Does Schuyler Hospital have an emergency room?

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

Where is Schuyler Hospital?

220 Steuben Street, Montour Falls, NY 14865, in Schuyler County, New York.

What is the phone number of Schuyler Hospital?

(607) 530-7121, as listed by Medicare (CMS).

What is the Medicare star rating of Schuyler Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Schuyler Hospital — Montour Falls, NY

Quick answers

Does Schuyler Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Schuyler Hospital. In a medical emergency, call 911.
Where is Schuyler Hospital?: 220 Steuben Street, Montour Falls, NY 14865, in Schuyler County, New York.
What is the phone number of Schuyler Hospital?: (607) 530-7121, as listed by Medicare (CMS).
What is the Medicare star rating of Schuyler Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[4][5][6][8][9]}

Emergency care
Inpatient medical-surgical care
Primary care / walk-in clinic
Diagnostic services
Short-stay surgery
Respiratory care

Treatments^[4]

Observation care

Procedures^[8][9]

Electrocardiography (EKG)
Echocardiography
Cardiac stress testing
Holter monitoring
Sleep lab
Pulmonary function testing
Arterial blood gas (ABG) testing

Programs and centers^[4]

Critical Access Hospital

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

Emergency room	Yes

Visiting and practical information

Visiting	Patient-directed visitation on the inpatient unit; between 5:30 p.m. and 8:30 a.m. visitors enter through the ED and get a badge^[6]
Patient portal	MyChart

Recognition^[4][8]

Critical Access Hospital (since 2005)
Accredited for adult transthoracic echocardiography by the Intersocietal Accreditation Commission (IAC)

Doctors and clinicians (152)

152 doctors and other clinicians list Schuyler 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 128 more: the button below opens the full list.

Other emergency rooms nearby

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

Arnot Ogden Medical Center18 mi · Elmira, NY · Acute Care Hospital
Corning Hospital18 mi · Corning, NY · Acute Care Hospital
Cayuga Medical Center at Ithaca18 mi · Ithaca, NY · Acute Care Hospital
Ira Davenport Memorial Hospital21 mi · Bath, NY · Rural Emergency Hospital
Soldiers and Sailors Memorial Hospital of Yates24 mi · Penn Yan, NY · Critical Access Hospital

Other hospitals nearby

Elmira Psych Center20 mi · Elmira, NY · Psychiatric 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

Schuyler Hospital Inc and Long Term Care Unit0.3 mi · Montour Falls, NY · 3 of 5 stars
Bethany Nursing Home & Health Related Facility Inc11 mi · Horseheads, NY · 4 of 5 stars
Elcor Nursing and Rehabilitation Center13 mi · Horseheads, NY · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Carefirst / Southern Tier Hospice and Palliative19 mi · Painted Post, NY · 4 of 5 stars
Hospicare & Palliative Care Services19 mi · Ithaca, NY · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Centerwell Home Health18 mi · Corning, NY
VNS Ithaca Tompkins Co Chha19 mi · Ithaca, NY · 4 of 5 stars
Chemung Co Dept Health Chha20 mi · Elmira, NY · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Corning Dialysis18 mi · Corning, NY · 4 of 5 stars
DaVita Ivy Dialysis18 mi · Elmira, NY · 3 of 5 stars
DaVita Ithaca Dialysis Center19 mi · Ithaca, NY · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Elmira Asc, LLC20 mi · Elmira, 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

Dundee Dental Center13 mi · Dundee, NY · Community health center
The Chautauqua Center - Elmira17 mi · Elmira, NY · Community health center
TCC - Elmira Able220 mi · Elmira, NY · Community health center

Clinics and urgent care

Schuyler Hospital Inc2.2 mi · Montour Falls, NY · Rural health clinic
Soldiers & Sailors Memorial Hospital13 mi · Dundee, NY · Rural health clinic
Wellnow Urgent Care, PC16 mi · Elmira, NY · Urgent care center

Pharmacies

Wal-Mart Stores East LP4.7 mi · Watkins Glen, NY · Community/retail pharmacy

Assisted living nearby

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

The New Falls2.2 mi · Montour Falls, NY
Bethany Village10 mi · Horseheads, 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 Schuyler 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)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	55%National average: 72%
Would definitely recommend the hospital	63%National average: 71%
Nurses “always” communicated well	72%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	62%National average: 62%
Were given information about recovery at home	79%National average: 86%
Room and bathroom “always” clean	64%National average: 74%
Area around the room “always” quiet at night	45%National average: 60%
Completed surveys	52Response rate: 24%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

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	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	17%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

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	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	17.4%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	111 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

