $120.91
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LABOR TRIAGE LEVEL FOUR	$666	$333	$77.36 – $375.90
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates Aetna Government Program — Medicare Advantage: $77.36 BCBS_Empire HealthChoice — Blue Access Large Group: $399.60 BCBS_Empire HealthChoice — Blue Access Small Group: $372.96 BCBS_Empire HealthChoice — Commercial All Products: $466.20 BCBS_Empire HealthChoice — Medicare Advantage: $131.30 Blue Shield — All Products: $375.90 CDPHP — Medicare Advantage: $125.05 Emblem — Commercial_All Products: $532.80 Emblem — Medicare Advantage: $138.81 Empire Plan NYSHIP — All Products: $466.20
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE OUTPATIENT VISIT 25 MINUTES	$666	$333	$77.36 – $375.90
Established patient office visit (about 30–39 minutes): 10 of 14 insurance plan rates Aetna Government Program — Medicare Advantage: $77.36 BCBS_Empire HealthChoice — Medicare Advantage: $131.30 Blue Shield — All Products: $375.90 CDPHP — Medicare Advantage: $125.05 Emblem — Commercial_All Products: $532.80 Emblem — Medicare Advantage: $138.81 Empire Plan NYSHIP — All Products: $566.10 MagnaCare — All Products: $599.40 Multiplan — PPO: $499.50 MVP Commercial — CIGNA All Products: $466.20
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$360	$180	$32.32 – $206.81
Office consultation with a specialist (moderate): 10 of 49 insurance plan rates Aetna — All Products_FAC: $95.34 Aetna — All Products_NONFAC: $121.95 Blue Cross — Blue Access_FAC: $59.63 Blue Cross — Blue Access_NONFAC: $77.44 Blue Cross — HMO_FAC: $63.14 Blue Cross — HMO_NONFAC: $82 Blue Cross — PPO_FAC: $74.94 Blue Cross — PPO_NONFAC: $97.32 Blue Shield Highmark — All Products_BH_Psychiatrist: $122.86 Blue Shield Highmark — All Products_NOF: $154.99
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN	$364	$182	$94.30 – $364
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna Government Program — Medicare Advantage: $94.30 Blue Shield — All Products: $364 Emblem — Commercial_All Products: $291.20 Emblem — Medicare Advantage: $218.40 Empire Plan NYSHIP — All Products: $309.40 MagnaCare — All Products: $327.60 Multiplan — PPO: $273 MVP Commercial — CIGNA All Products: $254.80 MVP Commercial — Individual_Student_CIGNA Health Plans: $273 United Healthcare — All Products: $309.40
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN	$76	$38	$76 – $94.30
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna Government Program — Medicare Advantage: $94.30 Blue Shield — All Products: $76 Emblem — Commercial_All Products: $60.80 Emblem — Medicare Advantage: $45.60 Empire Plan NYSHIP — All Products: $64.60 MagnaCare — All Products: $68.40 Multiplan — PPO: $57 MVP Commercial — CIGNA All Products: $53.20 MVP Commercial — Individual_Student_CIGNA Health Plans: $57 United Healthcare — All Products: $64.60
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$456	$228	$49.06 – $310.08
Office consultation with a specialist (moderate to high): 10 of 49 insurance plan rates Aetna — All Products_FAC: $145.43 Aetna — All Products_NONFAC: $174.53 Blue Cross — Blue Access_FAC: $83.90 Blue Cross — Blue Access_NONFAC: $102.32 Blue Cross — HMO_FAC: $88.84 Blue Cross — HMO_NONFAC: $108.34 Blue Cross — PPO_FAC: $105.44 Blue Cross — PPO_NONFAC: $128.58 Blue Shield Highmark — All Products_BH_Psychiatrist: $184.25 Blue Shield Highmark — All Products_NOF: $232.35
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN	$574	$287	$151.55 – $574
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna Government Program — Medicare Advantage: $151.55 Blue Shield — All Products: $574 Emblem — Commercial_All Products: $459.20 Emblem — Medicare Advantage: $344.40 Empire Plan NYSHIP — All Products: $487.90 MagnaCare — All Products: $516.60 Multiplan — PPO: $430.50 MVP Commercial — CIGNA All Products: $401.80 MVP Commercial — Individual_Student_CIGNA Health Plans: $430.50 United Healthcare — All Products: $487.90
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN	$83	$41.50	$83 – $151.55
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna Government Program — Medicare Advantage: $151.55 Blue Shield — All Products: $83 Emblem — Commercial_All Products: $66.40 Emblem — Medicare Advantage: $49.80 Empire Plan NYSHIP — All Products: $70.55 MagnaCare — All Products: $74.70 Multiplan — PPO: $62.25 MVP Commercial — CIGNA All Products: $58.10 MVP Commercial — Individual_Student_CIGNA Health Plans: $62.25 United Healthcare — All Products: $70.55
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$387	$193.50	$33.97 – $222.12
Preventive checkup, new patient, age 18–39: 10 of 100 insurance plan rates Aetna — All Products_FAC: $101.15 Aetna — All Products_NONFAC: $138.41 Aetna — Medicare_FAC: $89.97 Aetna — Medicare_NONFAC: $124.41 Blue Cross — Blue Access_FAC: $73.51 Blue Cross — Blue Access_NONFAC: $102.10 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $74.98 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $103.67 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $88.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $121.97
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$96.76 – $464.76
Preventive checkup, new patient, age 18–39: rates for 2 insurance plans Aetna Government Program — Medicare Advantage: $96.76 Blue Shield — All Products: $464.76
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$448	$224	$41.67 – $257.26
Preventive checkup, new patient, age 40–64: 10 of 98 insurance plan rates Aetna — All Products_FAC: $122.66 Aetna — All Products_NONFAC: $159.57 Aetna — Medicare_FAC: $108.99 Aetna — Medicare_NONFAC: $143.43 Blue Cross — Blue Access_FAC: $88.36 Blue Cross — Blue Access_NONFAC: $117.81 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $90.82 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $119.53 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $106.85 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $140.62
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$117.65 – $538.23
Preventive checkup, new patient, age 40–64: rates for 2 insurance plans Aetna Government Program — Medicare Advantage: $117.65 Blue Shield — All Products: $538.23
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT LOW MDM	$214	$107	$6.57 – $109.43
Emergency room visit (moderate): 10 of 99 insurance plan rates Aetna — All Products_FAC: $77.04 Aetna — All Products_NONFAC: $77.04 Aetna — Medicare_FAC: $67.62 Aetna — Medicare_NONFAC: $67.62 Blue Cross — Blue Access_FAC: $54.40 Blue Cross — Blue Access_NONFAC: $54.40 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $56.35 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $56.35 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $66.29 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $66.29
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$1,233	$616.50	$92.93 – $2,635
Emergency room visit (moderate): 10 of 23 insurance plan rates Aetna — Commercial: $1,626 Aetna Government Program — Medicare Advantage: $60.88 BCBS_Empire HealthChoice — Blue Access Large Group: $2,240 BCBS_Empire HealthChoice — Blue Access Small Group: $2,108 BCBS_Empire HealthChoice — Commercial All Products: $2,635 BCBS_Empire HealthChoice — Medicare Advantage: $97.58 Blue Shield — All Products: $1,473 Blue Shield — Senior Blue PPO: $645 CDPHP — All Products-High Deductible Plan: $1,194 CDPHP — All Products-Labcorp: $1,194
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$1,233	$616.50	$863.10 – $1,171.35
Emergency room visit (moderate): rates for 3 insurance plans MagnaCare — All Products: $1,171.35 Multiplan — PPO: $1,048.05 United Healthcare — All Products: $1,109.70
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$363	$181.50	$6.57 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $200.45
Emergency room visit (moderately high): 10 of 99 insurance plan rates Aetna — All Products_FAC: $129.83 Aetna — All Products_NONFAC: $129.83 Aetna — Medicare_FAC: $115.25 Aetna — Medicare_NONFAC: $115.25 Blue Cross — Blue Access_FAC: $90.90 Blue Cross — Blue Access_NONFAC: $90.90 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $96.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $96.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $112.99 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $112.99
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$1,593	$796.50	$158.43 – $2,635
Emergency room visit (moderately high): 10 of 23 insurance plan rates Aetna — Commercial: $1,626 Aetna Government Program — Medicare Advantage: $115.50 BCBS_Empire HealthChoice — Blue Access Large Group: $2,240 BCBS_Empire HealthChoice — Blue Access Small Group: $2,108 BCBS_Empire HealthChoice — Commercial All Products: $2,635 BCBS_Empire HealthChoice — Medicare Advantage: $166.35 Blue Shield — All Products: $1,473 Blue Shield — Senior Blue PPO: $645 CDPHP — All Products-High Deductible Plan: $1,194 CDPHP — All Products-Labcorp: $1,194
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$1,593	$796.50	$1,115.10 – $1,513.35
Emergency room visit (moderately high): rates for 3 insurance plans MagnaCare — All Products: $1,513.35 Multiplan — PPO: $1,354.05 United Healthcare — All Products: $1,433.70
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$528	$264	$6.57 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $291.13
Emergency room visit (high): 10 of 99 insurance plan rates Aetna — All Products_FAC: $188.76 Aetna — All Products_NONFAC: $188.76 Aetna — Medicare_FAC: $167.10 Aetna — Medicare_NONFAC: $167.10 Blue Cross — Blue Access_FAC: $132.35 Blue Cross — Blue Access_NONFAC: $132.35 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $139.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $139.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $163.82 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $163.82
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$2,102	$1,051	$229.94 – $2,635
Emergency room visit (high): 10 of 23 insurance plan rates Aetna — Commercial: $2,184 Aetna Government Program — Medicare Advantage: $170.41 BCBS_Empire HealthChoice — Blue Access Large Group: $2,240 BCBS_Empire HealthChoice — Blue Access Small Group: $2,108 BCBS_Empire HealthChoice — Commercial All Products: $2,635 BCBS_Empire HealthChoice — Medicare Advantage: $241.44 Blue Shield — All Products: $1,473 Blue Shield — Senior Blue PPO: $645 CDPHP — All Products-High Deductible Plan: $1,194 CDPHP — All Products-Labcorp: $1,194
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$2,102	$1,051	$1,471.40 – $1,996.90
Emergency room visit (high): rates for 3 insurance plans MagnaCare — All Products: $1,996.90 Multiplan — PPO: $1,786.70 United Healthcare — All Products: $1,891.80

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG BASIC METABOLIC PANEL CALCIUM TOTAL	$27	$13.50	$3.81 – $9.32
Basic metabolic panel (blood test): 10 of 84 insurance plan rates Aetna — All Products_FAC: $9.31 Aetna — All Products_NONFAC: $9.31 Aetna — Medicare_FAC: $8.63 Aetna — Medicare_NONFAC: $8.63 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $8.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $8.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $8.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $8.46 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $8.46 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL CALCIUM TOTAL - BUNDLED CHARGE	$321	$160.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $31.73
Basic metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — Commercial: $31.73 Aetna Government Program — Medicare Advantage: $8.63 BCBS_Empire HealthChoice — Blue Access Large Group: $125.19 BCBS_Empire HealthChoice — Blue Access Small Group: $118.77 BCBS_Empire HealthChoice — Commercial All Products: $147.66 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $8.88 Blue Shield — All Products: $22.92
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POCT BASIC METABOLIC PANEL CALCIUM TOTAL - BUNDLED CHARGE	$321	$160.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $31.73
Basic metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — Commercial: $31.73 Aetna Government Program — Medicare Advantage: $8.63 BCBS_Empire HealthChoice — Blue Access Large Group: $125.19 BCBS_Empire HealthChoice — Blue Access Small Group: $118.77 BCBS_Empire HealthChoice — Commercial All Products: $147.66 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $8.88 Blue Shield — All Products: $22.92
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG COMPREHENSIVE METABOLIC PANEL	$36	$18	$4.75 – $11.64
Comprehensive metabolic panel (blood test): 10 of 84 insurance plan rates Aetna — All Products_FAC: $11.62 Aetna — All Products_NONFAC: $11.62 Aetna — Medicare_FAC: $10.77 Aetna — Medicare_NONFAC: $10.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $10.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $10.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $10.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $10.56 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $10.56 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC METABOLIC PANEL,COMPREHENSIVE - BUNDLED CHARGE	$394	$197	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $39.60
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — Commercial: $39.60 Aetna Government Program — Medicare Advantage: $10.77 BCBS_Empire HealthChoice — Blue Access Large Group: $153.66 BCBS_Empire HealthChoice — Blue Access Small Group: $145.78 BCBS_Empire HealthChoice — Commercial All Products: $181.24 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $11.09 Blue Shield — All Products: $28.61
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB METABOLIC PANEL,COMPREHENSIVE - BUNDLED CHARGE	$36	$18	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $36
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — Commercial: $36 Aetna Government Program — Medicare Advantage: $10.77 BCBS_Empire HealthChoice — Blue Access Large Group: $14.04 BCBS_Empire HealthChoice — Blue Access Small Group: $13.32 BCBS_Empire HealthChoice — Commercial All Products: $16.56 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $11.09 Blue Shield — All Products: $28.61
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL - BUNDLED CHARGE	$1,195	$597.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $179.29
Obstetric blood test panel: 10 of 34 insurance plan rates Aetna — Commercial: $179.29 Aetna Government Program — Medicare Advantage: $48.77 BCBS_Empire HealthChoice — Blue Access Large Group: $466.05 BCBS_Empire HealthChoice — Blue Access Small Group: $442.15 BCBS_Empire HealthChoice — Commercial All Products: $549.70 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $50.20 Blue Shield — All Products: $129.51
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OBSTETRIC PANEL - BUNDLED CHARGE	$1,195	$597.50	$442.15 – $1,135.25
Obstetric blood test panel: rates for 3 insurance plans MagnaCare — All Products: $1,135.25 Multiplan — PPO: $1,015.75 United Healthcare — All Products: $1,075.50
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG LIPID PANEL	$73	$36.50	$6.03 – $14.76
Cholesterol panel (lipid panel): 10 of 84 insurance plan rates Aetna — All Products_FAC: $14.73 Aetna — All Products_NONFAC: $14.73 Aetna — Medicare_FAC: $13.66 Aetna — Medicare_NONFAC: $13.66 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $13.39 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $13.39 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $13.39 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $13.39 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $13.39 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL - BUNDLED CHARGE	$318	$159	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $50.21
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates Aetna — Commercial: $50.21 Aetna Government Program — Medicare Advantage: $13.66 BCBS_Empire HealthChoice — Blue Access Large Group: $124.02 BCBS_Empire HealthChoice — Blue Access Small Group: $117.66 BCBS_Empire HealthChoice — Commercial All Products: $146.28 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $14.06 Blue Shield — All Products: $36.27
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB LIPID PANEL - BUNDLED CHARGE	$247	$123.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $50.21
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates Aetna — Commercial: $50.21 Aetna Government Program — Medicare Advantage: $13.66 BCBS_Empire HealthChoice — Blue Access Large Group: $96.33 BCBS_Empire HealthChoice — Blue Access Small Group: $91.39 BCBS_Empire HealthChoice — Commercial All Products: $113.62 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $14.06 Blue Shield — All Products: $36.27
