Does Southwestern Vermont Medical Center have an emergency room?

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

Where is Southwestern Vermont Medical Center?

100 Hospital Drive, Bennington, VT 05201, in Bennington County, Vermont.

What is the phone number of Southwestern Vermont Medical Center?

(802) 442-6361, as listed by Medicare (CMS).

What is the Medicare star rating of Southwestern Vermont Medical Center?

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

Southwestern Vermont Medical Center

Quick answers

Does Southwestern Vermont Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Southwestern Vermont Medical Center. In a medical emergency, call 911.
Where is Southwestern Vermont Medical Center?: 100 Hospital Drive, Bennington, VT 05201, in Bennington County, Vermont.
What is the phone number of Southwestern Vermont Medical Center?: (802) 442-6361, as listed by Medicare (CMS).
What is the Medicare star rating of Southwestern Vermont Medical Center?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[4][5][7][9][10]}

Emergency Medicine
Imaging
Inpatient Medicine
Laboratory and Pathology
Perioperative Services
Pulmonary Function Laboratory
Renal Dialysis
Sleep Disorder Center
Transitional Care
Women's and Children's Services
Cardiology and vascular surgery
Cancer care (oncology)
Rehabilitation

Conditions treated^[12]

Breast cancer

Treatments^{[4][5][7][9][10][12]}

Renal dialysis
Chemotherapy
Radiation therapy
Clinical trials
Genetic counseling
Cardiac rehabilitation
Pulmonary rehabilitation
Physical therapy
Occupational therapy
Speech therapy
Holter and event monitoring
Stress testing

Procedures^{[9][11][12][15]}

Echocardiogram
Electrocardiogram (EKG)
Cardiac CT
Calcium scoring
Carotid ultrasound
Pacemaker implantation and care
Vascular surgery (vein procedures)
3D mammography
Breast ultrasound
Breast biopsy
CT scans
MRI scans
Nuclear medicine imaging
X-rays

Programs and centers^{[5][7][9][10][12]}

Breast Care Program
Dartmouth Cancer Center Bennington
Palliative care program
Cardiac rehabilitation program
Pulmonary rehabilitation program

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

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Parking	Campus lots P1-P7 by area; see parking map. Access changing for oncology construction from March 18, 2026^[8]

Recognition^{[7][12][13][14]}

Accredited by The Joint Commission
Accredited by the Commission on Cancer (Dartmouth Cancer Center Bennington)
ACR accreditation for breast mammography and ultrasound
Lantern Award (Kendall Emergency Department), 2024-2027
Nationally accredited Nurse Residency Program

Doctors and clinicians (366)

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

Main specialties

And 342 more: the button below opens the full list.

Other emergency rooms nearby

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

North Adams Regional Hospital Corporation13 mi · North Adams, MA · Critical Access Hospital
Samaritan Hospital of Troy, New York25 mi · Troy, NY · Acute Care Hospital
Brattleboro Retreat28 mi · Brattleboro, VT · Psychiatric Hospital
Berkshire Medical Center29 mi · Pittsfield, MA · Acute Care Hospital
Grace Cottage Hospital30 mi · Townshend, VT · Critical Access Hospital

Other hospitals nearby

Four Winds of Saratoga32 mi · Saratoga Springs, 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

Center for Living & Rehabilitation0.0 mi · Bennington, VT · 2 of 5 stars
Bennington Health & Rehab0.3 mi · Bennington, VT · 1 of 5 stars
Crescent Manor Care Ctrs0.8 mi · Bennington, VT · 2 of 5 stars

All nursing homes in the state →

Home health agencies

Eddy Visiting Nurse & Rehab Association22 mi · Troy, NY · 5 of 5 stars

All home health agencies in the state →

Dialysis facilities

Southwestern Vermont Renal Center4.0 mi · Bennington, VT
North Adams Renal Dialysis Suite of BMC14 mi · North Adams, MA · 2 of 5 stars
DCI - Rubin Dialysis Center - Troy22 mi · Troy, NY · 1 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.