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 80 common services exactly as Schuyler Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Rhc Est Patient Expanded	$360.15	$198.08	$180.08 – $810.34
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — All Products: $247.42 Excellus — All Products: $223.29 Excellus — Medicare Advantage: $180.08 Fidelis — Managed Medicaid_Aliessa and QHP: $810.34 Fidelis — Medicare Advantage: $180.08 Independent Health — All Products: $345.74 MVP Cigna — Individual (HMO_EPO_PPO): $216.09 MVP Cigna — Medicare Advantage: $180.08 UMR Pomco — All Products: $252.11 Wellcare — Medicare Advantage Today's Options: $180.08
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Rhc Est Patient Detailed	$508.20	$279.51	$254.10 – $1,143.45
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — All Products: $349.13 Excellus — All Products: $315.08 Excellus — Medicare Advantage: $254.10 Fidelis — Managed Medicaid_Aliessa and QHP: $1,143.45 Fidelis — Medicare Advantage: $254.10 Independent Health — All Products: $487.87 MVP Cigna — Individual (HMO_EPO_PPO): $304.92 MVP Cigna — Medicare Advantage: $254.10 UMR Pomco — All Products: $355.74 Wellcare — Medicare Advantage Today's Options: $254.10
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Preventive Visit,New,18-39	$129.15	$71.03	$63.41 – $290.59
Preventive checkup, new patient, age 18–39: 10 of 11 insurance plan rates Aetna — All Products: $66.51 Excellus — All Products: $80.07 Excellus — Medicare Advantage: $64.58 Fidelis — Managed Medicaid_Aliessa and QHP: $290.59 Fidelis — Medicare Advantage: $64.58 Independent Health — All Products: $123.98 MVP Cigna — Individual (HMO_EPO_PPO): $77.49 MVP Cigna — Medicare Advantage: $64.58 UMR Pomco — All Products: $90.41 United Healthcare — All Products: $63.41
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Preventive Visit,New,40-64	$131.25	$72.19	$64.44 – $295.31
Preventive checkup, new patient, age 40–64: 10 of 11 insurance plan rates Aetna — All Products: $67.59 Excellus — All Products: $81.38 Excellus — Medicare Advantage: $65.63 Fidelis — Managed Medicaid_Aliessa and QHP: $295.31 Fidelis — Medicare Advantage: $65.63 Independent Health — All Products: $126 MVP Cigna — Individual (HMO_EPO_PPO): $78.75 MVP Cigna — Medicare Advantage: $65.63 UMR Pomco — All Products: $91.88 United Healthcare — All Products: $64.44
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Emergency Department Level 3 Visit Moderate Severity	$663.60	$364.98	$435 – $803
Emergency room visit (moderate): 10 of 11 insurance plan rates Aetna — All Products: $435 Excellus — All Products: $411.43 Excellus — Medicare Advantage: $331.80 Fidelis — Managed Medicaid_Aliessa and QHP: $1,493.10 Fidelis — Medicare Advantage: $331.80 Independent Health — All Products: $637.06 MVP Cigna — Individual (HMO_EPO_PPO): $398.16 MVP Cigna — Medicare Advantage: $331.80 UMR Pomco — All Products: $464.52 United Healthcare — All Products: $803
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CAH Pro Fee Emergency Department Visit Moderate Severity	$220.50	$121.28	$435
Emergency room visit (moderate): rates for 10 insurance plans Aetna — All Products: $435 Excellus — All Products: $136.71 Excellus — Medicare Advantage: $110.25 Fidelis — Managed Medicaid_Aliessa and QHP: $496.13 Fidelis — Medicare Advantage: $110.25 Independent Health — All Products: $211.68 MVP Cigna — Individual (HMO_EPO_PPO): $132.30 MVP Cigna — Medicare Advantage: $110.25 UMR Pomco — All Products: $154.35 Wellcare — Medicare Advantage Today's Options: $110.25
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	$886.20	$487.41	$625 – $1,201
Emergency room visit (moderately high): 10 of 11 insurance plan rates Aetna — All Products: $625 Excellus — All Products: $549.44 Excellus — Medicare Advantage: $443.10 Fidelis — Managed Medicaid_Aliessa and QHP: $1,993.95 Fidelis — Medicare Advantage: $443.10 Independent Health — All Products: $850.75 MVP Cigna — Individual (HMO_EPO_PPO): $531.72 MVP Cigna — Medicare Advantage: $443.10 UMR Pomco — All Products: $620.34 United Healthcare — All Products: $1,201
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CAH Pro Fee Emergency Department Visit High/Urgent Severity	$474.60	$261.03	$625
Emergency room visit (moderately high): rates for 10 insurance plans Aetna — All Products: $625 Excellus — All Products: $294.25 Excellus — Medicare Advantage: $237.30 Fidelis — Managed Medicaid_Aliessa and QHP: $1,067.85 Fidelis — Medicare Advantage: $237.30 Independent Health — All Products: $455.62 MVP Cigna — Individual (HMO_EPO_PPO): $284.76 MVP Cigna — Medicare Advantage: $237.30 UMR Pomco — All Products: $332.22 Wellcare — Medicare Advantage Today's Options: $237.30
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	$1,303.05	$716.68	$985 – $1,393
Emergency room visit (high): 10 of 11 insurance plan rates Aetna — All Products: $985 Excellus — All Products: $807.89 Excellus — Medicare Advantage: $651.53 Fidelis — Managed Medicaid_Aliessa and QHP: $2,931.86 Fidelis — Medicare Advantage: $651.53 Independent Health — All Products: $1,250.93 MVP Cigna — Individual (HMO_EPO_PPO): $781.83 MVP Cigna — Medicare Advantage: $651.53 UMR Pomco — All Products: $912.14 United Healthcare — All Products: $1,393
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CAH Pro Fee Emergency Dept Visit High Severity&Threat Funcj	$687.75	$378.26	$985
Emergency room visit (high): rates for 10 insurance plans Aetna — All Products: $985 Excellus — All Products: $426.41 Excellus — Medicare Advantage: $343.88 Fidelis — Managed Medicaid_Aliessa and QHP: $1,547.44 Fidelis — Medicare Advantage: $343.88 Independent Health — All Products: $660.24 MVP Cigna — Individual (HMO_EPO_PPO): $412.65 MVP Cigna — Medicare Advantage: $343.88 UMR Pomco — All Products: $481.43 Wellcare — Medicare Advantage Today's Options: $343.88