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG RENAL FUNCTION PANEL	$140	$70	$3.91 – $9.57
Kidney function panel: 10 of 84 insurance plan rates Aetna — All Products_FAC: $9.55 Aetna — All Products_NONFAC: $9.55 Aetna — Medicare_FAC: $8.85 Aetna — Medicare_NONFAC: $8.85 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $8.68 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $8.68 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $8.68 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $8.68 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $8.68 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $8.68
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL - BUNDLED CHARGE	$346	$173	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $32.55
Kidney function panel: 10 of 34 insurance plan rates Aetna — Commercial: $32.55 Aetna Government Program — Medicare Advantage: $8.85 BCBS_Empire HealthChoice — Blue Access Large Group: $134.94 BCBS_Empire HealthChoice — Blue Access Small Group: $128.02 BCBS_Empire HealthChoice — Commercial All Products: $159.16 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $9.11 Blue Shield — All Products: $23.51
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL - BUNDLED CHARGE	$346	$173	$128.02 – $328.70
Kidney function panel: rates for 3 insurance plans MagnaCare — All Products: $328.70 Multiplan — PPO: $294.10 United Healthcare — All Products: $311.40
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG HEPATIC FUNCTION PANEL	$167	$83.50	$3.68 – $9.01
Liver function panel: 10 of 84 insurance plan rates Aetna — All Products_FAC: $8.99 Aetna — All Products_NONFAC: $8.99 Aetna — Medicare_FAC: $8.33 Aetna — Medicare_NONFAC: $8.33 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $8.17 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $8.17 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $8.17 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $8.17 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $8.17 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL - BUNDLED CHARGE	$396	$198	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $30.64
Liver function panel: 10 of 34 insurance plan rates Aetna — Commercial: $30.64 Aetna Government Program — Medicare Advantage: $8.33 BCBS_Empire HealthChoice — Blue Access Large Group: $154.44 BCBS_Empire HealthChoice — Blue Access Small Group: $146.52 BCBS_Empire HealthChoice — Commercial All Products: $182.16 BCBS_Empire HealthChoice — Essential Plans Aliessa: $89.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $89.17 BCBS_Empire HealthChoice — Managed Medicaid: $48.20 BCBS_Empire HealthChoice — Medicare Advantage: $8.58 Blue Shield — All Products: $22.13
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL - BUNDLED CHARGE	$396	$198	$146.52 – $376.20
Liver function panel: rates for 3 insurance plans MagnaCare — All Products: $376.20 Multiplan — PPO: $336.60 United Healthcare — All Products: $356.40
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$11	$5.50	$1.43 – $3.50
Urine test (automated, with microscope): 10 of 86 insurance plan rates Aetna — All Products_FAC: $3.49 Aetna — All Products_NONFAC: $3.49 Aetna — Medicare_FAC: $3.23 Aetna — Medicare_NONFAC: $3.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $3.17 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $3.17 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $3.17 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $3.17 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $3.17 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC	$180	$90	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $11.89
Urine test (automated, with microscope): 10 of 34 insurance plan rates Aetna — Commercial: $11.89 Aetna Government Program — Medicare Advantage: $3.23 BCBS_Empire HealthChoice — Blue Access Large Group: $70.20 BCBS_Empire HealthChoice — Blue Access Small Group: $66.60 BCBS_Empire HealthChoice — Commercial All Products: $82.80 BCBS_Empire HealthChoice — Essential Plans Aliessa: $50.78 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $50.78 BCBS_Empire HealthChoice — Managed Medicaid: $27.45 BCBS_Empire HealthChoice — Medicare Advantage: $3.33 Blue Shield — All Products: $8.59
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$180	$90	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $11.89
Urine test (automated, with microscope): 10 of 34 insurance plan rates Aetna — Commercial: $11.89 Aetna Government Program — Medicare Advantage: $3.23 BCBS_Empire HealthChoice — Blue Access Large Group: $70.20 BCBS_Empire HealthChoice — Blue Access Small Group: $66.60 BCBS_Empire HealthChoice — Commercial All Products: $82.80 BCBS_Empire HealthChoice — Essential Plans Aliessa: $50.78 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $50.78 BCBS_Empire HealthChoice — Managed Medicaid: $27.45 BCBS_Empire HealthChoice — Medicare Advantage: $3.33 Blue Shield — All Products: $8.59
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$16	$8	$1.57 – $3.83
Urine test (manual, without microscope): 10 of 87 insurance plan rates Aetna — All Products_FAC: $3.83 Aetna — All Products_NONFAC: $3.83 Aetna — Medicare_FAC: $3.55 Aetna — Medicare_NONFAC: $3.55 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $3.48 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $3.48 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $3.48 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $3.48 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $3.48 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB URINALYSIS NONAUTO W/O SCOPE	$78	$39	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $13.05
Urine test (manual, without microscope): 10 of 34 insurance plan rates Aetna — Commercial: $13.05 Aetna Government Program — Medicare Advantage: $3.55 BCBS_Empire HealthChoice — Blue Access Large Group: $30.42 BCBS_Empire HealthChoice — Blue Access Small Group: $28.86 BCBS_Empire HealthChoice — Commercial All Products: $35.88 BCBS_Empire HealthChoice — Essential Plans Aliessa: $50.78 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $50.78 BCBS_Empire HealthChoice — Managed Medicaid: $27.45 BCBS_Empire HealthChoice — Medicare Advantage: $3.65 Blue Shield — All Products: $9.43
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$102	$51	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $13.05
Urine test (manual, without microscope): 10 of 34 insurance plan rates Aetna — Commercial: $13.05 Aetna Government Program — Medicare Advantage: $3.55 BCBS_Empire HealthChoice — Blue Access Large Group: $39.78 BCBS_Empire HealthChoice — Blue Access Small Group: $37.74 BCBS_Empire HealthChoice — Commercial All Products: $46.92 BCBS_Empire HealthChoice — Essential Plans Aliessa: $50.78 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $50.78 BCBS_Empire HealthChoice — Managed Medicaid: $27.45 BCBS_Empire HealthChoice — Medicare Advantage: $3.65 Blue Shield — All Products: $9.43
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$8	$4	$1.01 – $2.48
Urine test (automated, without microscope): 10 of 86 insurance plan rates Aetna — All Products_FAC: $2.48 Aetna — All Products_NONFAC: $2.48 Aetna — Medicare_FAC: $2.30 Aetna — Medicare_NONFAC: $2.30 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $2.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $2.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2.25 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $2.25 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY	$102	$51	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $8.44
Urine test (automated, without microscope): 10 of 34 insurance plan rates Aetna — Commercial: $8.44 Aetna Government Program — Medicare Advantage: $2.30 BCBS_Empire HealthChoice — Blue Access Large Group: $39.78 BCBS_Empire HealthChoice — Blue Access Small Group: $37.74 BCBS_Empire HealthChoice — Commercial All Products: $46.92 BCBS_Empire HealthChoice — Essential Plans Aliessa: $50.78 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $50.78 BCBS_Empire HealthChoice — Managed Medicaid: $27.45 BCBS_Empire HealthChoice — Medicare Advantage: $2.36 Blue Shield — All Products: $6.10
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POINT OF CARE URINALYSIS DIPSTICK BY CLINITEK	$102	$51	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $8.44
Urine test (automated, without microscope): 10 of 34 insurance plan rates Aetna — Commercial: $8.44 Aetna Government Program — Medicare Advantage: $2.30 BCBS_Empire HealthChoice — Blue Access Large Group: $39.78 BCBS_Empire HealthChoice — Blue Access Small Group: $37.74 BCBS_Empire HealthChoice — Commercial All Products: $46.92 BCBS_Empire HealthChoice — Essential Plans Aliessa: $50.78 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $50.78 BCBS_Empire HealthChoice — Managed Medicaid: $27.45 BCBS_Empire HealthChoice — Medicare Advantage: $2.36 Blue Shield — All Products: $6.10
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$383	$191.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $68.96
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates Aetna — Commercial: $68.96 Aetna Government Program — Medicare Advantage: $18.76 BCBS_Empire HealthChoice — Blue Access Large Group: $149.37 BCBS_Empire HealthChoice — Blue Access Small Group: $141.71 BCBS_Empire HealthChoice — Commercial All Products: $176.18 BCBS_Empire HealthChoice — Essential Plans Aliessa: $51.32 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $51.32 BCBS_Empire HealthChoice — Managed Medicaid: $27.74 BCBS_Empire HealthChoice — Medicare Advantage: $19.31 Blue Shield — All Products: $49.82
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE	$383	$191.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $68.96
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates Aetna — Commercial: $68.96 Aetna Government Program — Medicare Advantage: $18.76 BCBS_Empire HealthChoice — Blue Access Large Group: $149.37 BCBS_Empire HealthChoice — Blue Access Small Group: $141.71 BCBS_Empire HealthChoice — Commercial All Products: $176.18 BCBS_Empire HealthChoice — Essential Plans Aliessa: $51.32 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $51.32 BCBS_Empire HealthChoice — Managed Medicaid: $27.74 BCBS_Empire HealthChoice — Medicare Advantage: $19.31 Blue Shield — All Products: $49.82
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE	$383	$191.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $68.96
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates Aetna — Commercial: $68.96 Aetna Government Program — Medicare Advantage: $18.76 BCBS_Empire HealthChoice — Blue Access Large Group: $149.37 BCBS_Empire HealthChoice — Blue Access Small Group: $141.71 BCBS_Empire HealthChoice — Commercial All Products: $176.18 BCBS_Empire HealthChoice — Essential Plans Aliessa: $51.32 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $51.32 BCBS_Empire HealthChoice — Managed Medicaid: $27.74 BCBS_Empire HealthChoice — Medicare Advantage: $19.31 Blue Shield — All Products: $49.82
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG ASSAY OF THYROID STIMULATING HORMONE TSH	$57	$28.50	$7.56 – $18.52
Thyroid stimulating hormone (TSH) test: 10 of 84 insurance plan rates Aetna — All Products_FAC: $18.48 Aetna — All Products_NONFAC: $18.48 Aetna — Medicare_FAC: $17.14 Aetna — Medicare_NONFAC: $17.14 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $16.80 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $16.80 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $16.80 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $16.80 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $16.80 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$469	$234.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $63
Thyroid stimulating hormone (TSH) test: 10 of 34 insurance plan rates Aetna — Commercial: $63 Aetna Government Program — Medicare Advantage: $17.14 BCBS_Empire HealthChoice — Blue Access Large Group: $182.91 BCBS_Empire HealthChoice — Blue Access Small Group: $173.53 BCBS_Empire HealthChoice — Commercial All Products: $215.74 BCBS_Empire HealthChoice — Essential Plans Aliessa: $87.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $87.69 BCBS_Empire HealthChoice — Managed Medicaid: $47.40 BCBS_Empire HealthChoice — Medicare Advantage: $17.64 Blue Shield — All Products: $45.51
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY THYROID STIM HORMONE - POCT THYROID STIMULATING HORMONE	$469	$234.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $63
Thyroid stimulating hormone (TSH) test: 10 of 34 insurance plan rates Aetna — Commercial: $63 Aetna Government Program — Medicare Advantage: $17.14 BCBS_Empire HealthChoice — Blue Access Large Group: $182.91 BCBS_Empire HealthChoice — Blue Access Small Group: $173.53 BCBS_Empire HealthChoice — Commercial All Products: $215.74 BCBS_Empire HealthChoice — Essential Plans Aliessa: $87.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $87.69 BCBS_Empire HealthChoice — Managed Medicaid: $47.40 BCBS_Empire HealthChoice — Medicare Advantage: $17.64 Blue Shield — All Products: $45.51
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$26	$13	$3.20 – $8.57
Complete blood count (CBC) with differential: 10 of 87 insurance plan rates Aetna — All Products_FAC: $8.55 Aetna — All Products_NONFAC: $8.55 Aetna — Medicare_FAC: $7.93 Aetna — Medicare_NONFAC: $7.93 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $7.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $7.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $7.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $7.77 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $7.77 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC & AUTO DIFF WBC - ADDITIONAL CHARGE	$212	$106	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $29.14
Complete blood count (CBC) with differential: 10 of 34 insurance plan rates Aetna — Commercial: $29.14 Aetna Government Program — Medicare Advantage: $7.93 BCBS_Empire HealthChoice — Blue Access Large Group: $82.68 BCBS_Empire HealthChoice — Blue Access Small Group: $78.44 BCBS_Empire HealthChoice — Commercial All Products: $97.52 BCBS_Empire HealthChoice — Essential Plans Aliessa: $52.10 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $52.10 BCBS_Empire HealthChoice — Managed Medicaid: $28.16 BCBS_Empire HealthChoice — Medicare Advantage: $8.16 Blue Shield — All Products: $21.05
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPLETE CBC & AUTO DIFF WBC - ADDITIONAL CHARGE	$212	$106	$78.44 – $201.40
Complete blood count (CBC) with differential: rates for 3 insurance plans MagnaCare — All Products: $201.40 Multiplan — PPO: $180.20 United Healthcare — All Products: $190.80
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG BLOOD COUNT COMPLETE AUTOMATED	$22	$11	$2.91 – $7.13
Complete blood count (CBC), automated: 10 of 84 insurance plan rates Aetna — All Products_FAC: $7.12 Aetna — All Products_NONFAC: $7.12 Aetna — Medicare_FAC: $6.60 Aetna — Medicare_NONFAC: $6.60 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $6.47 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $6.47 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $6.47 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $6.47 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $6.47 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC - CBC	$121	$60.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $24.26
Complete blood count (CBC), automated: 10 of 34 insurance plan rates Aetna — Commercial: $24.26 Aetna Government Program — Medicare Advantage: $6.60 BCBS_Empire HealthChoice — Blue Access Large Group: $47.19 BCBS_Empire HealthChoice — Blue Access Small Group: $44.77 BCBS_Empire HealthChoice — Commercial All Products: $55.66 BCBS_Empire HealthChoice — Essential Plans Aliessa: $52.10 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $52.10 BCBS_Empire HealthChoice — Managed Medicaid: $28.16 BCBS_Empire HealthChoice — Medicare Advantage: $6.79 Blue Shield — All Products: $17.53
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPLETE CBC - POCT CBC	$121	$60.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $24.26
Complete blood count (CBC), automated: 10 of 34 insurance plan rates Aetna — Commercial: $24.26 Aetna Government Program — Medicare Advantage: $6.60 BCBS_Empire HealthChoice — Blue Access Large Group: $47.19 BCBS_Empire HealthChoice — Blue Access Small Group: $44.77 BCBS_Empire HealthChoice — Commercial All Products: $55.66 BCBS_Empire HealthChoice — Essential Plans Aliessa: $52.10 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $52.10 BCBS_Empire HealthChoice — Managed Medicaid: $28.16 BCBS_Empire HealthChoice — Medicare Advantage: $6.79 Blue Shield — All Products: $17.53