Cataract & Laser Center Associates, PC18 mi · Adams, MA

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

Turning Point Recovery Center of Bennington, VT0.8 mi · Bennington, VT · Community health center
Battenkill Valley Health Center Inc.14 mi · Arlington, VT · Community health center
Battenkill Valley Health Center, Inc.14 mi · Arlington, VT · Community health center

Clinics and urgent care

Green Mountain Urgent Care LLC14 mi · North Adams, MA · Urgent care center
Williamstown Medical at North Adams14 mi · North Adams, MA · Rural health clinic
Berkshire Faculty Services Inc14 mi · Williamstown, MA · Urgent care center

Pharmacies

Martins Foods of South Burlington LLC4.0 mi · Bennington, VT · Community/retail pharmacy
Pharmacy Inc4.0 mi · Bennington, VT · Community/retail pharmacy
Price Chopper Operating Co of Vermont Inc4.0 mi · Bennington, VT · Community/retail pharmacy

Assisted living nearby

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

Danforth Adult Care Center7.3 mi · Hoosick Falls, NY
The Cambridge15 mi · Cambridge, NY
The Mansion at South Union15 mi · Cambridge, 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 Southwestern Vermont Medical Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	5 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	70%National average: 72%
Would definitely recommend the hospital	72%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	80%National average: 80%
Staff “always” explained medicines before giving them	64%National average: 62%
Were given information about recovery at home	91%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	47%National average: 60%
Completed surveys	348Response rate: 23%

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	1.091No 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	Too few cases to report
Deaths within 30 days: heart failure patients	9.7%
Deaths within 30 days: pneumonia patients	16.5%
Deaths within 30 days: COPD patients	8.4%
Deaths within 30 days: stroke patients	16.2%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.81No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	21.1%
Readmitted within 30 days: pneumonia	16.9%
Readmitted within 30 days: COPD	20.2%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	202 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	4%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	60%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Vermont