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Basic Metabolic Panel Calcium Total - Bundled Charge	$172.20	$94.71	$13.85 – $19.86
Basic metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — All Products: $19.86 Excellus — All Products: $106.76 Excellus — Managed Medicaid _CHP_SP: $72.45 Excellus — Medicare Advantage: $86.10 Fidelis — Health Benefit Exchange: $56.35 Fidelis — Managed Medicaid_Aliessa and QHP: $72.45 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $32.20 Fidelis — Medicare Advantage: $86.10 Independent Health — All Products: $165.31 MVP Cigna — Individual (HMO_EPO_PPO): $103.32
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BASIC METABOLIC PNL TOTAL CA	Not listed in the file	Not listed in the file	$19.86
Basic metabolic panel (blood test): rates for 1 insurance plan Aetna — All Products: $19.86
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Metabolic Panel,Comprehensive - Bundled Charge	$234.15	$128.78	$17.29 – $26.15
Comprehensive metabolic panel (blood test): 10 of 14 insurance plan rates Aetna — All Products: $26.15 Excellus — All Products: $145.17 Excellus — Managed Medicaid _CHP_SP: $72.45 Excellus — Medicare Advantage: $117.08 Fidelis — Health Benefit Exchange: $56.35 Fidelis — Managed Medicaid_Aliessa and QHP: $72.45 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $32.20 Fidelis — Medicare Advantage: $117.08 Independent Health — All Products: $224.78 MVP Cigna — Individual (HMO_EPO_PPO): $140.49
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: COMPREHEN METABOLIC PANEL	Not listed in the file	Not listed in the file	$26.15
Comprehensive metabolic panel (blood test): rates for 1 insurance plan Aetna — All Products: $26.15
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$32.20 – $72.45
Obstetric blood test panel: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $72.45 Fidelis — Health Benefit Exchange: $56.35 Fidelis — Managed Medicaid_Aliessa and QHP: $72.45 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $32.20
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$74.80
Obstetric blood test panel: rates for 1 insurance plan United Healthcare — All Products: $74.80
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Lipid Panel - Bundled Charge	$177.45	$97.60	$21.92 – $33.16
Cholesterol panel (lipid panel): 10 of 14 insurance plan rates Aetna — All Products: $33.16 Excellus — All Products: $110.02 Excellus — Managed Medicaid _CHP_SP: $72.45 Excellus — Medicare Advantage: $88.73 Fidelis — Health Benefit Exchange: $56.35 Fidelis — Managed Medicaid_Aliessa and QHP: $72.45 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $32.20 Fidelis — Medicare Advantage: $88.73 Independent Health — All Products: $170.35 MVP Cigna — Individual (HMO_EPO_PPO): $106.47
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: LIPID PANEL	Not listed in the file	Not listed in the file	$33.16
Cholesterol panel (lipid panel): rates for 1 insurance plan Aetna — All Products: $33.16
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Renal Function Panel - Bundled Charge	$203.70	$112.04	$14.22 – $21.51
Kidney function panel: 10 of 14 insurance plan rates Aetna — All Products: $21.51 Excellus — All Products: $126.29 Excellus — Managed Medicaid _CHP_SP: $72.45 Excellus — Medicare Advantage: $101.85 Fidelis — Health Benefit Exchange: $56.35 Fidelis — Managed Medicaid_Aliessa and QHP: $72.45 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $32.20 Fidelis — Medicare Advantage: $101.85 Independent Health — All Products: $195.55 MVP Cigna — Individual (HMO_EPO_PPO): $122.22
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: RENAL FUNCTION PANEL	Not listed in the file	Not listed in the file	$21.51
Kidney function panel: rates for 1 insurance plan Aetna — All Products: $21.51
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hepatic Function Panel - Bundled Charge	$281.40	$154.77	$13.37 – $19.86
Liver function panel: 10 of 14 insurance plan rates Aetna — All Products: $19.86 Excellus — All Products: $174.47 Excellus — Managed Medicaid _CHP_SP: $72.45 Excellus — Medicare Advantage: $140.70 Fidelis — Health Benefit Exchange: $56.35 Fidelis — Managed Medicaid_Aliessa and QHP: $72.45 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $32.20 Fidelis — Medicare Advantage: $140.70 Independent Health — All Products: $270.14 MVP Cigna — Individual (HMO_EPO_PPO): $168.84
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis, Auto, W/Scope - Urinalysis Microscopic	$110.25	$60.64	$5.18 – $7.84
Urine test (automated, with microscope): 10 of 14 insurance plan rates Aetna — All Products: $7.84 Excellus — All Products: $68.36 Excellus — Managed Medicaid _CHP_SP: $29.57 Excellus — Medicare Advantage: $55.13 Fidelis — Health Benefit Exchange: $23 Fidelis — Managed Medicaid_Aliessa and QHP: $29.57 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.14 Fidelis — Medicare Advantage: $55.13 Independent Health — All Products: $105.84 MVP Cigna — Individual (HMO_EPO_PPO): $66.15
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis, Auto, W/Scope - Bundled Charge	$110.25	$60.64	$5.18 – $7.84
Urine test (automated, with microscope): 10 of 14 insurance plan rates Aetna — All Products: $7.84 Excellus — All Products: $68.36 Excellus — Managed Medicaid _CHP_SP: $29.57 Excellus — Medicare Advantage: $55.13 Fidelis — Health Benefit Exchange: $23 Fidelis — Managed Medicaid_Aliessa and QHP: $29.57 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.14 Fidelis — Medicare Advantage: $55.13 Independent Health — All Products: $105.84 MVP Cigna — Individual (HMO_EPO_PPO): $66.15
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Nonauto W/O Scope	$63	$34.65	$4.19 – $6.33
Urine test (manual, without microscope): 10 of 14 insurance plan rates Aetna — All Products: $6.33 Excellus — All Products: $39.06 Excellus — Managed Medicaid _CHP_SP: $29.57 Excellus — Medicare Advantage: $31.50 Fidelis — Health Benefit Exchange: $23 Fidelis — Managed Medicaid_Aliessa and QHP: $29.57 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.14 Fidelis — Medicare Advantage: $31.50 Independent Health — All Products: $60.48 MVP Cigna — Individual (HMO_EPO_PPO): $37.80
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Nonauto W/O Scope - POCT Urinalysis Dipstick	$24.15	$13.28	$4.19 – $6.33
Urine test (manual, without microscope): 10 of 14 insurance plan rates Aetna — All Products: $6.33 Excellus — All Products: $14.97 Excellus — Managed Medicaid _CHP_SP: $29.57 Excellus — Medicare Advantage: $12.08 Fidelis — Health Benefit Exchange: $23 Fidelis — Managed Medicaid_Aliessa and QHP: $29.57 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.14 Fidelis — Medicare Advantage: $12.08 Independent Health — All Products: $23.18 MVP Cigna — Individual (HMO_EPO_PPO): $14.49
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	$63	$34.65	$3.67 – $5.57
Urine test (automated, without microscope): 10 of 14 insurance plan rates Aetna — All Products: $5.57 Excellus — All Products: $39.06 Excellus — Managed Medicaid _CHP_SP: $29.57 Excellus — Medicare Advantage: $31.50 Fidelis — Health Benefit Exchange: $23 Fidelis — Managed Medicaid_Aliessa and QHP: $29.57 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.14 Fidelis — Medicare Advantage: $31.50 Independent Health — All Products: $60.48 MVP Cigna — Individual (HMO_EPO_PPO): $37.80
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: URINALYSIS AUTO W/O SCOPE	Not listed in the file	Not listed in the file	$5.57
Urine test (automated, without microscope): rates for 1 insurance plan Aetna — All Products: $5.57
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prostate Specific Antigen,Total - Psa	$239.40	$131.67	$30.11 – $45.55
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — All Products: $45.55 Excellus — All Products: $148.43 Excellus — Managed Medicaid _CHP_SP: $30.15 Excellus — Medicare Advantage: $119.70 Fidelis — Health Benefit Exchange: $23.45 Fidelis — Managed Medicaid_Aliessa and QHP: $30.15 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.40 Fidelis — Medicare Advantage: $119.70 Independent Health — All Products: $229.82 MVP Cigna — Individual (HMO_EPO_PPO): $143.64
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prostate Specific Antigen,Total - Psa Screening	$239.40	$131.67	$30.11 – $45.55
PSA (prostate specific antigen) blood test: 10 of 14 insurance plan rates Aetna — All Products: $45.55 Excellus — All Products: $148.43 Excellus — Managed Medicaid _CHP_SP: $30.15 Excellus — Medicare Advantage: $119.70 Fidelis — Health Benefit Exchange: $23.45 Fidelis — Managed Medicaid_Aliessa and QHP: $30.15 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.40 Fidelis — Medicare Advantage: $119.70 Independent Health — All Products: $229.82 MVP Cigna — Individual (HMO_EPO_PPO): $143.64
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	$292.95	$161.12	$27.52 – $41.62
Thyroid stimulating hormone (TSH) test: 10 of 14 insurance plan rates Aetna — All Products: $41.62 Excellus — All Products: $181.63 Excellus — Managed Medicaid _CHP_SP: $70.79 Excellus — Medicare Advantage: $146.48 Fidelis — Health Benefit Exchange: $55.06 Fidelis — Managed Medicaid_Aliessa and QHP: $70.79 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $31.46 Fidelis — Medicare Advantage: $146.48 Independent Health — All Products: $281.23 MVP Cigna — Individual (HMO_EPO_PPO): $175.77
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	$292.95	$161.12	$27.52 – $41.62
Thyroid stimulating hormone (TSH) test: 10 of 14 insurance plan rates Aetna — All Products: $41.62 Excellus — All Products: $181.63 Excellus — Managed Medicaid _CHP_SP: $70.79 Excellus — Medicare Advantage: $146.48 Fidelis — Health Benefit Exchange: $55.06 Fidelis — Managed Medicaid_Aliessa and QHP: $70.79 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $31.46 Fidelis — Medicare Advantage: $146.48 Independent Health — All Products: $281.23 MVP Cigna — Individual (HMO_EPO_PPO): $175.77
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: ASSAY THYROID STIM HORMONE	Not listed in the file	Not listed in the file	$41.62
Thyroid stimulating hormone (TSH) test: rates for 1 insurance plan Aetna — All Products: $41.62
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	$156.78	$86.23	$12.73 – $19.15
Complete blood count (CBC) with differential: 10 of 14 insurance plan rates Aetna — All Products: $19.15 Excellus — All Products: $97.20 Excellus — Managed Medicaid _CHP_SP: $31.03 Excellus — Medicare Advantage: $78.39 Fidelis — Health Benefit Exchange: $24.13 Fidelis — Managed Medicaid_Aliessa and QHP: $31.03 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.79 Fidelis — Medicare Advantage: $78.39 Independent Health — All Products: $150.51 MVP Cigna — Individual (HMO_EPO_PPO): $94.07
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Complete Cbc - Cbc	$89.25	$49.09	$10.60 – $16.03
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — All Products: $16.03 Excellus — All Products: $55.34 Excellus — Managed Medicaid _CHP_SP: $31.03 Excellus — Medicare Advantage: $44.63 Fidelis — Health Benefit Exchange: $24.13 Fidelis — Managed Medicaid_Aliessa and QHP: $31.03 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.79 Fidelis — Medicare Advantage: $44.63 Independent Health — All Products: $85.68 MVP Cigna — Individual (HMO_EPO_PPO): $53.55
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Complete Cbc - Additional Charge	$89.25	$49.09	$10.60 – $16.03
Complete blood count (CBC), automated: 10 of 14 insurance plan rates Aetna — All Products: $16.03 Excellus — All Products: $55.34 Excellus — Managed Medicaid _CHP_SP: $31.03 Excellus — Medicare Advantage: $44.63 Fidelis — Health Benefit Exchange: $24.13 Fidelis — Managed Medicaid_Aliessa and QHP: $31.03 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $13.79 Fidelis — Medicare Advantage: $44.63 Independent Health — All Products: $85.68 MVP Cigna — Individual (HMO_EPO_PPO): $53.55
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prothrombin Time - Protime-Inr	$40.95	$22.52	$6.44 – $9.74
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — All Products: $9.74 Excellus — All Products: $25.39 Excellus — Managed Medicaid _CHP_SP: $37.31 Excellus — Medicare Advantage: $20.48 Fidelis — Health Benefit Exchange: $29.02 Fidelis — Managed Medicaid_Aliessa and QHP: $37.31 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $16.58 Fidelis — Medicare Advantage: $20.48 Independent Health — All Products: $39.31 MVP Cigna — Individual (HMO_EPO_PPO): $24.57
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prothrombin Time - Prothrombin Mixing Study	$40.95	$22.52	$6.44 – $9.74
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — All Products: $9.74 Excellus — All Products: $25.39 Excellus — Managed Medicaid _CHP_SP: $37.31 Excellus — Medicare Advantage: $20.48 Fidelis — Health Benefit Exchange: $29.02 Fidelis — Managed Medicaid_Aliessa and QHP: $37.31 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $16.58 Fidelis — Medicare Advantage: $20.48 Independent Health — All Products: $39.31 MVP Cigna — Individual (HMO_EPO_PPO): $24.57
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Prothrombin Time - Protime-Inr, Fingerstick	$40.95	$22.52	$6.44 – $9.74
Blood clotting time test (prothrombin time, PT): 10 of 14 insurance plan rates Aetna — All Products: $9.74 Excellus — All Products: $25.39 Excellus — Managed Medicaid _CHP_SP: $37.31 Excellus — Medicare Advantage: $20.48 Fidelis — Health Benefit Exchange: $29.02 Fidelis — Managed Medicaid_Aliessa and QHP: $37.31 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $16.58 Fidelis — Medicare Advantage: $20.48 Independent Health — All Products: $39.31 MVP Cigna — Individual (HMO_EPO_PPO): $24.57
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Thromboplas Time Partial - Aptt	$84	$46.20	$9.83 – $14.87
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — All Products: $14.87 Excellus — All Products: $52.08 Excellus — Managed Medicaid _CHP_SP: $37.31 Excellus — Medicare Advantage: $42 Fidelis — Health Benefit Exchange: $29.02 Fidelis — Managed Medicaid_Aliessa and QHP: $37.31 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $16.58 Fidelis — Medicare Advantage: $42 Independent Health — All Products: $80.64 MVP Cigna — Individual (HMO_EPO_PPO): $50.40
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	$84	$46.20	$9.83 – $14.87
Blood clotting test (partial thromboplastin time, PTT): 10 of 14 insurance plan rates Aetna — All Products: $14.87 Excellus — All Products: $52.08 Excellus — Managed Medicaid _CHP_SP: $37.31 Excellus — Medicare Advantage: $42 Fidelis — Health Benefit Exchange: $29.02 Fidelis — Managed Medicaid_Aliessa and QHP: $37.31 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $16.58 Fidelis — Medicare Advantage: $42 Independent Health — All Products: $80.64 MVP Cigna — Individual (HMO_EPO_PPO): $50.40