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG PROTHROMBIN TIME	$21	$10.50	$1.93 – $4.73
Blood clotting time test (prothrombin time, PT): 10 of 84 insurance plan rates Aetna — All Products_FAC: $4.72 Aetna — All Products_NONFAC: $4.72 Aetna — Medicare_FAC: $4.38 Aetna — Medicare_NONFAC: $4.38 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $4.29 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $4.29 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $4.29 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $4.29 Blue Cross — EssentialNonAliessa_Ancillary Providers_FAC: $4.29 Blue Cross — EssentialNonAliessa_Ancillary Providers_NONFAC: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB PROTHROMBIN TIME	$21	$10.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $16.09
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates Aetna — Commercial: $16.09 Aetna Government Program — Medicare Advantage: $4.38 BCBS_Empire HealthChoice — Blue Access Large Group: $8.19 BCBS_Empire HealthChoice — Blue Access Small Group: $7.77 BCBS_Empire HealthChoice — Commercial All Products: $9.66 BCBS_Empire HealthChoice — Essential Plans Aliessa: $57.72 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $57.72 BCBS_Empire HealthChoice — Managed Medicaid: $31.20 BCBS_Empire HealthChoice — Medicare Advantage: $4.50 Blue Shield — All Products: $11.62
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME - PROTIME-INR	$199	$99.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $16.09
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates Aetna — Commercial: $16.09 Aetna Government Program — Medicare Advantage: $4.38 BCBS_Empire HealthChoice — Blue Access Large Group: $77.61 BCBS_Empire HealthChoice — Blue Access Small Group: $73.63 BCBS_Empire HealthChoice — Commercial All Products: $91.54 BCBS_Empire HealthChoice — Essential Plans Aliessa: $57.72 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $57.72 BCBS_Empire HealthChoice — Managed Medicaid: $31.20 BCBS_Empire HealthChoice — Medicare Advantage: $4.50 Blue Shield — All Products: $11.62
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL - APTT	$191	$95.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $22.54
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — Commercial: $22.54 Aetna Government Program — Medicare Advantage: $6.13 BCBS_Empire HealthChoice — Blue Access Large Group: $74.49 BCBS_Empire HealthChoice — Blue Access Small Group: $70.67 BCBS_Empire HealthChoice — Commercial All Products: $87.86 BCBS_Empire HealthChoice — Essential Plans Aliessa: $57.72 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $57.72 BCBS_Empire HealthChoice — Managed Medicaid: $31.20 BCBS_Empire HealthChoice — Medicare Advantage: $6.31 Blue Shield — All Products: $16.28
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM	$191	$95.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $22.54
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — Commercial: $22.54 Aetna Government Program — Medicare Advantage: $6.13 BCBS_Empire HealthChoice — Blue Access Large Group: $74.49 BCBS_Empire HealthChoice — Blue Access Small Group: $70.67 BCBS_Empire HealthChoice — Commercial All Products: $87.86 BCBS_Empire HealthChoice — Essential Plans Aliessa: $57.72 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $57.72 BCBS_Empire HealthChoice — Managed Medicaid: $31.20 BCBS_Empire HealthChoice — Medicare Advantage: $6.31 Blue Shield — All Products: $16.28
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SILICA CLOT TIME CONFIRM TEST	$191	$95.50	$0.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $22.54
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — Commercial: $22.54 Aetna Government Program — Medicare Advantage: $6.13 BCBS_Empire HealthChoice — Blue Access Large Group: $74.49 BCBS_Empire HealthChoice — Blue Access Small Group: $70.67 BCBS_Empire HealthChoice — Commercial All Products: $87.86 BCBS_Empire HealthChoice — Essential Plans Aliessa: $57.72 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $57.72 BCBS_Empire HealthChoice — Managed Medicaid: $31.20 BCBS_Empire HealthChoice — Medicare Advantage: $6.31 Blue Shield — All Products: $16.28

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) · Doctor (professional) fee In the file: CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL	$596	$298	$68.56 – $424.77
CT scan of the head or brain, without contrast: 10 of 94 insurance plan rates Aetna — All Products_FAC: $117.88 Aetna — All Products_NONFAC: $117.88 Aetna — Medicare_FAC: $102.84 Aetna — Medicare_NONFAC: $102.84 Blue Cross — Blue Access_FAC: $103.18 Blue Cross — Blue Access_NONFAC: $103.18 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $85.70 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $85.70 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $100.82 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $100.82
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$2,430	$1,215	$1,190.70 – $2,308.50
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $1,190.70 Aetna Government Program — Medicare Advantage: $69.99 BCBS_Empire HealthChoice — Blue Access Large Group: $1,239.30 BCBS_Empire HealthChoice — Blue Access Small Group: $1,360.80 BCBS_Empire HealthChoice — Commercial All Products: $1,458 BCBS_Empire HealthChoice — Essential Plans Aliessa: $805.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $805.69 BCBS_Empire HealthChoice — Managed Medicaid: $435.51 BCBS_Empire HealthChoice — Medicare Advantage: $147.24 Blue Shield — All Products: $362.87
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL	$1,902	$951	$931.98 – $1,806.90
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $931.98 Aetna Government Program — Medicare Advantage: $69.99 BCBS_Empire HealthChoice — Blue Access Large Group: $970.02 BCBS_Empire HealthChoice — Blue Access Small Group: $1,065.12 BCBS_Empire HealthChoice — Commercial All Products: $1,141.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $805.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $805.69 BCBS_Empire HealthChoice — Managed Medicaid: $435.51 BCBS_Empire HealthChoice — Medicare Advantage: $147.24 Blue Shield — All Products: $362.87
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$9,683	$4,841.50	$4,647.84 – $9,198.85
MRI of the brain, before and after contrast: 10 of 34 insurance plan rates Aetna — Commercial: $4,744.67 Aetna Government Program — Medicare Advantage: $251.23 BCBS_Empire HealthChoice — Blue Access Large Group: $5,809.80 BCBS_Empire HealthChoice — Blue Access Small Group: $4,647.84 BCBS_Empire HealthChoice — Commercial All Products: $6,778.10 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,467.46 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,467.46 BCBS_Empire HealthChoice — Managed Medicaid: $793.22 BCBS_Empire HealthChoice — Medicare Advantage: $442.44 Blue Shield — All Products: $1,268.14
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST	$9,683	$4,841.50	$4,647.84 – $9,198.85
MRI of the brain, before and after contrast: 10 of 34 insurance plan rates Aetna — Commercial: $4,744.67 Aetna Government Program — Medicare Advantage: $251.23 BCBS_Empire HealthChoice — Blue Access Large Group: $5,809.80 BCBS_Empire HealthChoice — Blue Access Small Group: $4,647.84 BCBS_Empire HealthChoice — Commercial All Products: $6,778.10 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,467.46 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,467.46 BCBS_Empire HealthChoice — Managed Medicaid: $793.22 BCBS_Empire HealthChoice — Medicare Advantage: $442.44 Blue Shield — All Products: $1,268.14
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$9,683	$4,841.50	$4,647.84 – $9,198.85
MRI of the brain, before and after contrast: rates for 3 insurance plans MagnaCare — All Products: $9,198.85 Multiplan — PPO: $8,230.55 United Healthcare — All Products: $8,714.70
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG RADIOLOGIC EXAM CHEST 2 VIEWS	$70	$35	$21.23 – $89.04
Chest X-ray, 2 views: 10 of 94 insurance plan rates Aetna — All Products_FAC: $36.08 Aetna — All Products_NONFAC: $36.08 Aetna — Medicare_FAC: $31.85 Aetna — Medicare_NONFAC: $31.85 Blue Cross — Blue Access_FAC: $25.46 Blue Cross — Blue Access_NONFAC: $25.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $26.55 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $26.55 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $31.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $31.23
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC XRAY CHEST 2 VIEWS	$644	$322	$315.56 – $611.80
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Commercial: $315.56 Aetna Government Program — Medicare Advantage: $106.28 BCBS_Empire HealthChoice — Blue Access Large Group: $328.44 BCBS_Empire HealthChoice — Blue Access Small Group: $360.64 BCBS_Empire HealthChoice — Commercial All Products: $386.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $100.51 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $100.51 BCBS_Empire HealthChoice — Managed Medicaid: $54.33 BCBS_Empire HealthChoice — Medicare Advantage: $46.13 Blue Shield — All Products: $103.13
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB RADIOLOGIC EXAM CHEST 2 VIEWS	$502	$251	$245.98 – $476.90
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna — Commercial: $245.98 Aetna Government Program — Medicare Advantage: $106.28 BCBS_Empire HealthChoice — Blue Access Large Group: $256.02 BCBS_Empire HealthChoice — Blue Access Small Group: $281.12 BCBS_Empire HealthChoice — Commercial All Products: $301.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $100.51 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $100.51 BCBS_Empire HealthChoice — Managed Medicaid: $54.33 BCBS_Empire HealthChoice — Medicare Advantage: $46.13 Blue Shield — All Products: $103.13
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$240	$120	$32.76 – $132.42
X-ray of the lower spine, at least 4 views: 10 of 95 insurance plan rates Aetna — All Products_FAC: $54.96 Aetna — All Products_NONFAC: $54.96 Aetna — Medicare_FAC: $49.14 Aetna — Medicare_NONFAC: $49.14 Blue Cross — Blue Access_FAC: $37.09 Blue Cross — Blue Access_NONFAC: $37.09 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $40.95 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $40.95 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $48.18 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $48.18
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$1,166	$583	$571.34 – $1,107.70
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates Aetna — Commercial: $571.34 Aetna Government Program — Medicare Advantage: $31.54 BCBS_Empire HealthChoice — Blue Access Large Group: $594.66 BCBS_Empire HealthChoice — Blue Access Small Group: $652.96 BCBS_Empire HealthChoice — Commercial All Products: $699.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $100.51 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $100.51 BCBS_Empire HealthChoice — Managed Medicaid: $54.33 BCBS_Empire HealthChoice — Medicare Advantage: $72.48 Blue Shield — All Products: $155.14
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB X-RAY LUMBAR SPINE 4 VW	$911	$455.50	$446.39 – $865.45
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates Aetna — Commercial: $446.39 Aetna Government Program — Medicare Advantage: $31.54 BCBS_Empire HealthChoice — Blue Access Large Group: $464.61 BCBS_Empire HealthChoice — Blue Access Small Group: $510.16 BCBS_Empire HealthChoice — Commercial All Products: $546.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $100.51 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $100.51 BCBS_Empire HealthChoice — Managed Medicaid: $54.33 BCBS_Empire HealthChoice — Medicare Advantage: $72.48 Blue Shield — All Products: $155.14
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 - MRI COMPLETE SPINE WO CONTRAST	$5,221	$2,610.50	$2,506.08 – $4,959.95
MRI of the lower back (lumbar spine), without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $2,558.29 Aetna Government Program — Medicare Advantage: $142.46 BCBS_Empire HealthChoice — Blue Access Large Group: $3,132.60 BCBS_Empire HealthChoice — Blue Access Small Group: $2,506.08 BCBS_Empire HealthChoice — Commercial All Products: $3,654.70 BCBS_Empire HealthChoice — Essential Plans Aliessa: $981.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $981.17 BCBS_Empire HealthChoice — Managed Medicaid: $530.36 BCBS_Empire HealthChoice — Medicare Advantage: $264.14 Blue Shield — All Products: $756.31
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 - MRI LUMBAR SPINE WO CONTRAST	$5,221	$2,610.50	$2,506.08 – $4,959.95
MRI of the lower back (lumbar spine), without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $2,558.29 Aetna Government Program — Medicare Advantage: $142.46 BCBS_Empire HealthChoice — Blue Access Large Group: $3,132.60 BCBS_Empire HealthChoice — Blue Access Small Group: $2,506.08 BCBS_Empire HealthChoice — Commercial All Products: $3,654.70 BCBS_Empire HealthChoice — Essential Plans Aliessa: $981.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $981.17 BCBS_Empire HealthChoice — Managed Medicaid: $530.36 BCBS_Empire HealthChoice — Medicare Advantage: $264.14 Blue Shield — All Products: $756.31
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MRI, LUMBAR SPINE - MRI COMPLETE SPINE WO CONTRAST	$5,221	$2,610.50	$2,506.08 – $4,959.95
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans MagnaCare — All Products: $4,959.95 Multiplan — PPO: $4,437.85 United Healthcare — All Products: $4,698.90
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$3,830	$1,915	$1,876.70 – $3,638.50
CT scan of the pelvis, with contrast: 10 of 34 insurance plan rates Aetna — Commercial: $1,876.70 Aetna Government Program — Medicare Advantage: $160.49 BCBS_Empire HealthChoice — Blue Access Large Group: $1,953.30 BCBS_Empire HealthChoice — Blue Access Small Group: $2,144.80 BCBS_Empire HealthChoice — Commercial All Products: $2,298 BCBS_Empire HealthChoice — Essential Plans Aliessa: $805.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $805.69 BCBS_Empire HealthChoice — Managed Medicaid: $435.51 BCBS_Empire HealthChoice — Medicare Advantage: $321.02 Blue Shield — All Products: $732.03
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$3,830	$1,915	$1,876.70 – $3,638.50
CT scan of the pelvis, with contrast: rates for 3 insurance plans MagnaCare — All Products: $3,638.50 Multiplan — PPO: $3,255.50 United Healthcare — All Products: $3,447
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: CT PELVIS W/DYE	Not listed in the file	Not listed in the file	$57.96 – $187.40
CT scan of the pelvis, with contrast: rates for 2 insurance plans Aetna Government Program — Medicare Advantage: $57.96 Blue Shield — All Products: $187.40
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 LWR EXTRE W/O CONTRAST	$3,619	$1,809.50	$1,737.12 – $3,438.05
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $1,773.31 Aetna Government Program — Medicare Advantage: $161.41 BCBS_Empire HealthChoice — Blue Access Large Group: $2,171.40 BCBS_Empire HealthChoice — Blue Access Small Group: $1,737.12 BCBS_Empire HealthChoice — Commercial All Products: $2,533.30 BCBS_Empire HealthChoice — Essential Plans Aliessa: $981.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $981.17 BCBS_Empire HealthChoice — Managed Medicaid: $530.36 BCBS_Empire HealthChoice — Medicare Advantage: $283.66 Blue Shield — All Products: $796.47
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 LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CO	$3,619	$1,809.50	$1,737.12 – $3,438.05
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $1,773.31 Aetna Government Program — Medicare Advantage: $161.41 BCBS_Empire HealthChoice — Blue Access Large Group: $2,171.40 BCBS_Empire HealthChoice — Blue Access Small Group: $1,737.12 BCBS_Empire HealthChoice — Commercial All Products: $2,533.30 BCBS_Empire HealthChoice — Essential Plans Aliessa: $981.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $981.17 BCBS_Empire HealthChoice — Managed Medicaid: $530.36 BCBS_Empire HealthChoice — Medicare Advantage: $283.66 Blue Shield — All Products: $796.47
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 LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CO	$3,619	$1,809.50	$1,737.12 – $3,438.05