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Southwestern Vermont Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 33 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) · Hospital (facility) fee In the file: NEW PATIENT VISIT LEVEL 3	$260	$260	$130 – $260
New patient office visit (about 30–44 minutes): rates for 10 insurance plans Aetna — Commercial: $235.30 Aetna — Medicare Advantage: $130 BCBS — Commercial: $246.22 CDPHP — Commercial: $247 CDPHP — Medicaid: $135.20 Cigna — Commercial: $252.20 MVP — Commercial: $227.24 MVP — Medicaid: $260 MVP Essential — Commercial: $260 UHC — Commercial: $247
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OUTPT VISIT L-3	$227.50	$227.50	$113.75 – $227.50
New patient office visit (about 30–44 minutes): rates for 10 insurance plans Aetna — Commercial: $205.89 Aetna — Medicare Advantage: $113.75 BCBS — Commercial: $215.44 CDPHP — Commercial: $216.12 CDPHP — Medicaid: $118.30 Cigna — Commercial: $220.68 MVP — Commercial: $198.84 MVP — Medicaid: $227.50 MVP Essential — Commercial: $227.50 UHC — Commercial: $216.12
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HOSPITALIST NEW PATIENT L-3	$260	$260	$130 – $260
New patient office visit (about 30–44 minutes): rates for 10 insurance plans Aetna — Commercial: $235.30 Aetna — Medicare Advantage: $130 BCBS — Commercial: $246.22 CDPHP — Commercial: $247 CDPHP — Medicaid: $135.20 Cigna — Commercial: $252.20 MVP — Commercial: $227.24 MVP — Medicaid: $260 MVP Essential — Commercial: $260 UHC — Commercial: $247
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT VISIT LEVEL 4	$325	$325	$162.50 – $325
New patient office visit (about 45–59 minutes): rates for 10 insurance plans Aetna — Commercial: $294.12 Aetna — Medicare Advantage: $162.50 BCBS — Commercial: $307.77 CDPHP — Commercial: $308.75 CDPHP — Medicaid: $169 Cigna — Commercial: $315.25 MVP — Commercial: $284.05 MVP — Medicaid: $325 MVP Essential — Commercial: $325 UHC — Commercial: $308.75
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OUTPT VISIT L-4	$273.25	$273.25	$136.62 – $273.25
New patient office visit (about 45–59 minutes): rates for 10 insurance plans Aetna — Commercial: $247.29 Aetna — Medicare Advantage: $136.62 BCBS — Commercial: $258.77 CDPHP — Commercial: $259.59 CDPHP — Medicaid: $142.09 Cigna — Commercial: $265.05 MVP — Commercial: $238.82 MVP — Medicaid: $273.25 MVP Essential — Commercial: $273.25 UHC — Commercial: $259.59
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUT PATIENT LEVEL 4	$325	$325	$162.50 – $325
New patient office visit (about 45–59 minutes): rates for 10 insurance plans Aetna — Commercial: $294.12 Aetna — Medicare Advantage: $162.50 BCBS — Commercial: $307.77 CDPHP — Commercial: $308.75 CDPHP — Medicaid: $169 Cigna — Commercial: $315.25 MVP — Commercial: $284.05 MVP — Medicaid: $325 MVP Essential — Commercial: $325 UHC — Commercial: $308.75
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT VISIT LEVEL 5	$410	$410	$205 – $410
New patient office visit (about 60–74 minutes): rates for 10 insurance plans Aetna — Commercial: $371.05 Aetna — Medicare Advantage: $205 BCBS — Commercial: $388.27 CDPHP — Commercial: $389.50 CDPHP — Medicaid: $213.20 Cigna — Commercial: $397.70 MVP — Commercial: $358.34 MVP — Medicaid: $410 MVP Essential — Commercial: $410 UHC — Commercial: $389.50
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NW PT OUTPT VISIT L-5	$355	$355	$177.50 – $355
New patient office visit (about 60–74 minutes): rates for 10 insurance plans Aetna — Commercial: $321.28 Aetna — Medicare Advantage: $177.50 BCBS — Commercial: $336.18 CDPHP — Commercial: $337.25 CDPHP — Medicaid: $184.60 Cigna — Commercial: $344.35 MVP — Commercial: $310.27 MVP — Medicaid: $355 MVP Essential — Commercial: $355 UHC — Commercial: $337.25
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HOSPITALIST NEW PT L-5	$410	$410	$205 – $410
New patient office visit (about 60–74 minutes): rates for 10 insurance plans Aetna — Commercial: $371.05 Aetna — Medicare Advantage: $205 BCBS — Commercial: $388.27 CDPHP — Commercial: $389.50 CDPHP — Medicaid: $213.20 Cigna — Commercial: $397.70 MVP — Commercial: $358.34 MVP — Medicaid: $410 MVP Essential — Commercial: $410 UHC — Commercial: $389.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT VISIT L3	$205	$205	$102.50 – $205
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — Commercial: $185.52 Aetna — Medicare Advantage: $102.50 BCBS — Commercial: $194.14 CDPHP — Commercial: $194.75 CDPHP — Medicaid: $106.60 Cigna — Commercial: $198.85 MVP — Commercial: $179.17 MVP — Medicaid: $205 MVP Essential — Commercial: $205 UHC — Commercial: $194.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST PT OUTPT VISIT L-3	$188.25	$188.25	$94.12 – $188.25
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — Commercial: $170.37 Aetna — Medicare Advantage: $94.12 BCBS — Commercial: $178.27 CDPHP — Commercial: $178.84 CDPHP — Medicaid: $97.89 Cigna — Commercial: $182.60 MVP — Commercial: $164.53 MVP — Medicaid: $188.25 MVP Essential — Commercial: $188.25 UHC — Commercial: $178.84
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST PATIENT LEVEL 3	$205	$205	$102.50 – $205