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Scan,Head/Brain,W/O Contrast Matl - CT Head WO Contrast	$1,690.50	$929.78	$121.20 – $550
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates Aetna — All Products: $550 Excellus — All Products: $1,048.11 Excellus — Medicare Advantage: $845.25 Fidelis — Managed Medicaid_Aliessa and QHP: $121.20 Fidelis — Medicare Advantage: $845.25 Independent Health — All Products: $1,622.88 MVP Cigna — Individual (HMO_EPO_PPO): $1,014.30 MVP Cigna — Medicare Advantage: $845.25 UMR Pomco — All Products: $1,183.35 United Healthcare — All Products: $170.73
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI Brain Combo - MR Pituitary W/WO IV Contrast	$4,332.30	$2,382.77	$505 – $728
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates Aetna — All Products: $700 Excellus — All Products: $2,686.03 Excellus — Medicare Advantage: $2,166.15 Fidelis — Managed Medicaid_Aliessa and QHP: $505 Fidelis — Medicare Advantage: $2,166.15 Independent Health — All Products: $4,159.01 MVP Cigna — Individual (HMO_EPO_PPO): $728 MVP Cigna — Medicare Advantage: $2,166.15 UMR Pomco — All Products: $3,032.61 United Healthcare — All Products: $665.44
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	$4,332.30	$2,382.77	$505 – $728
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates Aetna — All Products: $700 Excellus — All Products: $2,686.03 Excellus — Medicare Advantage: $2,166.15 Fidelis — Managed Medicaid_Aliessa and QHP: $505 Fidelis — Medicare Advantage: $2,166.15 Independent Health — All Products: $4,159.01 MVP Cigna — Individual (HMO_EPO_PPO): $728 MVP Cigna — Medicare Advantage: $2,166.15 UMR Pomco — All Products: $3,032.61 United Healthcare — All Products: $665.44
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Radiologic Exam Chest 2 Views - Xr Chest 2 Views	$358.05	$196.93	$179.03 – $343.73
Chest X-ray, 2 views: rates for 10 insurance plans Aetna — All Products: $232.37 Excellus — All Products: $221.99 Excellus — Medicare Advantage: $179.03 Fidelis — Managed Medicaid_Aliessa and QHP: $15.15 Fidelis — Medicare Advantage: $179.03 Independent Health — All Products: $343.73 MVP Cigna — Individual (HMO_EPO_PPO): $214.83 MVP Cigna — Medicare Advantage: $179.03 UMR Pomco — All Products: $250.64 Wellcare — Medicare Advantage Today's Options: $179.03
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	$616.35	$338.99	$308.18 – $591.70
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Aetna — All Products: $400.01 Excellus — All Products: $382.14 Excellus — Medicare Advantage: $308.18 Fidelis — Managed Medicaid_Aliessa and QHP: $30.30 Fidelis — Medicare Advantage: $308.18 Independent Health — All Products: $591.70 MVP Cigna — Individual (HMO_EPO_PPO): $369.81 MVP Cigna — Medicare Advantage: $308.18 UMR Pomco — All Products: $431.45 Wellcare — Medicare Advantage Today's Options: $308.18
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	$3,176.25	$1,746.94	$397.95 – $728
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates Aetna — All Products: $700 Excellus — All Products: $1,969.28 Excellus — Medicare Advantage: $1,588.13 Fidelis — Managed Medicaid_Aliessa and QHP: $505 Fidelis — Medicare Advantage: $1,588.13 Independent Health — All Products: $3,049.20 MVP Cigna — Individual (HMO_EPO_PPO): $728 MVP Cigna — Medicare Advantage: $1,588.13 UMR Pomco — All Products: $2,223.38 United Healthcare — All Products: $397.95
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	$2,094.75	$1,152.11	$171.70 – $550
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates Aetna — All Products: $550 Excellus — All Products: $1,298.75 Excellus — Medicare Advantage: $1,047.38 Fidelis — Managed Medicaid_Aliessa and QHP: $171.70 Fidelis — Medicare Advantage: $1,047.38 Independent Health — All Products: $2,010.96 MVP Cigna — Individual (HMO_EPO_PPO): $1,256.85 MVP Cigna — Medicare Advantage: $1,047.38 UMR Pomco — All Products: $1,466.33 United Healthcare — All Products: $336.15
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Ext Low Jnt W/O Con	$1,295.70	$712.64	$397.95 – $728
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates Aetna — All Products: $700 Excellus — All Products: $803.33 Excellus — Medicare Advantage: $647.85 Fidelis — Managed Medicaid_Aliessa and QHP: $505 Fidelis — Medicare Advantage: $647.85 Independent Health — All Products: $1,243.87 MVP Cigna — Individual (HMO_EPO_PPO): $728 MVP Cigna — Medicare Advantage: $647.85 UMR Pomco — All Products: $906.99 United Healthcare — All Products: $397.95
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	$3,546.90	$1,950.80	$109.01 – $550
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates Aetna — All Products: $550 Excellus — All Products: $2,199.08 Excellus — Medicare Advantage: $1,773.45 Fidelis — Managed Medicaid_Aliessa and QHP: $109.01 Fidelis — Medicare Advantage: $1,773.45 Independent Health — All Products: $3,405.02 MVP Cigna — Individual (HMO_EPO_PPO): $2,128.14 MVP Cigna — Medicare Advantage: $1,773.45 UMR Pomco — All Products: $2,482.83 United Healthcare — All Products: $526.68
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	$1,037.40	$570.57	$518.70 – $995.90
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates Aetna — All Products: $729.29 Excellus — All Products: $643.19 Excellus — Medicare Advantage: $518.70 Fidelis — Managed Medicaid_Aliessa and QHP: $60.60 Fidelis — Medicare Advantage: $518.70 Independent Health — All Products: $995.90 MVP Cigna — Individual (HMO_EPO_PPO): $622.44 MVP Cigna — Medicare Advantage: $518.70 UMR Pomco — All Products: $726.18 United Healthcare — All Products: $181.67
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	$733.95	$403.67	$366.98 – $704.59
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates Aetna — All Products: $515.97 Excellus — All Products: $455.05 Excellus — Medicare Advantage: $366.98 Fidelis — Managed Medicaid_Aliessa and QHP: $55.55 Fidelis — Medicare Advantage: $366.98 Independent Health — All Products: $704.59 MVP Cigna — Individual (HMO_EPO_PPO): $440.37 MVP Cigna — Medicare Advantage: $366.98 UMR Pomco — All Products: $513.77 United Healthcare — All Products: $181.67
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Echography,Transvaginal - US Pelvis Transvaginal	$694.05	$381.73	$347.03 – $666.29
Transvaginal ultrasound: 10 of 11 insurance plan rates Aetna — All Products: $487.92 Excellus — All Products: $430.31 Excellus — Medicare Advantage: $347.03 Fidelis — Managed Medicaid_Aliessa and QHP: $60.60 Fidelis — Medicare Advantage: $347.03 Independent Health — All Products: $666.29 MVP Cigna — Individual (HMO_EPO_PPO): $416.43 MVP Cigna — Medicare Advantage: $347.03 UMR Pomco — All Products: $485.84 United Healthcare — All Products: $181.67
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic	$391.65	$215.41	$195.83 – $375.98
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates Aetna — All Products: $275.33 Excellus — All Products: $242.82 Excellus — Medicare Advantage: $195.83 Fidelis — Managed Medicaid_Aliessa and QHP: $97.97 Fidelis — Medicare Advantage: $195.83 Independent Health — All Products: $375.98 MVP Cigna — Individual (HMO_EPO_PPO): $234.99 MVP Cigna — Medicare Advantage: $195.83 UMR Pomco — All Products: $274.16 United Healthcare — All Products: $127.18
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Dx Mammo Incl Cad Bi - Mammo Breast Diagnostic Bilateral	$553.35	$304.34	$276.68 – $531.22
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates Aetna — All Products: $389.01 Excellus — All Products: $343.08 Excellus — Medicare Advantage: $276.68 Fidelis — Managed Medicaid_Aliessa and QHP: $97.97 Fidelis — Medicare Advantage: $276.68 Independent Health — All Products: $531.22 MVP Cigna — Individual (HMO_EPO_PPO): $332.01 MVP Cigna — Medicare Advantage: $276.68 UMR Pomco — All Products: $387.35 United Healthcare — All Products: $162.49
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Scr Mammo Bi Incl Cad - Mammo Breast Screening	$490.35	$269.69	$245.18 – $470.74
Screening mammogram, both breasts: 10 of 11 insurance plan rates Aetna — All Products: $344.72 Excellus — All Products: $304.02 Excellus — Medicare Advantage: $245.18 Fidelis — Managed Medicaid_Aliessa and QHP: $97.97 Fidelis — Medicare Advantage: $245.18 Independent Health — All Products: $470.74 MVP Cigna — Individual (HMO_EPO_PPO): $294.21 MVP Cigna — Medicare Advantage: $245.18 UMR Pomco — All Products: $343.25 United Healthcare — All Products: $134.45