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates Aetna — Commercial: $1,773.31 Aetna Government Program — Medicare Advantage: $161.41 BCBS_Empire HealthChoice — Blue Access Large Group: $2,171.40 BCBS_Empire HealthChoice — Blue Access Small Group: $1,737.12 BCBS_Empire HealthChoice — Commercial All Products: $2,533.30 BCBS_Empire HealthChoice — Essential Plans Aliessa: $981.17 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $981.17 BCBS_Empire HealthChoice — Managed Medicaid: $530.36 BCBS_Empire HealthChoice — Medicare Advantage: $283.66 Blue Shield — All Products: $796.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$8,048	$4,024	$3,943.52 – $7,645.60
CT scan of the abdomen and pelvis, with contrast: 10 of 34 insurance plan rates Aetna — Commercial: $3,943.52 Aetna Government Program — Medicare Advantage: $210.50 BCBS_Empire HealthChoice — Blue Access Large Group: $4,104.48 BCBS_Empire HealthChoice — Blue Access Small Group: $4,506.88 BCBS_Empire HealthChoice — Commercial All Products: $4,828.80 BCBS_Empire HealthChoice — Essential Plans Aliessa: $805.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $805.69 BCBS_Empire HealthChoice — Managed Medicaid: $435.51 BCBS_Empire HealthChoice — Medicare Advantage: $423.63 Blue Shield — All Products: $1,048.90
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$8,048	$4,024	$3,943.52 – $7,645.60
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans MagnaCare — All Products: $7,645.60 Multiplan — PPO: $6,840.80 United Healthcare — All Products: $7,243.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$313	$156.50	$55.42 – $155.09
CT scan of the abdomen and pelvis, with contrast: 10 of 94 insurance plan rates Aetna — All Products_FAC: $94.03 Aetna — All Products_NONFAC: $94.03 Aetna — Medicare_FAC: $83.13 Aetna — Medicare_NONFAC: $83.13 Blue Cross — Blue Access_FAC: $77.70 Blue Cross — Blue Access_NONFAC: $77.70 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $69.28 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $69.28 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $81.50 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $81.50
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$322	$161	$72.85 – $334.65
Ultrasound of the abdomen, complete: 10 of 94 insurance plan rates Aetna — All Products_FAC: $125.62 Aetna — All Products_NONFAC: $125.62 Aetna — Medicare_FAC: $109.27 Aetna — Medicare_NONFAC: $109.27 Blue Cross — Blue Access_FAC: $101.35 Blue Cross — Blue Access_NONFAC: $101.35 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $91.06 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $91.06 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $107.13 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $107.13
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$1,776	$888	$870.24 – $1,687.20
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates Aetna — Commercial: $870.24 Aetna Government Program — Medicare Advantage: $79.18 BCBS_Empire HealthChoice — Blue Access Large Group: $905.76 BCBS_Empire HealthChoice — Blue Access Small Group: $994.56 BCBS_Empire HealthChoice — Commercial All Products: $1,065.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,427.16 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,427.16 BCBS_Empire HealthChoice — Managed Medicaid: $771.44 BCBS_Empire HealthChoice — Medicare Advantage: $157.64 Blue Shield — All Products: $381.85
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLET	$1,776	$888	$870.24 – $1,687.20
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates Aetna — Commercial: $870.24 Aetna Government Program — Medicare Advantage: $79.18 BCBS_Empire HealthChoice — Blue Access Large Group: $905.76 BCBS_Empire HealthChoice — Blue Access Small Group: $994.56 BCBS_Empire HealthChoice — Commercial All Products: $1,065.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,427.16 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,427.16 BCBS_Empire HealthChoice — Managed Medicaid: $771.44 BCBS_Empire HealthChoice — Medicare Advantage: $157.64 Blue Shield — All Products: $381.85
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST	$1,047	$523.50	$513.03 – $994.65
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates Aetna — Commercial: $513.03 Aetna Government Program — Medicare Advantage: $89.04 BCBS_Empire HealthChoice — Blue Access Large Group: $533.97 BCBS_Empire HealthChoice — Blue Access Small Group: $586.32 BCBS_Empire HealthChoice — Commercial All Products: $628.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $303.81 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $303.81 BCBS_Empire HealthChoice — Managed Medicaid: $164.22 BCBS_Empire HealthChoice — Medicare Advantage: $182.88 Blue Shield — All Products: $440.74
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US, OB >/= 14 WKS, SNGL FETUS	$1,047	$523.50	$513.03 – $994.65
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates Aetna — Commercial: $513.03 Aetna Government Program — Medicare Advantage: $89.04 BCBS_Empire HealthChoice — Blue Access Large Group: $533.97 BCBS_Empire HealthChoice — Blue Access Small Group: $586.32 BCBS_Empire HealthChoice — Commercial All Products: $628.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $303.81 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $303.81 BCBS_Empire HealthChoice — Managed Medicaid: $164.22 BCBS_Empire HealthChoice — Medicare Advantage: $182.88 Blue Shield — All Products: $440.74
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB US, OB >/= 14 WKS, SNGL FETUS	$262	$131	$128.38 – $248.90
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates Aetna — Commercial: $128.38 Aetna Government Program — Medicare Advantage: $89.04 BCBS_Empire HealthChoice — Blue Access Large Group: $133.62 BCBS_Empire HealthChoice — Blue Access Small Group: $146.72 BCBS_Empire HealthChoice — Commercial All Products: $157.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $303.81 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $303.81 BCBS_Empire HealthChoice — Managed Medicaid: $164.22 BCBS_Empire HealthChoice — Medicare Advantage: $182.88 Blue Shield — All Products: $262
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ECHOGRAPHY,TRANSVAGINAL	$1,338	$669	$655.62 – $1,271.10
Transvaginal ultrasound: 10 of 34 insurance plan rates Aetna — Commercial: $655.62 Aetna Government Program — Medicare Advantage: $84.62 BCBS_Empire HealthChoice — Blue Access Large Group: $682.38 BCBS_Empire HealthChoice — Blue Access Small Group: $749.28 BCBS_Empire HealthChoice — Commercial All Products: $802.80 BCBS_Empire HealthChoice — Essential Plans Aliessa: $347.73 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $347.73 BCBS_Empire HealthChoice — Managed Medicaid: $187.96 BCBS_Empire HealthChoice — Medicare Advantage: $162.71 Blue Shield — All Products: $382.27
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB ECHOGRAPHY,TRANSVAGINAL	$256	$128	$125.44 – $243.20
Transvaginal ultrasound: 10 of 34 insurance plan rates Aetna — Commercial: $125.44 Aetna Government Program — Medicare Advantage: $84.62 BCBS_Empire HealthChoice — Blue Access Large Group: $130.56 BCBS_Empire HealthChoice — Blue Access Small Group: $143.36 BCBS_Empire HealthChoice — Commercial All Products: $153.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $347.73 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $347.73 BCBS_Empire HealthChoice — Managed Medicaid: $187.96 BCBS_Empire HealthChoice — Medicare Advantage: $162.71 Blue Shield — All Products: $256
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ECHOGRAPHY,TRANSVAGINAL	$1,338	$669	$655.62 – $1,271.10
Transvaginal ultrasound: rates for 3 insurance plans MagnaCare — All Products: $1,271.10 Multiplan — PPO: $1,137.30 United Healthcare — All Products: $1,204.20
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$379	$189.50	$79.32 – $364.92
Diagnostic mammogram, one breast: 10 of 94 insurance plan rates Aetna — All Products_FAC: $134.49 Aetna — All Products_NONFAC: $134.49 Aetna — Medicare_FAC: $118.97 Aetna — Medicare_NONFAC: $118.97 Blue Cross — Blue Access_FAC: $86.69 Blue Cross — Blue Access_NONFAC: $86.69 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $99.14 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $99.14 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $116.64 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $116.64
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNI ADDITIONAL VIEWS	$615	$307.50	$301.35 – $584.25
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates Aetna — Commercial: $301.35 Aetna Government Program — Medicare Advantage: $90.06 BCBS_Empire HealthChoice — Blue Access Large Group: $313.65 BCBS_Empire HealthChoice — Blue Access Small Group: $344.40 BCBS_Empire HealthChoice — Commercial All Products: $369 BCBS_Empire HealthChoice — Essential Plans Aliessa: $293 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $293 BCBS_Empire HealthChoice — Managed Medicaid: $158.38 BCBS_Empire HealthChoice — Medicare Advantage: $172.75 Blue Shield — All Products: $422.41
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC DX MAMMO INCL CAD UNI ADDITIONAL VIEWS	$615	$307.50	$301.35 – $584.25
Diagnostic mammogram, one breast: rates for 3 insurance plans MagnaCare — All Products: $584.25 Multiplan — PPO: $522.75 United Healthcare — All Products: $553.50
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$471	$235.50	$99.99 – $461.52
Diagnostic mammogram, both breasts: 10 of 94 insurance plan rates Aetna — All Products_FAC: $169.61 Aetna — All Products_NONFAC: $169.61 Aetna — Medicare_FAC: $149.98 Aetna — Medicare_NONFAC: $149.98 Blue Cross — Blue Access_FAC: $109.51 Blue Cross — Blue Access_NONFAC: $109.51 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $124.98 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $124.98 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $147.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $147.04
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMOGRAPHY, DIGITAL BILATERAL W/ CAD	$1,227	$613.50	$601.23 – $1,165.65
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Commercial: $601.23 Aetna Government Program — Medicare Advantage: $115.24 BCBS_Empire HealthChoice — Blue Access Large Group: $625.77 BCBS_Empire HealthChoice — Blue Access Small Group: $687.12 BCBS_Empire HealthChoice — Commercial All Products: $736.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $293 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $293 BCBS_Empire HealthChoice — Managed Medicaid: $158.38 BCBS_Empire HealthChoice — Medicare Advantage: $218.35 Blue Shield — All Products: $534.66
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMMOGRAPHY, DIGITAL BILATERAL W/ CAD	$1,227	$613.50	$601.23 – $1,165.65
Diagnostic mammogram, both breasts: rates for 3 insurance plans MagnaCare — All Products: $1,165.65 Multiplan — PPO: $1,042.95 United Healthcare — All Products: $1,104.30
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$358	$179	$80.98 – $372.42
Screening mammogram, both breasts: 10 of 94 insurance plan rates Aetna — All Products_FAC: $137.59 Aetna — All Products_NONFAC: $137.59 Aetna — Medicare_FAC: $121.47 Aetna — Medicare_NONFAC: $121.47 Blue Cross — Blue Access_FAC: $88.50 Blue Cross — Blue Access_NONFAC: $88.50 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $101.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $101.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $119.09 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $119.09
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO BREAST SCREENING BILAT INCL CAD	$795	$397.50	$389.55 – $755.25
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Commercial: $389.55 Aetna Government Program — Medicare Advantage: $95.17 BCBS_Empire HealthChoice — Blue Access Large Group: $405.45 BCBS_Empire HealthChoice — Blue Access Small Group: $445.20 BCBS_Empire HealthChoice — Commercial All Products: $477 BCBS_Empire HealthChoice — Essential Plans Aliessa: $293 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $293 BCBS_Empire HealthChoice — Managed Medicaid: $158.38 BCBS_Empire HealthChoice — Medicare Advantage: $177.51 Blue Shield — All Products: $432.15
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB SCREENING MAMMOGRAPHY BI 2-VIEW BREAST	$255	$127.50	$124.95 – $242.25
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna — Commercial: $124.95 Aetna Government Program — Medicare Advantage: $95.17 BCBS_Empire HealthChoice — Blue Access Large Group: $130.05 BCBS_Empire HealthChoice — Blue Access Small Group: $142.80 BCBS_Empire HealthChoice — Commercial All Products: $153 BCBS_Empire HealthChoice — Essential Plans Aliessa: $293 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $293 BCBS_Empire HealthChoice — Managed Medicaid: $158.38 BCBS_Empire HealthChoice — Medicare Advantage: $177.51 Blue Shield — All Products: $255

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$94	$47	$9.07 – $28.19
Electrocardiogram (ECG/EKG) with reading: 10 of 96 insurance plan rates Aetna — All Products_FAC: $15.41 Aetna — All Products_NONFAC: $15.41 Aetna — Medicare_FAC: $13.61 Aetna — Medicare_NONFAC: $13.61 Blue Cross — Blue Access_FAC: $13.52 Blue Cross — Blue Access_NONFAC: $13.52 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $11.34 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $11.34 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $13.34 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $13.34
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$49	$24.50	$24.99 – $46.55
Electrocardiogram (ECG/EKG) with reading: 10 of 29 insurance plan rates Aetna — Commercial: $30.58 Aetna Government Program — Medicare Advantage: $16.45 BCBS_Empire HealthChoice — Blue Access Large Group: $24.99 BCBS_Empire HealthChoice — Blue Access Small Group: $27.44 BCBS_Empire HealthChoice — Commercial All Products: $29.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $116.29 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $116.29 BCBS_Empire HealthChoice — Managed Medicaid: $62.86 BCBS_Empire HealthChoice — Medicare Advantage: $18.43 Blue Shield — All Products: $49
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$49	$24.50	$24.99 – $46.55
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans MagnaCare — All Products: $46.55 Multiplan — PPO: $41.65 United Healthcare — All Products: $44.10
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$720	$360	$409.11 – $2,594.46
Left heart catheterization (diagnostic): 10 of 94 insurance plan rates Aetna — All Products_FAC: $959.62 Aetna — All Products_NONFAC: $959.62 Aetna — Medicare_FAC: $804.78 Aetna — Medicare_NONFAC: $804.78 Blue Cross — Blue Access_FAC: $650.86 Blue Cross — Blue Access_NONFAC: $650.86 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $670.65 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $670.65 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $789 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $789
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CATH LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/	$12,437	$6,218.50	$1,117.68 – $13,874
Left heart catheterization (diagnostic): 10 of 35 insurance plan rates Aetna — Commercial: $7,948 Aetna Government Program — Medicare Advantage: $559.38 BCBS_Empire HealthChoice — Blue Access Large Group: $10,335 BCBS_Empire HealthChoice — Blue Access Small Group: $9,727 BCBS_Empire HealthChoice — Commercial All Products: $12,158 BCBS_Empire HealthChoice — Essential Plans Aliessa: $3,969.64 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $3,969.64 BCBS_Empire HealthChoice — Managed Medicaid: $2,145.75 BCBS_Empire HealthChoice — Medicare Advantage: $1,173.56 Blue Shield — All Products: $8,714
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CATH LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/	$12,437	$6,218.50	$8,705.90 – $11,815.15
Left heart catheterization (diagnostic): rates for 3 insurance plans MagnaCare — All Products: $11,815.15 Multiplan — PPO: $10,571.45 United Healthcare — All Products: $11,193.30
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$648.48 – $12,212.06
Heart rhythm study (electrophysiology evaluation): 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,199.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,199.69 BCBS_Empire HealthChoice — Managed Medicaid: $648.48 CDPHP — Essential Plans 1_2_3_4: $1,459.08 CDPHP — Managed Medicaid: $648.48 Fidelis — Essential Plan_QHP: $1,459.08 Hamaspik — Medicaid Managed Care: $1,523.93 MVP Essential Plan — Plans 1_2: $1,296.96 MVP Essential Plan — Plans 3_4: $648.48 MVP Govt Programs — Managed Medicaid_Child Health Plus: $648.48
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$648.48 – $12,212.06