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$15.15
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan Fidelis — Managed Medicaid_Aliessa and QHP: $15.15
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$1,959.46 – $6,080
Left heart catheterization (diagnostic): rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,408.79 Fidelis — Health Benefit Exchange: $3,429.06 Fidelis — Managed Medicaid_Aliessa and QHP: $4,408.79 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,959.46
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$1,959.46 – $6,080
Left heart catheterization (diagnostic): rates for 1 insurance plan United Healthcare — All Products: $6,080
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	$583.74 – $6,967
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $1,313.42 Fidelis — Health Benefit Exchange: $1,021.55 Fidelis — Managed Medicaid_Aliessa and QHP: $1,313.42 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $583.74
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	$583.74 – $6,967
Heart rhythm study (electrophysiology evaluation): rates for 1 insurance plan United Healthcare — All Products: $6,967
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	$1,003.55 – $6,967
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $2,257.99 Fidelis — Health Benefit Exchange: $1,756.21 Fidelis — Managed Medicaid_Aliessa and QHP: $2,257.99 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,003.55
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	$1,003.55 – $6,967
Heart rhythm study with ablation for atrial fibrillation: rates for 1 insurance plan United Healthcare — All Products: $6,967
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	$3,820.95	$2,101.52	$1,910.48 – $3,668.11
Sleep study (overnight, in a sleep lab): 10 of 14 insurance plan rates Aetna — All Products: $2,686.13 Excellus — All Products: $2,368.99 Excellus — Managed Medicaid _CHP_SP: $2,100.56 Excellus — Medicare Advantage: $1,910.48 Fidelis — Health Benefit Exchange: $1,633.77 Fidelis — Managed Medicaid_Aliessa and QHP: $2,100.56 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $933.58 Fidelis — Medicare Advantage: $1,910.48 Independent Health — All Products: $3,668.11 MVP Cigna — Individual (HMO_EPO_PPO): $2,292.57