Heart rhythm study (electrophysiology evaluation): rates for 8 insurance plans Aetna Government Program — Medicare Advantage: $9,159.04 BCBS_Empire HealthChoice — Medicare Advantage: $9,428.43 Blue Shield — All Products: $2,593.78 Blue Shield — Senior Blue PPO: $7,509.60 CDPHP — Medicare Advantage: $8,979.45 Emblem — Commercial_All Products: $8,979.45 Fidelis — Medicaid Managed Care: $8,979.45 Hamaspik — Medicare Advantage: $12,212.06
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 26 In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$385.91 – $1,413.50
Heart rhythm study (electrophysiology evaluation): rates for 2 insurance plans Aetna Government Program — Medicare Advantage: $385.91 Blue Shield — All Products: $1,413.50
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre ep eval abltj atr fib	Not listed in the file	Not listed in the file	$1,105.38 – $39,481.54
Heart rhythm study with ablation for atrial fibrillation: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $2,044.95 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $2,044.95 BCBS_Empire HealthChoice — Managed Medicaid: $1,105.38 CDPHP — Essential Plans 1_2_3_4: $2,487.11 CDPHP — Managed Medicaid: $1,105.38 Fidelis — Essential Plan_QHP: $2,487.11 Hamaspik — Medicaid Managed Care: $2,597.64 MVP Essential Plan — Plans 1_2: $2,210.76 MVP Essential Plan — Plans 3_4: $1,105.38 MVP Govt Programs — Managed Medicaid_Child Health Plus: $1,105.38
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$1,105.92
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans Aetna Government Program — Medicare Advantage: $1,105.92 BCBS_Empire HealthChoice — Medicare Advantage: $30,482.07 CDPHP — Medicare Advantage: $29,030.54 Emblem — Commercial_All Products: $29,030.54 Fidelis — Medicaid Managed Care: $29,030.54 Hamaspik — Medicare Advantage: $39,481.54
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$366	$183	$360.10 – $1,670.14
Sleep study (overnight, in a sleep lab): 10 of 94 insurance plan rates Aetna — All Products_FAC: $646.68 Aetna — All Products_NONFAC: $646.68 Aetna — Medicare_FAC: $591.45 Aetna — Medicare_NONFAC: $591.45 Blue Cross — Blue Access_FAC: $360.10 Blue Cross — Blue Access_NONFAC: $360.10 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $492.87 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $492.87 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $579.85 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $579.85
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$1,127	$563.50	$574.77 – $1,070.65
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates Aetna — Commercial: $712.26 Aetna Government Program — Medicare Advantage: $479.87 BCBS_Empire HealthChoice — Blue Access Large Group: $574.77 BCBS_Empire HealthChoice — Blue Access Small Group: $631.12 BCBS_Empire HealthChoice — Commercial All Products: $676.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,904.08 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,904.08 BCBS_Empire HealthChoice — Managed Medicaid: $1,029.23 BCBS_Empire HealthChoice — Medicare Advantage: $881.19 Blue Shield — All Products: $1,127
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$3,035	$1,517.50	$1,547.85 – $2,883.25
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates Aetna — Commercial: $1,918.12 Aetna Government Program — Medicare Advantage: $479.87 BCBS_Empire HealthChoice — Blue Access Large Group: $1,547.85 BCBS_Empire HealthChoice — Blue Access Small Group: $1,699.60 BCBS_Empire HealthChoice — Commercial All Products: $1,821 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,904.08 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,904.08 BCBS_Empire HealthChoice — Managed Medicaid: $1,029.23 BCBS_Empire HealthChoice — Medicare Advantage: $881.19 Blue Shield — All Products: $1,837.05

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) · Doctor (professional) fee In the file: PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$96	$48	$16 – $95.56
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 94 insurance plan rates Aetna — All Products_FAC: $31.96 Aetna — All Products_NONFAC: $31.96 Aetna — Medicare_FAC: $28.55 Aetna — Medicare_NONFAC: $28.55 Blue Cross — Blue Access_FAC: $19.82 Blue Cross — Blue Access_NONFAC: $19.82 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $23.79 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $23.79 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $27.99 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $27.99
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT THERAPEUTIC EXERCISES	$226	$113	$39.32 – $214.70
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans MagnaCare — All Products: $214.70 Multiplan — PPO: $192.10 United Healthcare — All Products: $203.40
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OT THERAPEUTIC EXERCISES	$226	$113	$39.32 – $214.70
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans MagnaCare — All Products: $214.70 Multiplan — PPO: $192.10 United Healthcare — All Products: $203.40
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$137	$68.50	$23.84 – $130.15
Physical therapy evaluation (low complexity): rates for 3 insurance plans MagnaCare — All Products: $130.15 Multiplan — PPO: $116.45 United Healthcare — All Products: $123.30
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$78.84 – $246.91
Physical therapy evaluation (low complexity): rates for 8 insurance plans Aetna Government Program — Medicare Advantage: $78.84 BCBS_Empire HealthChoice — Medicare Advantage: $132.50 Blue Shield — All Products: $246.91 CDPHP — Medicare Advantage: $126.19 Emblem — Commercial_All Products: $126.19 Emblem — Medicare Advantage: $140.07 Fidelis — Medicaid Managed Care: $126.19 Hamaspik — Medicare Advantage: $171.62
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$137	$68.50	$138 – $256
Physical therapy evaluation (low complexity): 10 of 26 insurance plan rates Aetna — Commercial: $206 Aetna Government Program — Medicare Advantage: $23.84 BCBS_Empire HealthChoice — Blue Access Large Group: $82.20 BCBS_Empire HealthChoice — Blue Access Small Group: $65.76 BCBS_Empire HealthChoice — Commercial All Products: $82.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $298.61 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $298.61 BCBS_Empire HealthChoice — Managed Medicaid: $161.41 Blue Shield — All Products: $256 Blue Shield — Senior Blue PPO: $138
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$226	$113	$39.32 – $214.70
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans MagnaCare — All Products: $214.70 Multiplan — PPO: $192.10 United Healthcare — All Products: $203.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$78.84 – $246.91
Physical therapy evaluation (moderate complexity): rates for 8 insurance plans Aetna Government Program — Medicare Advantage: $78.84 BCBS_Empire HealthChoice — Medicare Advantage: $132.50 Blue Shield — All Products: $246.91 CDPHP — Medicare Advantage: $126.19 Emblem — Commercial_All Products: $126.19 Emblem — Medicare Advantage: $140.07 Fidelis — Medicaid Managed Care: $126.19 Hamaspik — Medicare Advantage: $171.62
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$226	$113	$138 – $256
Physical therapy evaluation (moderate complexity): 10 of 26 insurance plan rates Aetna — Commercial: $206 Aetna Government Program — Medicare Advantage: $39.32 BCBS_Empire HealthChoice — Blue Access Large Group: $135.60 BCBS_Empire HealthChoice — Blue Access Small Group: $108.48 BCBS_Empire HealthChoice — Commercial All Products: $135.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $298.61 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $298.61 BCBS_Empire HealthChoice — Managed Medicaid: $161.41 Blue Shield — All Products: $256 Blue Shield — Senior Blue PPO: $138
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$226	$113	$39.32 – $214.70
Physical therapy evaluation (high complexity): rates for 3 insurance plans MagnaCare — All Products: $214.70 Multiplan — PPO: $192.10 United Healthcare — All Products: $203.40
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$78.84 – $246.91
Physical therapy evaluation (high complexity): rates for 8 insurance plans Aetna Government Program — Medicare Advantage: $78.84 BCBS_Empire HealthChoice — Medicare Advantage: $132.50 Blue Shield — All Products: $246.91 CDPHP — Medicare Advantage: $126.19 Emblem — Commercial_All Products: $126.19 Emblem — Medicare Advantage: $140.07 Fidelis — Medicaid Managed Care: $126.19 Hamaspik — Medicare Advantage: $171.62
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$226	$113	$138 – $256
Physical therapy evaluation (high complexity): 10 of 26 insurance plan rates Aetna — Commercial: $206 Aetna Government Program — Medicare Advantage: $39.32 BCBS_Empire HealthChoice — Blue Access Large Group: $135.60 BCBS_Empire HealthChoice — Blue Access Small Group: $108.48 BCBS_Empire HealthChoice — Commercial All Products: $135.60 BCBS_Empire HealthChoice — Essential Plans Aliessa: $298.61 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $298.61 BCBS_Empire HealthChoice — Managed Medicaid: $161.41 Blue Shield — All Products: $256 Blue Shield — Senior Blue PPO: $138
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$204	$102	$21.43 – $126.46
Psychotherapy, 30 minutes: 10 of 144 insurance plan rates Aetna — All Products_FAC: $72.28 Aetna — All Products_NONFAC: $81.86 Aetna — Medicare_FAC: $69.53 Aetna — Medicare_NONFAC: $79.24 Blue Cross — Blue Access_FAC: $54.66 Blue Cross — Blue Access_NONFAC: $62.83 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $57.94 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $66.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_FAC: $51.13 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_NONFAC: $58.27
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES	$494	$247	$62.53 – $226.46
Psychotherapy, 30 minutes: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $62.53 BCBS_Empire HealthChoice — Blue Access Large Group: $184 BCBS_Empire HealthChoice — Blue Access Small Group: $173 BCBS_Empire HealthChoice — Commercial All Products: $216 BCBS_Empire HealthChoice — Essential Plans Aliessa: $273.67 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $273.67 BCBS_Empire HealthChoice — Managed Medicaid: $147.93 BCBS_Empire HealthChoice — Medicare Advantage: $104.01 Blue Shield — All Products: $226.46 Blue Shield — Senior Blue PPO: $105.39
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB PSYCHOTHERAPY W/PATIENT 30 MINUTES	$26	$13	$26 – $105.39
Psychotherapy, 30 minutes: 10 of 28 insurance plan rates Aetna Government Program — Medicare Advantage: $62.53 BCBS_Empire HealthChoice — Essential Plans Aliessa: $273.67 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $273.67 BCBS_Empire HealthChoice — Managed Medicaid: $147.93 BCBS_Empire HealthChoice — Medicare Advantage: $104.01 Blue Shield — All Products: $26 Blue Shield — Senior Blue PPO: $105.39 CDPHP — Essential Plans 1_2_3_4: $332.84 CDPHP — Managed Medicaid: $147.93 CDPHP — Medicare Advantage: $190.13
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$270	$135	$32.13 – $166.91
Psychotherapy, 45 minutes: 10 of 144 insurance plan rates Aetna — All Products_FAC: $95.80 Aetna — All Products_NONFAC: $108.23 Aetna — Medicare_FAC: $91.75 Aetna — Medicare_NONFAC: $104.58 Blue Cross — Blue Access_FAC: $78.58 Blue Cross — Blue Access_NONFAC: $90.32 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $76.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $87.15 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_FAC: $67.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_NONFAC: $76.90
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$730	$365	$83.35 – $301.04
Psychotherapy, 45 minutes: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $83.35 BCBS_Empire HealthChoice — Blue Access Large Group: $184 BCBS_Empire HealthChoice — Blue Access Small Group: $173 BCBS_Empire HealthChoice — Commercial All Products: $216 BCBS_Empire HealthChoice — Essential Plans Aliessa: $356.79 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $356.79 BCBS_Empire HealthChoice — Managed Medicaid: $192.86 BCBS_Empire HealthChoice — Medicare Advantage: $137.20 Blue Shield — All Products: $301.04 Blue Shield — Senior Blue PPO: $189.02
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB PSYCHOTHERAPY W/PATIENT 45 MINUTES	$35	$17.50	$35 – $189.02
Psychotherapy, 45 minutes: 10 of 28 insurance plan rates Aetna Government Program — Medicare Advantage: $83.35 BCBS_Empire HealthChoice — Essential Plans Aliessa: $356.79 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $356.79 BCBS_Empire HealthChoice — Managed Medicaid: $192.86 BCBS_Empire HealthChoice — Medicare Advantage: $137.20 Blue Shield — All Products: $35 Blue Shield — Senior Blue PPO: $189.02 CDPHP — Essential Plans 1_2_3_4: $433.94 CDPHP — Managed Medicaid: $192.86 CDPHP — Medicare Advantage: $190.13
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$399	$199.50	$48.50 – $247.19
Psychotherapy, 60 minutes: 10 of 144 insurance plan rates Aetna — All Products_FAC: $140.86 Aetna — All Products_NONFAC: $159.31 Aetna — Medicare_FAC: $135.79 Aetna — Medicare_NONFAC: $154.89 Blue Cross — Blue Access_FAC: $79.27 Blue Cross — Blue Access_NONFAC: $91.11 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $113.16 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $129.07 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_FAC: $99.85 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_NONFAC: $113.89
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES	$1,065	$532.50	$125.31 – $452.61
Psychotherapy, 60 minutes: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $125.31 BCBS_Empire HealthChoice — Blue Access Large Group: $184 BCBS_Empire HealthChoice — Blue Access Small Group: $173 BCBS_Empire HealthChoice — Commercial All Products: $216 BCBS_Empire HealthChoice — Essential Plans Aliessa: $356.79 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $356.79 BCBS_Empire HealthChoice — Managed Medicaid: $192.86 BCBS_Empire HealthChoice — Medicare Advantage: $203.06 Blue Shield — All Products: $452.61 Blue Shield — Senior Blue PPO: $189.02
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB PSYCHOTHERAPY W/PATIENT 60 MINUTES	$51	$25.50	$51 – $189.02
Psychotherapy, 60 minutes: 10 of 28 insurance plan rates Aetna Government Program — Medicare Advantage: $125.31 BCBS_Empire HealthChoice — Essential Plans Aliessa: $356.79 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $356.79 BCBS_Empire HealthChoice — Managed Medicaid: $192.86 BCBS_Empire HealthChoice — Medicare Advantage: $203.06 Blue Shield — All Products: $51 Blue Shield — Senior Blue PPO: $189.02 CDPHP — Essential Plans 1_2_3_4: $433.94 CDPHP — Managed Medicaid: $192.86 CDPHP — Medicare Advantage: $190.13
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$293	$146.50	$36.84 – $173.16
Family psychotherapy, without the patient: 10 of 146 insurance plan rates Aetna — All Products_FAC: $103.47 Aetna — All Products_NONFAC: $103.82 Aetna — Medicare_FAC: $99.18 Aetna — Medicare_NONFAC: $99.49 Blue Cross — Blue Access_FAC: $90.48 Blue Cross — Blue Access_NONFAC: $94.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $82.65 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $82.91 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_FAC: $72.93 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_NONFAC: $73.16
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY,NO PT	$438	$219	$100.91 – $309.51
Family psychotherapy, without the patient: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $100.91 BCBS_Empire HealthChoice — Blue Access Large Group: $170 BCBS_Empire HealthChoice — Blue Access Small Group: $160 BCBS_Empire HealthChoice — Commercial All Products: $200 BCBS_Empire HealthChoice — Essential Plans Aliessa: $273.67 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $273.67 BCBS_Empire HealthChoice — Managed Medicaid: $147.93 BCBS_Empire HealthChoice — Medicare Advantage: $148.04 Blue Shield — All Products: $309.51 Blue Shield — Senior Blue PPO: $189.02
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY,NO PT	$438	$219	$306.60 – $416.10
Family psychotherapy, without the patient: rates for 3 insurance plans MagnaCare — All Products: $416.10 Multiplan — PPO: $372.30 United Healthcare — All Products: $394.20
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$317	$158.50	$52.03 – $179.30
Family psychotherapy, with the patient: 10 of 145 insurance plan rates Aetna — All Products_FAC: $107.90 Aetna — All Products_NONFAC: $108.25 Aetna — Medicare_FAC: $103.44 Aetna — Medicare_NONFAC: $103.74 Blue Cross — Blue Access_FAC: $90.48 Blue Cross — Blue Access_NONFAC: $94.25 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $86.20 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $86.45 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_FAC: $76.06 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_NONFAC: $76.28