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC Pt Therapeutic Exercises	$121.80	$66.99	$60.90 – $116.93
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates Aetna — All Products: $86.97 Excellus — All Products: $75.52 Excellus — Managed Medicaid _CHP_SP: $174.53 Excellus — Medicare Advantage: $60.90 Fidelis — Health Benefit Exchange: $135.75 Fidelis — Managed Medicaid_Aliessa and QHP: $174.53 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $77.57 Fidelis — Medicare Advantage: $60.90 Independent Health — All Products: $116.93 MVP Cigna — Individual (HMO_EPO_PPO): $73.08
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: HC Ot Therapeutic Exercises	$121.80	$66.99	$60.90 – $116.93
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates Aetna — All Products: $86.97 Excellus — All Products: $75.52 Excellus — Managed Medicaid _CHP_SP: $174.53 Excellus — Medicare Advantage: $60.90 Fidelis — Health Benefit Exchange: $135.75 Fidelis — Managed Medicaid_Aliessa and QHP: $174.53 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $77.57 Fidelis — Medicare Advantage: $60.90 Independent Health — All Products: $116.93 MVP Cigna — Individual (HMO_EPO_PPO): $73.08
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	$286.65	$157.66	$143.33 – $275.18
Physical therapy evaluation (low complexity): 10 of 14 insurance plan rates Aetna — All Products: $204.67 Excellus — All Products: $177.72 Excellus — Managed Medicaid _CHP_SP: $306.50 Excellus — Medicare Advantage: $143.33 Fidelis — Health Benefit Exchange: $238.39 Fidelis — Managed Medicaid_Aliessa and QHP: $306.50 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $136.22 Fidelis — Medicare Advantage: $143.33 Independent Health — All Products: $275.18 MVP Cigna — Individual (HMO_EPO_PPO): $171.99
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	$340.20	$187.11	$170.10 – $326.59
Physical therapy evaluation (moderate complexity): 10 of 14 insurance plan rates Aetna — All Products: $242.90 Excellus — All Products: $210.92 Excellus — Managed Medicaid _CHP_SP: $306.50 Excellus — Medicare Advantage: $170.10 Fidelis — Health Benefit Exchange: $238.39 Fidelis — Managed Medicaid_Aliessa and QHP: $306.50 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $136.22 Fidelis — Medicare Advantage: $170.10 Independent Health — All Products: $326.59 MVP Cigna — Individual (HMO_EPO_PPO): $204.12
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	$406.35	$223.49	$203.18 – $390.10
Physical therapy evaluation (high complexity): 10 of 14 insurance plan rates Aetna — All Products: $290.13 Excellus — All Products: $251.94 Excellus — Managed Medicaid _CHP_SP: $306.50 Excellus — Medicare Advantage: $203.18 Fidelis — Health Benefit Exchange: $238.39 Fidelis — Managed Medicaid_Aliessa and QHP: $306.50 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $136.22 Fidelis — Medicare Advantage: $203.18 Independent Health — All Products: $390.10 MVP Cigna — Individual (HMO_EPO_PPO): $243.81
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 30 minutes	Not listed in the file	Not listed in the file	$123.83 – $278.62
Psychotherapy, 30 minutes: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $278.62 Fidelis — Health Benefit Exchange: $216.70 Fidelis — Managed Medicaid_Aliessa and QHP: $278.62 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $123.83
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 45 minutes	Not listed in the file	Not listed in the file	$165.11 – $371.50
Psychotherapy, 45 minutes: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $371.50 Fidelis — Health Benefit Exchange: $288.94 Fidelis — Managed Medicaid_Aliessa and QHP: $371.50 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $165.11
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psytx w pt 60 minutes	Not listed in the file	Not listed in the file	$165.11 – $371.50
Psychotherapy, 60 minutes: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $371.50 Fidelis — Health Benefit Exchange: $288.94 Fidelis — Managed Medicaid_Aliessa and QHP: $371.50 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $165.11
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/o pt 50 min	Not listed in the file	Not listed in the file	$123.83 – $278.62
Family psychotherapy, without the patient: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $278.62 Fidelis — Health Benefit Exchange: $216.70 Fidelis — Managed Medicaid_Aliessa and QHP: $278.62 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $123.83
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family psytx w/pt 50 min	Not listed in the file	Not listed in the file	$123.83 – $278.62
Family psychotherapy, with the patient: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $278.62 Fidelis — Health Benefit Exchange: $216.70 Fidelis — Managed Medicaid_Aliessa and QHP: $278.62 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $123.83
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Group psychotherapy	Not listed in the file	Not listed in the file	$63.98 – $143.96
Group psychotherapy: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $143.96 Fidelis — Health Benefit Exchange: $111.97 Fidelis — Managed Medicaid_Aliessa and QHP: $143.96 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $63.98