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W PHYS	$438	$219	$104.84 – $320.55
Family psychotherapy, with the patient: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $104.84 BCBS_Empire HealthChoice — Blue Access Large Group: $170 BCBS_Empire HealthChoice — Blue Access Small Group: $160 BCBS_Empire HealthChoice — Commercial All Products: $200 BCBS_Empire HealthChoice — Essential Plans Aliessa: $273.67 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $273.67 BCBS_Empire HealthChoice — Managed Medicaid: $147.93 BCBS_Empire HealthChoice — Medicare Advantage: $154.38 Blue Shield — All Products: $320.55 Blue Shield — Senior Blue PPO: $189.02
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC FAMILY PSYCHOTHERAPY W PHYS	$438	$219	$306.60 – $416.10
Family psychotherapy, with the patient: rates for 3 insurance plans MagnaCare — All Products: $416.10 Multiplan — PPO: $372.30 United Healthcare — All Products: $394.20
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR GROUP PSYCHOTHERAPY	$82	$41	$12.48 – $59.22
Group psychotherapy: 10 of 146 insurance plan rates Aetna — All Products_FAC: $25.39 Aetna — All Products_NONFAC: $28.93 Aetna — Medicare_FAC: $24.43 Aetna — Medicare_NONFAC: $28.19 Blue Cross — Blue Access_FAC: $40.52 Blue Cross — Blue Access_NONFAC: $47.12 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $20.36 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $23.49 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_FAC: $17.96 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_CSW_NONFAC: $20.73
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC GROUP PSYCHOTHERAPY	$278	$139	$25.06 – $124
Group psychotherapy: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $25.06 BCBS_Empire HealthChoice — Blue Access Large Group: $105 BCBS_Empire HealthChoice — Blue Access Small Group: $99 BCBS_Empire HealthChoice — Commercial All Products: $124 BCBS_Empire HealthChoice — Essential Plans Aliessa: $153.16 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $153.16 BCBS_Empire HealthChoice — Managed Medicaid: $82.79 BCBS_Empire HealthChoice — Medicare Advantage: $36.46 Blue Shield — All Products: $85.85 Blue Shield — Senior Blue PPO: $105.39
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB GROUP PSYCHOTHERAPY	$11	$5.50	$11 – $105.39
Group psychotherapy: 10 of 28 insurance plan rates Aetna Government Program — Medicare Advantage: $25.06 BCBS_Empire HealthChoice — Essential Plans Aliessa: $153.16 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $153.16 BCBS_Empire HealthChoice — Managed Medicaid: $82.79 BCBS_Empire HealthChoice — Medicare Advantage: $36.46 Blue Shield — All Products: $11 Blue Shield — Senior Blue PPO: $105.39 CDPHP — Essential Plans 1_2_3_4: $186.28 CDPHP — Managed Medicaid: $82.79 CDPHP — Medicare Advantage: $109.46

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,431	$715.50	$183.82 – $841.72
Removal of breast growth (open surgery): 10 of 94 insurance plan rates Aetna — All Products_FAC: $444.32 Aetna — All Products_NONFAC: $553.27 Aetna — Medicare_FAC: $399.03 Aetna — Medicare_NONFAC: $493.59 Blue Cross — Blue Access_FAC: $301.79 Blue Cross — Blue Access_NONFAC: $372.58 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $332.53 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $411.32 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $391.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $483.91
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EXCISE BREAST CYST	$11,896	$5,948	$401.77 – $6,343.99
Removal of breast growth (open surgery): 10 of 34 insurance plan rates Aetna Government Program — Medicare Advantage: $401.77 BCBS_Empire HealthChoice — Blue Access Large Group: $2,240 BCBS_Empire HealthChoice — Blue Access Small Group: $2,108 BCBS_Empire HealthChoice — Commercial All Products: $2,635 BCBS_Empire HealthChoice — Essential Plans Aliessa: $3,468.14 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $3,468.14 BCBS_Empire HealthChoice — Managed Medicaid: $1,874.67 BCBS_Empire HealthChoice — Medicare Advantage: $528.48 Blue Shield — All Products: $1,558.44 Blue Shield — Senior Blue PPO: $3,749.22
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EXCISE BREAST CYST	$11,896	$5,948	$8,327.20 – $11,301.20
Removal of breast growth (open surgery): rates for 3 insurance plans MagnaCare — All Products: $11,301.20 Multiplan — PPO: $10,111.60 United Healthcare — All Products: $10,706.40
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$4,025	$2,012.50	$697.27 – $2,280.82
Total hip replacement: 10 of 94 insurance plan rates Aetna — All Products_FAC: $1,366.56 Aetna — All Products_NONFAC: $1,366.56 Aetna — Medicare_FAC: $1,223.34 Aetna — Medicare_NONFAC: $1,223.34 Blue Cross — Blue Access_FAC: $1,160.46 Blue Cross — Blue Access_NONFAC: $1,160.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $1,019.45 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $1,019.45 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $1,199.35 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $1,199.35
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$4,153.31 – $23,193
Total hip replacement: 10 of 12 insurance plan rates Aetna — Commercial: $6,845 Aetna Government Program — Medicare Advantage: $1,330.24 BCBS_Empire HealthChoice — Blue Access Large Group: $10,617 BCBS_Empire HealthChoice — Commercial All Products: $12,490 BCBS_Empire HealthChoice — Medicare Advantage: $15,987.38 CDPHP — All Products-High Deductible Plan: $23,193 CDPHP — Medicare Advantage: $15,226.08 Emblem — Commercial_All Products: $15,226.08 Empire Plan NYSHIP — All Products: $12,490 Fidelis — Medicaid Managed Care: $15,226.08
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$4,153.31 – $23,193
Total hip replacement: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $7,683.62 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $7,683.62 BCBS_Empire HealthChoice — Managed Medicaid: $4,153.31 CDPHP — Essential Plans 1_2_3_4: $9,344.95 CDPHP — Managed Medicaid: $4,153.31 Fidelis — Essential Plan_QHP: $9,344.95 Hamaspik — Medicaid Managed Care: $9,760.28 MVP Essential Plan — Plans 1_2: $8,306.62 MVP Essential Plan — Plans 3_4: $4,153.31 MVP Govt Programs — Managed Medicaid_Child Health Plus: $4,153.31
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$4,021	$2,010.50	$749.09 – $2,278.24
Total knee replacement: 10 of 94 insurance plan rates Aetna — All Products_FAC: $1,365.22 Aetna — All Products_NONFAC: $1,365.22 Aetna — Medicare_FAC: $1,221.85 Aetna — Medicare_NONFAC: $1,221.85 Blue Cross — Blue Access_FAC: $1,153.46 Blue Cross — Blue Access_NONFAC: $1,153.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $1,018.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $1,018.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $1,197.89 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $1,197.89
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$1,329.65 – $9,718.38
Total knee replacement: 10 of 12 insurance plan rates Aetna Government Program — Medicare Advantage: $1,329.65 BCBS_Empire HealthChoice — Blue Access Large Group: $11,259 BCBS_Empire HealthChoice — Blue Access Small Group: $10,597 BCBS_Empire HealthChoice — Commercial All Products: $13,246 BCBS_Empire HealthChoice — Medicare Advantage: $15,987.38 CDPHP — All Products-High Deductible Plan: $23,193 CDPHP — Medicare Advantage: $15,226.08 Emblem — Commercial_All Products: $15,226.08 Empire Plan NYSHIP — All Products: $13,246 Fidelis — Medicaid Managed Care: $15,226.08
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$4,153.31 – $23,193
Total knee replacement: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $7,683.62 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $7,683.62 BCBS_Empire HealthChoice — Managed Medicaid: $4,153.31 CDPHP — Essential Plans 1_2_3_4: $9,344.95 CDPHP — Managed Medicaid: $4,153.31 Fidelis — Essential Plan_QHP: $9,344.95 Hamaspik — Medicaid Managed Care: $9,760.28 MVP Essential Plan — Plans 1_2: $8,306.62 MVP Essential Plan — Plans 3_4: $4,153.31 MVP Govt Programs — Managed Medicaid_Child Health Plus: $4,153.31
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$6,882	$3,441	$211.41 – $6,598
Shoulder arthroscopy: shaving of shoulder bone: 10 of 32 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $173.40 BCBS_Empire HealthChoice — Blue Access Large Group: $5,609 BCBS_Empire HealthChoice — Blue Access Small Group: $5,279 BCBS_Empire HealthChoice — Commercial All Products: $6,598 BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,022.05 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,022.05 BCBS_Empire HealthChoice — Managed Medicaid: $2,174.08 BCBS_Empire HealthChoice — Medicare Advantage: $221.98 Blue Shield — All Products: $6,221
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$6,882	$3,441	$4,817.40 – $6,537.90
Shoulder arthroscopy: shaving of shoulder bone: rates for 3 insurance plans MagnaCare — All Products: $6,537.90 Multiplan — PPO: $5,849.70 United Healthcare — All Products: $6,193.80
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$3,281	$1,640.50	$308.07 – $908.58
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 94 insurance plan rates Aetna — All Products_FAC: $581.43 Aetna — All Products_NONFAC: $581.43 Aetna — Medicare_FAC: $522.89 Aetna — Medicare_NONFAC: $522.89 Blue Cross — Blue Access_FAC: $460.28 Blue Cross — Blue Access_NONFAC: $460.28 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $435.74 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $435.74 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $512.64 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $512.64
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$2,174.08 – $6,598
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,022.05 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,022.05 BCBS_Empire HealthChoice — Managed Medicaid: $2,174.08 CDPHP — Essential Plans 1_2_3_4: $4,891.68 CDPHP — Managed Medicaid: $2,174.08 Fidelis — Essential Plan_QHP: $4,891.68 Hamaspik — Medicaid Managed Care: $5,109.09 MVP Essential Plan — Plans 1_2: $4,348.16 MVP Essential Plan — Plans 3_4: $2,174.08 MVP Govt Programs — Managed Medicaid_Child Health Plus: $2,174.08
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$529.23 – $1,658.12
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 8 insurance plans Aetna Government Program — Medicare Advantage: $529.23 BCBS_Empire HealthChoice — Medicare Advantage: $4,031.52 CDPHP — Medicare Advantage: $3,839.54 Emblem — Commercial_All Products: $3,839.54 Empire Plan NYSHIP — All Products: $6,598 Fidelis — Medicaid Managed Care: $3,839.54 Fidelis — Medicare Advantage: $1,658.12 Hamaspik — Medicare Advantage: $5,221.78
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$856	$428	$141.04 – $485.11
Removal of tonsils and adenoids (under age 12): 10 of 94 insurance plan rates Aetna — All Products_FAC: $313.80 Aetna — All Products_NONFAC: $313.80 Aetna — Medicare_FAC: $281.08 Aetna — Medicare_NONFAC: $281.08 Blue Cross — Blue Access_FAC: $226.97 Blue Cross — Blue Access_NONFAC: $226.97 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $234.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $234.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $275.57 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $275.57
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$1,722.53 – $9,520.48
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates Aetna — Commercial: $5,044 Aetna Government Program — Medicare Advantage: $285.13 BCBS_Empire HealthChoice — Blue Access Large Group: $6,572 BCBS_Empire HealthChoice — Commercial All Products: $7,731 BCBS_Empire HealthChoice — Medicare Advantage: $7,350.37 CDPHP — All Products-High Deductible Plan: $4,934 CDPHP — Medicare Advantage: $7,000.36 Emblem — Commercial_All Products: $7,000.36 Empire Plan NYSHIP — All Products: $7,731 Fidelis — Medicaid Managed Care: $7,000.36
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$1,722.53 – $9,520.48
Removal of tonsils and adenoids (under age 12): 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $3,186.68 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $3,186.68 BCBS_Empire HealthChoice — Managed Medicaid: $1,722.53 CDPHP — Essential Plans 1_2_3_4: $3,875.69 CDPHP — Managed Medicaid: $1,722.53 Fidelis — Essential Plan_QHP: $3,875.69 Hamaspik — Medicaid Managed Care: $4,047.95 MVP Essential Plan — Plans 1_2: $3,445.06 MVP Essential Plan — Plans 3_4: $1,722.53 MVP Govt Programs — Managed Medicaid_Child Health Plus: $1,722.53
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$747	$373.50	$77.25 – $467.79
Upper GI endoscopy (diagnostic): 10 of 94 insurance plan rates Aetna — All Products_FAC: $129.46 Aetna — All Products_NONFAC: $309.02 Aetna — Medicare_FAC: $115.87 Aetna — Medicare_NONFAC: $268.97 Blue Cross — Blue Access_FAC: $91.51 Blue Cross — Blue Access_NONFAC: $223.20 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $96.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $224.15 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $113.60 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $263.70
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$661	$330.50	$151.68 – $4,445
Upper GI endoscopy (diagnostic): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $123.91 BCBS_Empire HealthChoice — Blue Access Large Group: $396.60 BCBS_Empire HealthChoice — Blue Access Small Group: $370.16 BCBS_Empire HealthChoice — Commercial All Products: $462.70 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,790.23 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,790.23 BCBS_Empire HealthChoice — Managed Medicaid: $967.69 BCBS_Empire HealthChoice — Medicare Advantage: $159.26 Blue Shield — All Products: $3,262
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC - EGD	$2,977	$1,488.50	$151.68 – $4,445
Upper GI endoscopy (diagnostic): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $123.91 BCBS_Empire HealthChoice — Blue Access Large Group: $1,786.20 BCBS_Empire HealthChoice — Blue Access Small Group: $1,667.12 BCBS_Empire HealthChoice — Commercial All Products: $2,083.90 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,790.23 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,790.23 BCBS_Empire HealthChoice — Managed Medicaid: $967.69 BCBS_Empire HealthChoice — Medicare Advantage: $159.26 Blue Shield — All Products: $3,262
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$998	$499	$86.88 – $623.12
Upper GI endoscopy with biopsy: 10 of 94 insurance plan rates Aetna — All Products_FAC: $146.08 Aetna — All Products_NONFAC: $404.43 Aetna — Medicare_FAC: $130.32 Aetna — Medicare_NONFAC: $347.62 Blue Cross — Blue Access_FAC: $102.64 Blue Cross — Blue Access_NONFAC: $285.11 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $108.60 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $289.68 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $127.76 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $340.80
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD	$892	$446	$171.17 – $4,445
Upper GI endoscopy with biopsy: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $140.17 BCBS_Empire HealthChoice — Blue Access Large Group: $535.20 BCBS_Empire HealthChoice — Blue Access Small Group: $499.52 BCBS_Empire HealthChoice — Commercial All Products: $624.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,790.23 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,790.23 BCBS_Empire HealthChoice — Managed Medicaid: $967.69 BCBS_Empire HealthChoice — Medicare Advantage: $179.73 Blue Shield — All Products: $4,443
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$2,586	$1,293	$171.17 – $4,445
Upper GI endoscopy with biopsy: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $140.17 BCBS_Empire HealthChoice — Blue Access Large Group: $1,551.60 BCBS_Empire HealthChoice — Blue Access Small Group: $1,448.16 BCBS_Empire HealthChoice — Commercial All Products: $1,810.20 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,790.23 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,790.23 BCBS_Empire HealthChoice — Managed Medicaid: $967.69 BCBS_Empire HealthChoice — Medicare Advantage: $179.73 Blue Shield — All Products: $4,443
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$923	$461.50	$103.24 – $552.77