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$1,710.39 – $3,848.38
Removal of breast growth (open surgery): rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $3,848.38 Fidelis — Health Benefit Exchange: $2,993.18 Fidelis — Managed Medicaid_Aliessa and QHP: $3,848.38 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,710.39
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$1,710.39 – $3,848.38
Removal of breast growth (open surgery): rates for 1 insurance plan United Healthcare — All Products: $3,167
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	$3,804.04 – $8,559.09
Total hip replacement: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $8,559.09 Fidelis — Health Benefit Exchange: $6,657.07 Fidelis — Managed Medicaid_Aliessa and QHP: $8,559.09 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $3,804.04
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	$3,804.04 – $8,559.09
Total hip replacement: rates for 1 insurance plan United Healthcare — All Products: $6,967
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	$3,804.04 – $8,559.09
Total knee replacement: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $8,559.09 Fidelis — Health Benefit Exchange: $6,657.07 Fidelis — Managed Medicaid_Aliessa and QHP: $8,559.09 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $3,804.04
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	$3,804.04 – $8,559.09
Total knee replacement: rates for 1 insurance plan United Healthcare — All Products: $6,967
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$1,649 – $4,467.35
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,467.35 Fidelis — Health Benefit Exchange: $3,474.61 Fidelis — Managed Medicaid_Aliessa and QHP: $4,467.35 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,985.49
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$1,649 – $4,467.35
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan United Healthcare — All Products: $1,649
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	$1,985.49 – $4,467.35
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,467.35 Fidelis — Health Benefit Exchange: $3,474.61 Fidelis — Managed Medicaid_Aliessa and QHP: $4,467.35 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,985.49
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	$1,985.49 – $4,467.35
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan United Healthcare — All Products: $3,799
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	$1,570.60 – $3,533.85
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $3,533.85 Fidelis — Health Benefit Exchange: $2,748.55 Fidelis — Managed Medicaid_Aliessa and QHP: $3,533.85 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,570.60
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	$1,570.60 – $3,533.85
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan United Healthcare — All Products: $3,167
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Esophagogastroduodenoscopy Transoral Diagnostic	$4,164.30	$2,290.37	$2,082.15 – $3,997.73
Upper GI endoscopy (diagnostic): 10 of 14 insurance plan rates Aetna — All Products: $2,860.87 Excellus — All Products: $2,581.87 Excellus — Managed Medicaid _CHP_SP: $1,973.34 Excellus — Medicare Advantage: $2,082.15 Fidelis — Health Benefit Exchange: $1,534.82 Fidelis — Managed Medicaid_Aliessa and QHP: $1,973.34 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $877.04 Fidelis — Medicare Advantage: $2,082.15 Independent Health — All Products: $3,997.73 MVP Cigna — Individual (HMO_EPO_PPO): $2,498.58
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Transoral Biopsy Single/Multiple - Egd	$4,093.95	$2,251.67	$2,046.98 – $3,930.19
Upper GI endoscopy with biopsy: 10 of 14 insurance plan rates Aetna — All Products: $2,812.54 Excellus — All Products: $2,538.25 Excellus — Managed Medicaid _CHP_SP: $1,973.34 Excellus — Medicare Advantage: $2,046.98 Fidelis — Health Benefit Exchange: $1,534.82 Fidelis — Managed Medicaid_Aliessa and QHP: $1,973.34 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $877.04 Fidelis — Medicare Advantage: $2,046.98 Independent Health — All Products: $3,930.19 MVP Cigna — Individual (HMO_EPO_PPO): $2,456.37
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy	$4,106.55	$2,258.60	$2,053.28 – $3,942.29
Colonoscopy (diagnostic): 10 of 14 insurance plan rates Aetna — All Products: $2,821.20 Excellus — All Products: $2,546.06 Excellus — Managed Medicaid _CHP_SP: $1,895.63 Excellus — Medicare Advantage: $2,053.28 Fidelis — Health Benefit Exchange: $1,474.38 Fidelis — Managed Medicaid_Aliessa and QHP: $1,895.63 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $842.50 Fidelis — Medicare Advantage: $2,053.28 Independent Health — All Products: $3,942.29 MVP Cigna — Individual (HMO_EPO_PPO): $2,463.93
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy W/Biopsy Single/Multiple - Colonoscopy	$4,395.30	$2,417.42	$2,197.65 – $4,219.49
Colonoscopy with biopsy: 10 of 14 insurance plan rates Aetna — All Products: $3,019.57 Excellus — All Products: $2,725.09 Excellus — Managed Medicaid _CHP_SP: $1,895.63 Excellus — Medicare Advantage: $2,197.65 Fidelis — Health Benefit Exchange: $1,474.38 Fidelis — Managed Medicaid_Aliessa and QHP: $1,895.63 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $842.50 Fidelis — Medicare Advantage: $2,197.65 Independent Health — All Products: $4,219.49 MVP Cigna — Individual (HMO_EPO_PPO): $2,637.18
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	$4,379.55	$2,408.75	$2,189.78 – $4,204.37
Colonoscopy with removal of polyps (snare): 10 of 14 insurance plan rates Aetna — All Products: $3,008.75 Excellus — All Products: $2,715.32 Excellus — Managed Medicaid _CHP_SP: $1,895.63 Excellus — Medicare Advantage: $2,189.78 Fidelis — Health Benefit Exchange: $1,474.38 Fidelis — Managed Medicaid_Aliessa and QHP: $1,895.63 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $842.50 Fidelis — Medicare Advantage: $2,189.78 Independent Health — All Products: $4,204.37 MVP Cigna — Individual (HMO_EPO_PPO): $2,627.73
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$842.50 – $2,198
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $1,895.63 Fidelis — Health Benefit Exchange: $1,474.38 Fidelis — Managed Medicaid_Aliessa and QHP: $1,895.63 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $842.50
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$842.50 – $2,198
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan United Healthcare — All Products: $2,198
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	$4,247.25	$2,335.99	$2,123.63 – $4,077.36
Screening colonoscopy (not high risk): 10 of 14 insurance plan rates Aetna — All Products: $2,917.86 Excellus — All Products: $2,633.30 Excellus — Managed Medicaid _CHP_SP: $1,895.63 Excellus — Medicare Advantage: $2,123.63 Fidelis — Health Benefit Exchange: $1,474.38 Fidelis — Managed Medicaid_Aliessa and QHP: $1,895.63 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $842.50 Fidelis — Medicare Advantage: $2,123.63 Independent Health — All Products: $4,077.36 MVP Cigna — Individual (HMO_EPO_PPO): $2,548.35
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$2,935.10 – $6,967
Gallbladder removal by laparoscope: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $6,603.98 Fidelis — Health Benefit Exchange: $5,136.43 Fidelis — Managed Medicaid_Aliessa and QHP: $6,603.98 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,935.10
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$2,935.10 – $6,967
Gallbladder removal by laparoscope: rates for 1 insurance plan United Healthcare — All Products: $6,967
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	$2,268.77 – $5,104.73
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $5,104.73 Fidelis — Health Benefit Exchange: $3,970.35 Fidelis — Managed Medicaid_Aliessa and QHP: $5,104.73 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,268.77
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	$2,268.77 – $5,104.73
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan United Healthcare — All Products: $3,799
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$2,168.21 – $4,878.47
Prostate biopsy: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,878.47 Fidelis — Health Benefit Exchange: $3,794.37 Fidelis — Managed Medicaid_Aliessa and QHP: $4,878.47 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,168.21
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$2,168.21 – $4,878.47
Prostate biopsy: rates for 1 insurance plan United Healthcare — All Products: $2,198
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	$2,932.91 – $6,967
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $6,599.05 Fidelis — Health Benefit Exchange: $5,132.59 Fidelis — Managed Medicaid_Aliessa and QHP: $6,599.05 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,932.91
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	$2,932.91 – $6,967
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan United Healthcare — All Products: $6,967
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$1,520.73 – $3,421.64
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $3,421.64 Fidelis — Health Benefit Exchange: $2,661.28 Fidelis — Managed Medicaid_Aliessa and QHP: $3,421.64 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,520.73
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$1,520.73 – $3,421.64
Hysteroscopy with biopsy of the uterus lining: rates for 1 insurance plan United Healthcare — All Products: $3,167
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	$2,206.05	$1,213.33	$1,103.03 – $2,117.81
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates Aetna — All Products: $1,515.56 Excellus — All Products: $1,367.75 Excellus — Managed Medicaid _CHP_SP: $1,357.72 Excellus — Medicare Advantage: $1,103.03 Fidelis — Health Benefit Exchange: $1,056 Fidelis — Managed Medicaid_Aliessa and QHP: $1,357.72 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $603.43 Fidelis — Medicare Advantage: $1,103.03 Independent Health — All Products: $2,117.81 MVP Cigna — Individual (HMO_EPO_PPO): $1,323.63
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	$2,324.70	$1,278.59	$1,162.35 – $2,231.71
Nerve root injection, lower back, with imaging guidance: 10 of 14 insurance plan rates Aetna — All Products: $1,597.07 Excellus — All Products: $1,441.31 Excellus — Managed Medicaid _CHP_SP: $1,357.72 Excellus — Medicare Advantage: $1,162.35 Fidelis — Health Benefit Exchange: $1,056 Fidelis — Managed Medicaid_Aliessa and QHP: $1,357.72 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $603.43 Fidelis — Medicare Advantage: $1,162.35 Independent Health — All Products: $2,231.71 MVP Cigna — Individual (HMO_EPO_PPO): $1,394.82
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	$1,444.92 – $3,251.07
Carpal tunnel release: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $3,251.07 Fidelis — Health Benefit Exchange: $2,528.61 Fidelis — Managed Medicaid_Aliessa and QHP: $3,251.07 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,444.92
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	$1,444.92 – $3,251.07
Carpal tunnel release: rates for 1 insurance plan United Healthcare — All Products: $3,167
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$1,754.04 – $3,946.59
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $3,946.59 Fidelis — Health Benefit Exchange: $3,069.57 Fidelis — Managed Medicaid_Aliessa and QHP: $3,946.59 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $1,754.04
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$1,754.04 – $3,946.59
Laser treatment of clouding after cataract surgery: rates for 1 insurance plan United Healthcare — All Products: $1,900
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	$2,219.10 – $4,992.98
Cataract removal with lens implant: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,992.98 Fidelis — Health Benefit Exchange: $3,883.43 Fidelis — Managed Medicaid_Aliessa and QHP: $4,992.98 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,219.10
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	$2,219.10 – $4,992.98
Cataract removal with lens implant: rates for 1 insurance plan United Healthcare — All Products: $3,167

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$2,176.69 – $4,897.55
Vaginal delivery, with care before and after: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,897.55 Fidelis — Health Benefit Exchange: $3,809.21 Fidelis — Managed Medicaid_Aliessa and QHP: $4,897.55 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,176.69
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	$2,176.69 – $4,897.55
Vaginal delivery after a previous C-section, with care before and after: rates for 4 insurance plans Excellus — Managed Medicaid _CHP_SP: $4,897.55 Fidelis — Health Benefit Exchange: $3,809.21 Fidelis — Managed Medicaid_Aliessa and QHP: $4,897.55 Fidelis — Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP: $2,176.69

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	$70,064.41 – $117,413.17
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 2 insurance plans Aetna — All Products: $70,064.41 Independent Health — All Products: $117,413.17
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	$13,814.78 – $23,150.66
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans Aetna — All Products: $13,814.78 Independent Health — All Products: $23,150.66
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	$17,484.59 – $29,300.48
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans Aetna — All Products: $17,484.59 Independent Health — All Products: $29,300.48
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	$8,885.89 – $14,890.88
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans Aetna — All Products: $8,885.89 Independent Health — All Products: $14,890.88

Source: Schuyler Hospital’s standard charges file (cayugahealth.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 27, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Critical Access Hospital
Address	220 Steuben Street, Montour Falls, NY 14865
County	Schuyler County
State	New York
Phone	(607) 530‑7121
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	331313
Name in Medicare records	SCHUYLER HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(607) 535‑7121^[4][5]
Official website	cayugahealth.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.

Cayuga Health | Schuyler Hospital — cayugahealth.org
Cayuga Health | Schuyler Hospital — cayugahealth.org
Cayuga Health | Visiting Schuyler Hospital — cayugahealth.org
For 12th Year, Schuyler Hospital Earns Quality Respiratory Care Recognition Award, Plus Accredited for Echocardiograms | — cayugahealth.org
For 13th Year, Schuyler Hospital Earns Quality Respiratory Care Recognition Award, Plus Accredited for Echocardiograms | — cayugahealth.org

Schuyler Hospital

Summary

Profile from official sources

At a glance