Colonoscopy (diagnostic): 10 of 94 insurance plan rates Aetna — All Products_FAC: $194.89 Aetna — All Products_NONFAC: $364.16 Aetna — Medicare_FAC: $173.99 Aetna — Medicare_NONFAC: $319.59 Blue Cross — Blue Access_FAC: $144.98 Blue Cross — Blue Access_NONFAC: $273.54 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $144.99 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $266.32 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $170.58 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $313.32
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$2,603	$1,301.50	$229 – $4,445
Colonoscopy (diagnostic): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $186.61 BCBS_Empire HealthChoice — Blue Access Large Group: $2,931 BCBS_Empire HealthChoice — Blue Access Small Group: $2,759 BCBS_Empire HealthChoice — Commercial All Products: $3,449 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $240.45 Blue Shield — All Products: $4,443
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY	$2,603	$1,301.50	$229 – $4,445
Colonoscopy (diagnostic): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $186.61 BCBS_Empire HealthChoice — Blue Access Large Group: $1,561.80 BCBS_Empire HealthChoice — Blue Access Small Group: $1,457.68 BCBS_Empire HealthChoice — Commercial All Products: $1,822.10 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $240.45 Blue Shield — All Products: $4,443
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$1,180	$590	$126.16 – $711.94
Colonoscopy with biopsy: 10 of 94 insurance plan rates Aetna — All Products_FAC: $211.94 Aetna — All Products_NONFAC: $465.67 Aetna — Medicare_FAC: $189.24 Aetna — Medicare_NONFAC: $404.03 Blue Cross — Blue Access_FAC: $158.22 Blue Cross — Blue Access_NONFAC: $351.61 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $157.70 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $336.69 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $185.53 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $396.11
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY	$3,392	$1,696	$249.22 – $4,445
Colonoscopy with biopsy: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $202.73 BCBS_Empire HealthChoice — Blue Access Large Group: $2,035.20 BCBS_Empire HealthChoice — Blue Access Small Group: $1,899.52 BCBS_Empire HealthChoice — Commercial All Products: $2,374.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $261.68 Blue Shield — All Products: $4,443
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$3,392	$1,696	$249.22 – $4,445
Colonoscopy with biopsy: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $202.73 BCBS_Empire HealthChoice — Blue Access Large Group: $2,035.20 BCBS_Empire HealthChoice — Blue Access Small Group: $1,899.52 BCBS_Empire HealthChoice — Commercial All Products: $2,374.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $261.68 Blue Shield — All Products: $4,443
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,657	$828.50	$146.87 – $744.58
Colonoscopy with removal of polyps (snare): 10 of 94 insurance plan rates Aetna — All Products_FAC: $268.25 Aetna — All Products_NONFAC: $486.85 Aetna — Medicare_FAC: $238.82 Aetna — Medicare_NONFAC: $425.13 Blue Cross — Blue Access_FAC: $197.61 Blue Cross — Blue Access_NONFAC: $365.94 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $199.02 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $354.27 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $234.14 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $416.79
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY	$3,392	$1,696	$315.68 – $4,445
Colonoscopy with removal of polyps (snare): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $257.11 BCBS_Empire HealthChoice — Blue Access Large Group: $2,035.20 BCBS_Empire HealthChoice — Blue Access Small Group: $1,899.52 BCBS_Empire HealthChoice — Commercial All Products: $2,374.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $331.46 Blue Shield — All Products: $4,443
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$3,392	$1,696	$315.68 – $4,445
Colonoscopy with removal of polyps (snare): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $257.11 BCBS_Empire HealthChoice — Blue Access Large Group: $2,035.20 BCBS_Empire HealthChoice — Blue Access Small Group: $1,899.52 BCBS_Empire HealthChoice — Commercial All Products: $2,374.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $331.46 Blue Shield — All Products: $4,443
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX - ENDO US (L	$2,244	$1,122	$320.44 – $4,445
Ultrasound of the lower bowel by endoscope: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $260.83 BCBS_Empire HealthChoice — Blue Access Large Group: $1,346.40 BCBS_Empire HealthChoice — Blue Access Small Group: $1,256.64 BCBS_Empire HealthChoice — Commercial All Products: $1,570.80 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $336.46 Blue Shield — All Products: $4,443
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$3,392	$1,696	$320.44 – $4,445
Ultrasound of the lower bowel by endoscope: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $260.83 BCBS_Empire HealthChoice — Blue Access Large Group: $2,035.20 BCBS_Empire HealthChoice — Blue Access Small Group: $1,899.52 BCBS_Empire HealthChoice — Commercial All Products: $2,374.40 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $336.46 Blue Shield — All Products: $4,443
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX - ENDO US (L	$2,244	$1,122	$1,256.64 – $2,131.80
Ultrasound of the lower bowel by endoscope: rates for 3 insurance plans MagnaCare — All Products: $2,131.80 Multiplan — PPO: $1,907.40 United Healthcare — All Products: $2,019.60
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLON CA SCRN NOT HI RSK IND	$2,439	$1,219.50	$229.19 – $4,443
Screening colonoscopy (not high risk): 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $186.61 BCBS_Empire HealthChoice — Blue Access Large Group: $1,463.40 BCBS_Empire HealthChoice — Blue Access Small Group: $1,365.84 BCBS_Empire HealthChoice — Commercial All Products: $1,707.30 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,720.69 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,720.69 BCBS_Empire HealthChoice — Managed Medicaid: $930.10 BCBS_Empire HealthChoice — Medicare Advantage: $240.65 Blue Shield — All Products: $4,443
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLON CA SCRN NOT HI RSK IND	$2,439	$1,219.50	$1,365.84 – $2,317.05
Screening colonoscopy (not high risk): rates for 3 insurance plans MagnaCare — All Products: $2,317.05 Multiplan — PPO: $2,073.15 United Healthcare — All Products: $2,195.10
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$93.69
Screening colonoscopy (not high risk): rates for 1 insurance plan Aetna Government Program — Medicare Advantage: $93.69
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAPAROSCOPY SURG CHOLECYSTECTOMY	$3,156	$1,578	$333.58 – $1,108.88
Gallbladder removal by laparoscope: 10 of 94 insurance plan rates Aetna — All Products_FAC: $699.91 Aetna — All Products_NONFAC: $699.91 Aetna — Medicare_FAC: $626.95 Aetna — Medicare_NONFAC: $626.95 Blue Cross — Blue Access_FAC: $485.82 Blue Cross — Blue Access_NONFAC: $485.82 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $522.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $522.46 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $614.66 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $614.66
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LAPAROSCOPY SURG CHOLECYSTECTOMY	$18,123	$9,061.50	$801.89 – $11,336
Gallbladder removal by laparoscope: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $643.15 BCBS_Empire HealthChoice — Blue Access Large Group: $10,873.80 BCBS_Empire HealthChoice — Blue Access Small Group: $7,341 BCBS_Empire HealthChoice — Commercial All Products: $9,176 BCBS_Empire HealthChoice — Essential Plans Aliessa: $5,934.06 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $5,934.06 BCBS_Empire HealthChoice — Managed Medicaid: $3,207.60 BCBS_Empire HealthChoice — Medicare Advantage: $841.98 Blue Shield — All Products: $7,824
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LAPAROSCOPY SURG CHOLECYSTECTOMY	$18,123	$9,061.50	$10,873.80 – $17,216.85
Gallbladder removal by laparoscope: rates for 3 insurance plans MagnaCare — All Products: $17,216.85 Multiplan — PPO: $15,404.55 United Healthcare — All Products: $16,310.70
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,575	$787.50	$233.75 – $877.13
Groin (inguinal) hernia repair, age 5 or older: 10 of 94 insurance plan rates Aetna — All Products_FAC: $556.31 Aetna — All Products_NONFAC: $556.31 Aetna — Medicare_FAC: $498.24 Aetna — Medicare_NONFAC: $498.24 Blue Cross — Blue Access_FAC: $441.70 Blue Cross — Blue Access_NONFAC: $441.70 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $415.20 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $415.20 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $488.47 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $488.47
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$2,482.39 – $6,598
Groin (inguinal) hernia repair, age 5 or older: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,592.42 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,592.42 BCBS_Empire HealthChoice — Managed Medicaid: $2,482.39 CDPHP — Essential Plans 1_2_3_4: $5,585.38 CDPHP — Managed Medicaid: $2,482.39 Fidelis — Essential Plan_QHP: $5,585.38 Hamaspik — Medicaid Managed Care: $5,833.62 MVP Essential Plan — Plans 1_2: $4,964.78 MVP Essential Plan — Plans 3_4: $2,482.39 MVP Govt Programs — Managed Medicaid_Child Health Plus: $2,482.39
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$508.43 – $1,769.43
Groin (inguinal) hernia repair, age 5 or older: rates for 8 insurance plans Aetna Government Program — Medicare Advantage: $508.43 BCBS_Empire HealthChoice — Commercial All Products: $6,598 BCBS_Empire HealthChoice — Medicare Advantage: $4,384.96 CDPHP — Medicare Advantage: $4,176.15 Emblem — Commercial_All Products: $4,176.15 Fidelis — Medicaid Managed Care: $4,176.15 Fidelis — Medicare Advantage: $1,769.43 Hamaspik — Medicare Advantage: $5,679.56
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR PROSTATE NEEDLE BIOPSY ANY APPROACH	$386	$193	$66.66 – $416.67
Prostate biopsy: 10 of 94 insurance plan rates Aetna — All Products_FAC: $137.32 Aetna — All Products_NONFAC: $257.98 Aetna — Medicare_FAC: $122.99 Aetna — Medicare_NONFAC: $227.88 Blue Cross — Blue Access_FAC: $112.24 Blue Cross — Blue Access_NONFAC: $211.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $102.49 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $189.90 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $120.58 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $223.41
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BIOPSY OF PROSTATE,NEEDLE/PUNCH	$3,977	$1,988.50	$164.27 – $5,576.41
Prostate biopsy: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $130.90 BCBS_Empire HealthChoice — Blue Access Large Group: $4,644 BCBS_Empire HealthChoice — Blue Access Small Group: $4,371 BCBS_Empire HealthChoice — Commercial All Products: $5,463 BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,389.94 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,389.94 BCBS_Empire HealthChoice — Managed Medicaid: $2,372.94 BCBS_Empire HealthChoice — Medicare Advantage: $172.48 Blue Shield — All Products: $4,443
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB BIOPSY OF PROSTATE,NEEDLE/PUNCH	$2,195	$1,097.50	$130.90 – $3,393.77
Prostate biopsy: 10 of 34 insurance plan rates Aetna Government Program — Medicare Advantage: $130.90 BCBS_Empire HealthChoice — Blue Access Large Group: $1,317 BCBS_Empire HealthChoice — Blue Access Small Group: $1,229.20 BCBS_Empire HealthChoice — Commercial All Products: $1,536.50 BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,389.94 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,389.94 BCBS_Empire HealthChoice — Managed Medicaid: $2,372.94 BCBS_Empire HealthChoice — Medicare Advantage: $172.48 Blue Shield — All Products: $790.58 Blue Shield — Senior Blue PPO: $2,466.99
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$4,325	$2,162.50	$758.60 – $2,461.04
Prostate removal by laparoscope (radical prostatectomy): 10 of 94 insurance plan rates Aetna — All Products_FAC: $1,267.63 Aetna — All Products_NONFAC: $1,267.63 Aetna — Medicare_FAC: $1,137.85 Aetna — Medicare_NONFAC: $1,137.85 Blue Cross — Blue Access_FAC: $1,151.91 Blue Cross — Blue Access_NONFAC: $1,151.91 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $948.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $948.21 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $1,115.54 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $1,115.54
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad	Not listed in the file	Not listed in the file	$3,205.21 – $16,755.50
Prostate removal by laparoscope (radical prostatectomy): 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $5,929.64 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $5,929.64 BCBS_Empire HealthChoice — Managed Medicaid: $3,205.21 CDPHP — Essential Plans 1_2_3_4: $7,211.72 CDPHP — Managed Medicaid: $3,205.21 Fidelis — Essential Plan_QHP: $7,211.72 Hamaspik — Medicaid Managed Care: $7,532.24 MVP Essential Plan — Plans 1_2: $6,410.42 MVP Essential Plan — Plans 3_4: $3,205.21 MVP Govt Programs — Managed Medicaid_Child Health Plus: $3,205.21
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$3,205.21 – $16,755.50
Prostate removal by laparoscope (radical prostatectomy): rates for 10 insurance plans Aetna — Commercial: $6,069 Aetna Government Program — Medicare Advantage: $1,441.53 BCBS_Empire HealthChoice — Commercial All Products: $13,246 BCBS_Empire HealthChoice — Medicare Advantage: $12,936.23 CDPHP — All Products-High Deductible Plan: $5,581 CDPHP — Medicare Advantage: $12,320.22 Emblem — Commercial_All Products: $12,320.22 Empire Plan NYSHIP — All Products: $13,246 Fidelis — Medicaid Managed Care: $12,320.22 Hamaspik — Medicare Advantage: $16,755.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$1,390	$695	$131.67 – $2,314.84
Hysteroscopy with biopsy of the uterus lining: 10 of 94 insurance plan rates Aetna — All Products_FAC: $246.57 Aetna — All Products_NONFAC: $1,439.27 Aetna — Medicare_FAC: $219.23 Aetna — Medicare_NONFAC: $1,170.45 Blue Cross — Blue Access_FAC: $161.22 Blue Cross — Blue Access_NONFAC: $948.37 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $182.69 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $975.38 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $214.93 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $1,147.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB HYSTEROSCOPY,W/ENDO BX	$2,901	$1,450.50	$287.95 – $6,221
Hysteroscopy with biopsy of the uterus lining: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $231.37 BCBS_Empire HealthChoice — Blue Access Large Group: $4,644 BCBS_Empire HealthChoice — Blue Access Small Group: $4,371 BCBS_Empire HealthChoice — Commercial All Products: $5,463 BCBS_Empire HealthChoice — Essential Plans Aliessa: $3,086.28 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $3,086.28 BCBS_Empire HealthChoice — Managed Medicaid: $1,668.26 BCBS_Empire HealthChoice — Medicare Advantage: $302.35 Blue Shield — All Products: $6,221
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PBB HYSTEROSCOPY,W/ENDO BX	$2,901	$1,450.50	$2,030.70 – $2,755.95
Hysteroscopy with biopsy of the uterus lining: rates for 3 insurance plans MagnaCare — All Products: $2,755.95 Multiplan — PPO: $2,465.85 United Healthcare — All Products: $2,610.90
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$300	$150	$55.41 – $428.01
Spinal injection, lower back (epidural), with imaging guidance: 10 of 94 insurance plan rates Aetna — All Products_FAC: $105.44 Aetna — All Products_NONFAC: $276.47 Aetna — Medicare_FAC: $94.81 Aetna — Medicare_NONFAC: $240.71 Blue Cross — Blue Access_FAC: $75.34 Blue Cross — Blue Access_NONFAC: $203.61 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $79.01 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $200.59 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $92.95 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $235.99
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$1,900	$950	$125.56 – $3,449
Spinal injection, lower back (epidural), with imaging guidance: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $99.75 BCBS_Empire HealthChoice — Blue Access Large Group: $2,931 BCBS_Empire HealthChoice — Blue Access Small Group: $2,759 BCBS_Empire HealthChoice — Commercial All Products: $3,449 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,239.33 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,239.33 BCBS_Empire HealthChoice — Managed Medicaid: $669.91 BCBS_Empire HealthChoice — Medicare Advantage: $131.84 Blue Shield — All Products: $3,262
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$1,900	$950	$1,330 – $1,805
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans MagnaCare — All Products: $1,805 Multiplan — PPO: $1,615 United Healthcare — All Products: $1,710
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$972	$486	$51.02 – $395.59
Nerve root injection, lower back, with imaging guidance: 10 of 94 insurance plan rates Aetna — All Products_FAC: $118.03 Aetna — All Products_NONFAC: $263.18 Aetna — Medicare_FAC: $106.31 Aetna — Medicare_NONFAC: $230.62 Blue Cross — Blue Access_FAC: $68.48 Blue Cross — Blue Access_NONFAC: $155.64 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $88.60 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $192.19 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $104.23 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $226.10
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVE	$4,884	$2,442	$139.66 – $3,449
Nerve root injection, lower back, with imaging guidance: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $111.30 BCBS_Empire HealthChoice — Blue Access Large Group: $2,931 BCBS_Empire HealthChoice — Blue Access Small Group: $2,759 BCBS_Empire HealthChoice — Commercial All Products: $3,449 BCBS_Empire HealthChoice — Essential Plans Aliessa: $1,239.33 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $1,239.33 BCBS_Empire HealthChoice — Managed Medicaid: $669.91 BCBS_Empire HealthChoice — Medicare Advantage: $146.64 Blue Shield — All Products: $3,262
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVE	$4,884	$2,442	$3,418.80 – $4,639.80
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans MagnaCare — All Products: $4,639.80 Multiplan — PPO: $4,151.40 United Healthcare — All Products: $4,395.60
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$2,179	$1,089.50	$200.67 – $730.63
Carpal tunnel release: 10 of 94 insurance plan rates Aetna — All Products_FAC: $469.72 Aetna — All Products_NONFAC: $478.24 Aetna — Medicare_FAC: $423.66 Aetna — Medicare_NONFAC: $430.86 Blue Cross — Blue Access_FAC: $304.73 Blue Cross — Blue Access_NONFAC: $310.95 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $353.05 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $359.05 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $415.35 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $422.41
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$1,585.75 – $3,726.51
Carpal tunnel release: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $2,933.64 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $2,933.64 BCBS_Empire HealthChoice — Managed Medicaid: $1,585.75 CDPHP — Essential Plans 1_2_3_4: $3,567.94 CDPHP — Managed Medicaid: $1,585.75 Fidelis — Essential Plan_QHP: $3,567.94 Hamaspik — Medicaid Managed Care: $3,726.51 MVP Essential Plan — Plans 1_2: $3,171.50 MVP Essential Plan — Plans 3_4: $1,585.75 MVP Govt Programs — Managed Medicaid_Child Health Plus: $1,585.75
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$415.68 – $971.18
Carpal tunnel release: rates for 7 insurance plans Aetna Government Program — Medicare Advantage: $415.68 BCBS_Empire HealthChoice — Medicare Advantage: $2,426.37 CDPHP — Medicare Advantage: $2,310.83 Emblem — Commercial_All Products: $2,310.83 Fidelis — Medicaid Managed Care: $2,310.83 Fidelis — Medicare Advantage: $971.18 Hamaspik — Medicare Advantage: $3,142.73
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR POST-CATARACT LASER SURGERY	$1,876	$938	$131.95 – $554.66
Laser treatment of clouding after cataract surgery: 10 of 94 insurance plan rates Aetna — All Products_FAC: $330.29 Aetna — All Products_NONFAC: $355.12 Aetna — Medicare_FAC: $293.28 Aetna — Medicare_NONFAC: $313.63 Blue Cross — Blue Access_FAC: $247.13 Blue Cross — Blue Access_NONFAC: $265.73 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $244.40 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $261.36 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $287.53 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $307.48
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DISCISSION,2ND CATARACT,LASER	$1,705	$852.50	$384.76 – $4,517.12
Laser treatment of clouding after cataract surgery: 10 of 35 insurance plan rates Aetna — Commercial: $3,020 Aetna Government Program — Medicare Advantage: $303.70 BCBS_Empire HealthChoice — Blue Access Large Group: $2,931 BCBS_Empire HealthChoice — Blue Access Small Group: $2,759 BCBS_Empire HealthChoice — Commercial All Products: $3,449 BCBS_Empire HealthChoice — Essential Plans Aliessa: $3,556.03 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $3,556.03 BCBS_Empire HealthChoice — Managed Medicaid: $1,922.18 BCBS_Empire HealthChoice — Medicare Advantage: $404 Blue Shield — All Products: $4,443
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PBB DISCISSION,2ND CATARACT,LASER	$627	$313.50	$303.70 – $908.87
Laser treatment of clouding after cataract surgery: 10 of 31 insurance plan rates Aetna Government Program — Medicare Advantage: $303.70 BCBS_Empire HealthChoice — Essential Plans Aliessa: $3,556.03 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $3,556.03 BCBS_Empire HealthChoice — Managed Medicaid: $1,922.18 BCBS_Empire HealthChoice — Medicare Advantage: $404 Blue Shield — All Products: $627 Blue Shield — Senior Blue PPO: $704.81 CDPHP — All Products-High Deductible Plan: $4,172 CDPHP — All Products-Labcorp: $4,172 CDPHP — Essential Plans 1_2_3_4: $4,324.91
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$3,150	$1,575	$342.33 – $914.97
Cataract removal with lens implant: 10 of 94 insurance plan rates Aetna — All Products_FAC: $576.28 Aetna — All Products_NONFAC: $576.28 Aetna — Medicare_FAC: $513.47 Aetna — Medicare_NONFAC: $513.47 Blue Cross — Blue Access_FAC: $500.73 Blue Cross — Blue Access_NONFAC: $500.73 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $427.89 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $427.89 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $503.40 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $503.40
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$627.16 – $1,275.03
Cataract removal with lens implant: 10 of 11 insurance plan rates Aetna Government Program — Medicare Advantage: $627.16 BCBS_Empire HealthChoice — Blue Access Large Group: $4,644 BCBS_Empire HealthChoice — Blue Access Small Group: $4,371 BCBS_Empire HealthChoice — Commercial All Products: $5,463 BCBS_Empire HealthChoice — Medicare Advantage: $2,833.87 CDPHP — Medicare Advantage: $2,698.92 Emblem — Commercial_All Products: $2,698.92 Empire Plan NYSHIP — All Products: $5,463 Fidelis — Medicaid Managed Care: $2,698.92 Fidelis — Medicare Advantage: $1,275.03
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$2,428.33 – $5,706.58
Cataract removal with lens implant: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,492.41 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,492.41 BCBS_Empire HealthChoice — Managed Medicaid: $2,428.33 CDPHP — Essential Plans 1_2_3_4: $5,463.74 CDPHP — Managed Medicaid: $2,428.33 Fidelis — Essential Plan_QHP: $5,463.74 Hamaspik — Medicaid Managed Care: $5,706.58 MVP Essential Plan — Plans 1_2: $4,856.66 MVP Essential Plan — Plans 3_4: $2,428.33 MVP Govt Programs — Managed Medicaid_Child Health Plus: $2,428.33

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$6,999	$3,499.50	$1,669.33 – $3,811.57
Vaginal delivery, with care before and after: 10 of 95 insurance plan rates Aetna — All Products_FAC: $2,539.36 Aetna — All Products_NONFAC: $2,539.36 Aetna — Medicare_FAC: $2,270.29 Aetna — Medicare_NONFAC: $2,270.29 Blue Cross — Blue Access_FAC: $3,033.04 Blue Cross — Blue Access_NONFAC: $3,033.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $1,891.90 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $1,891.90 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2,225.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2,225.77
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ROUTINE OBSTETRIC CARE	$6,999	$3,499.50	$1,669.33 – $3,811.57
Vaginal delivery, with care before and after: 10 of 95 insurance plan rates Aetna — All Products_FAC: $2,539.36 Aetna — All Products_NONFAC: $2,539.36 Aetna — Medicare_FAC: $2,270.29 Aetna — Medicare_NONFAC: $2,270.29 Blue Cross — Blue Access_FAC: $3,033.04 Blue Cross — Blue Access_NONFAC: $3,033.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $1,891.90 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $1,891.90 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2,225.77 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2,225.77
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$2,382.17 – $5,598.10
Vaginal delivery, with care before and after: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,407.01 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,407.01 BCBS_Empire HealthChoice — Managed Medicaid: $2,382.17 CDPHP — Essential Plans 1_2_3_4: $5,359.88 CDPHP — Managed Medicaid: $2,382.17 Fidelis — Essential Plan_QHP: $5,359.88 Hamaspik — Medicaid Managed Care: $5,598.10 MVP Essential Plan — Plans 1_2: $4,764.34 MVP Essential Plan — Plans 3_4: $2,382.17 MVP Govt Programs — Managed Medicaid_Child Health Plus: $2,382.17
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$7,712	$3,856	$1,848.34 – $4,011.73
Cesarean delivery (C-section), with care before and after: 10 of 95 insurance plan rates Aetna — All Products_FAC: $2,800.82 Aetna — All Products_NONFAC: $2,800.82 Aetna — Medicare_FAC: $2,513.74 Aetna — Medicare_NONFAC: $2,513.74 Blue Cross — Blue Access_FAC: $3,033.04 Blue Cross — Blue Access_NONFAC: $3,033.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $2,094.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $2,094.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2,464.45 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2,464.45
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CESAREAN DELIVERY ROUTINE	$7,394	$3,697	$1,848.34 – $4,011.73
Cesarean delivery (C-section), with care before and after: 10 of 95 insurance plan rates Aetna — All Products_FAC: $2,800.82 Aetna — All Products_NONFAC: $2,800.82 Aetna — Medicare_FAC: $2,513.74 Aetna — Medicare_NONFAC: $2,513.74 Blue Cross — Blue Access_FAC: $3,033.04 Blue Cross — Blue Access_NONFAC: $3,033.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $2,094.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $2,094.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2,464.45 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2,464.45
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$7,711.53	$3,855.77	$1,848.34 – $4,011.73
Cesarean delivery (C-section), with care before and after: 10 of 95 insurance plan rates Aetna — All Products_FAC: $2,800.82 Aetna — All Products_NONFAC: $2,800.82 Aetna — Medicare_FAC: $2,513.74 Aetna — Medicare_NONFAC: $2,513.74 Blue Cross — Blue Access_FAC: $3,033.04 Blue Cross — Blue Access_NONFAC: $3,033.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $2,094.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $2,094.78 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2,464.45 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2,464.45
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$7,298	$3,649	$1,742.26 – $3,811.57
Vaginal delivery after a previous C-section, with care before and after: 10 of 95 insurance plan rates Aetna — All Products_FAC: $2,650.91 Aetna — All Products_NONFAC: $2,650.91 Aetna — Medicare_FAC: $2,369.47 Aetna — Medicare_NONFAC: $2,369.47 Blue Cross — Blue Access_FAC: $3,033.04 Blue Cross — Blue Access_NONFAC: $3,033.04 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FAC: $1,974.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NONFA: $1,974.56 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_FAC: $2,323.01 Blue Cross — EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC: $2,323.01
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$2,382.17 – $5,598.10
Vaginal delivery after a previous C-section, with care before and after: 10 of 11 insurance plan rates BCBS_Empire HealthChoice — Essential Plans Aliessa: $4,407.01 BCBS_Empire HealthChoice — Essential Plans Non Aliessa: $4,407.01 BCBS_Empire HealthChoice — Managed Medicaid: $2,382.17 CDPHP — Essential Plans 1_2_3_4: $5,359.88 CDPHP — Managed Medicaid: $2,382.17 Fidelis — Essential Plan_QHP: $5,359.88 Hamaspik — Medicaid Managed Care: $5,598.10 MVP Essential Plan — Plans 1_2: $4,764.34 MVP Essential Plan — Plans 3_4: $2,382.17 MVP Govt Programs — Managed Medicaid_Child Health Plus: $2,382.17
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$2,137.73 – $6,315.82
Vaginal delivery after a previous C-section, with care before and after: rates for 2 insurance plans Aetna Government Program — Medicare Advantage: $2,137.73 Blue Shield — All Products: $6,315.82

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	$86,268.70 – $156,038.98
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 13 insurance plan rates Aetna — Commercial: $156,038.98 Aetna Government Program — Medicare Advantage: $87,994.07 BCBS_Empire HealthChoice — Medicare Advantage: $90,582.14 Blue Shield — Senior Blue PPO: $86,268.70 CDPHP — Medicare Advantage: $88,856.76 Emblem — Medicare Advantage: $96,615 Fidelis — Medicare Advantage: $91,392.57 Hamaspik — Medicare Advantage: $117,325.43 Nascentia Health Options — Medicare Advantage: $93,170.20 United Healthcare — Medicare Advantage: $87,040.54
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	$17,216.24 – $30,484.76
Hip or knee replacement (major joint of the leg), without major complications: rates for 9 insurance plans Aetna Government Program — Medicare Advantage: $17,560.56 BCBS_Empire HealthChoice — Medicare Advantage: $18,077.05 Blue Shield — Senior Blue PPO: $17,216.24 CDPHP — Medicare Advantage: $17,732.73 Emblem — Medicare Advantage: $19,277.40 Fidelis — Medicare Advantage: $18,235.39 Hamaspik — Medicare Advantage: $23,414.09 Nascentia Health Options — Medicare Advantage: $18,593.54 United Healthcare — Medicare Advantage: $17,367.03
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	$17,216.24 – $30,484.76
Hip or knee replacement (major joint of the leg), without major complications: rates for 4 insurance plans Aetna — Commercial: $30,484.76 MagnaCare — All Products: 95% (a percentage in the contract, not a dollar amount) Multiplan — PPO: 85% (a percentage in the contract, not a dollar amount) United Healthcare — All Products: 90% (a percentage in the contract, not a dollar amount)
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	$21,501.34 – $38,276.12
Neck (cervical) spinal fusion, without complications: 10 of 13 insurance plan rates Aetna — Commercial: $38,276.12 Aetna Government Program — Medicare Advantage: $21,931.37 BCBS_Empire HealthChoice — Medicare Advantage: $22,576.41 Blue Shield — Senior Blue PPO: $21,501.34 CDPHP — Medicare Advantage: $22,146.38 Emblem — Medicare Advantage: $24,076.64 Fidelis — Medicare Advantage: $22,775.21 Hamaspik — Medicare Advantage: $29,241.82 Nascentia Health Options — Medicare Advantage: $23,221.45 United Healthcare — Medicare Advantage: $21,690.67
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	$11,109.15 – $19,380.58
Uterus and ovary surgery (not for cancer), without complications: 10 of 13 insurance plan rates Aetna — Commercial: $19,380.58 Aetna Government Program — Medicare Advantage: $11,331.33 BCBS_Empire HealthChoice — Medicare Advantage: $11,664.61 Blue Shield — Senior Blue PPO: $11,109.15 CDPHP — Medicare Advantage: $11,442.42 Emblem — Medicare Advantage: $12,437.56 Fidelis — Medicare Advantage: $11,765.27 Hamaspik — Medicare Advantage: $15,108.44 Nascentia Health Options — Medicare Advantage: $11,997.88 United Healthcare — Medicare Advantage: $11,205.01

Source: Saratoga Hospital’s standard charges file (albany.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on December 31, 2025; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	211 Church Street, Saratoga Springs, NY 12866
County	Saratoga County
State	New York
Phone	(518) 587‑3222
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	330222
Name in Medicare records	SARATOGA HOSPITAL
Profile level	Medicare data + hospital website
Official website	albanymed.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.

About Saratoga Hospital - Albany Med — albanymed.org
Surgical Services Saratoga Hospital - Albany Med — albanymed.org
Alfred Z. Solomon Emergency Center - Albany Med Health System — albanymed.org
Parking - Albany Med Health System — albanymed.org
Primary Stroke Centers - Albany Med Health System — albanymed.org

Saratoga Hospital

Summary

Profile from official sources

At a glance