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans Aetna — Commercial: $185.52 Aetna — Medicare Advantage: $102.50 BCBS — Commercial: $194.14 CDPHP — Commercial: $194.75 CDPHP — Medicaid: $106.60 Cigna — Commercial: $198.85 MVP — Commercial: $179.17 MVP — Medicaid: $205 MVP Essential — Commercial: $205 UHC — Commercial: $194.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT VISIT L4	$245	$245	$122.50 – $245
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — Commercial: $221.72 Aetna — Medicare Advantage: $122.50 BCBS — Commercial: $232.02 CDPHP — Commercial: $232.75 CDPHP — Medicaid: $127.40 Cigna — Commercial: $237.65 MVP — Commercial: $214.13 MVP — Medicaid: $245 MVP Essential — Commercial: $245 UHC — Commercial: $232.75
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST PT OUPT PT VISIT L-4	$227.50	$227.50	$113.75 – $227.50
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — Commercial: $205.89 Aetna — Medicare Advantage: $113.75 BCBS — Commercial: $215.44 CDPHP — Commercial: $216.12 CDPHP — Medicaid: $118.30 Cigna — Commercial: $220.68 MVP — Commercial: $198.84 MVP — Medicaid: $227.50 MVP Essential — Commercial: $227.50 UHC — Commercial: $216.12
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST PATIENT LEVEL 4	$245	$245	$122.50 – $245
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans Aetna — Commercial: $221.72 Aetna — Medicare Advantage: $122.50 BCBS — Commercial: $232.02 CDPHP — Commercial: $232.75 CDPHP — Medicaid: $127.40 Cigna — Commercial: $237.65 MVP — Commercial: $214.13 MVP — Medicaid: $245 MVP Essential — Commercial: $245 UHC — Commercial: $232.75
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUTPATIENT CONSULT LEVEL 3	$317	$317	$158.50 – $317
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — Commercial: $286.88 Aetna — Medicare Advantage: $158.50 BCBS — Commercial: $300.20 CDPHP — Commercial: $301.15 CDPHP — Medicaid: $164.84 Cigna — Commercial: $307.49 MVP — Commercial: $277.06 MVP — Medicaid: $317 MVP Essential — Commercial: $317 UHC — Commercial: $301.15
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 3	$317	$317	$158.50 – $317
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — Commercial: $286.88 Aetna — Medicare Advantage: $158.50 BCBS — Commercial: $300.20 CDPHP — Commercial: $301.15 CDPHP — Medicaid: $164.84 Cigna — Commercial: $307.49 MVP — Commercial: $277.06 MVP — Medicaid: $317 MVP Essential — Commercial: $317 UHC — Commercial: $301.15
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULTATION DETAILED, HOSPITA	$317	$317	$158.50 – $317
Office consultation with a specialist (moderate): rates for 10 insurance plans Aetna — Commercial: $286.88 Aetna — Medicare Advantage: $158.50 BCBS — Commercial: $300.20 CDPHP — Commercial: $301.15 CDPHP — Medicaid: $164.84 Cigna — Commercial: $307.49 MVP — Commercial: $277.06 MVP — Medicaid: $317 MVP Essential — Commercial: $317 UHC — Commercial: $301.15
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OUTPATIENT CONSULT LEVEL 4	$467	$467	$233.50 – $467
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — Commercial: $422.64 Aetna — Medicare Advantage: $233.50 BCBS — Commercial: $442.25 CDPHP — Commercial: $443.65 CDPHP — Medicaid: $242.84 Cigna — Commercial: $452.99 MVP — Commercial: $408.16 MVP — Medicaid: $467 MVP Essential — Commercial: $467 UHC — Commercial: $443.65
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULT LEVEL 4	$467	$467	$233.50 – $467
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — Commercial: $422.64 Aetna — Medicare Advantage: $233.50 BCBS — Commercial: $442.25 CDPHP — Commercial: $443.65 CDPHP — Medicaid: $242.84 Cigna — Commercial: $452.99 MVP — Commercial: $408.16 MVP — Medicaid: $467 MVP Essential — Commercial: $467 UHC — Commercial: $443.65
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CONSULTATION MOD./COMPLEX E.R.	$467	$467	$233.50 – $467
Office consultation with a specialist (moderate to high): rates for 10 insurance plans Aetna — Commercial: $422.64 Aetna — Medicare Advantage: $233.50 BCBS — Commercial: $442.25 CDPHP — Commercial: $443.65 CDPHP — Medicaid: $242.84 Cigna — Commercial: $452.99 MVP — Commercial: $408.16 MVP — Medicaid: $467 MVP Essential — Commercial: $467 UHC — Commercial: $443.65
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPORTS PHYSICAL	$154	$154	$77 – $154
Preventive checkup, new patient, age 18–39: rates for 10 insurance plans Aetna — Commercial: $139.37 Aetna — Medicare Advantage: $77 BCBS — Commercial: $145.84 CDPHP — Commercial: $146.30 CDPHP — Medicaid: $80.08 Cigna — Commercial: $149.38 MVP — Commercial: $134.60 MVP — Medicaid: $154 MVP Essential — Commercial: $154 UHC — Commercial: $146.30
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPORTS PHYSICAL	$154	$154	$65.30 – $149.38
Preventive checkup, new patient, age 18–39: rates for 8 insurance plans Aetna — Commercial: $139.37 Aetna — Medicare Advantage: $77 BCBS — Commercial: $145.84 CDPHP — Commercial: $146.30 Cigna — Commercial: $149.38 Martin's Point — Commercial: $65.30 MVP — Commercial: $134.60 UHC — Commercial: $146.30
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prev visit new age 18-39	Not listed in the file	Not listed in the file	$77.62 – $175.50
Preventive checkup, new patient, age 18–39: rates for 7 insurance plans Aetna — Commercial: $113.52 BCBS — Commercial: $175.50 Cigna — Commercial: $133.81 Fidelis — Medicaid: $77.62 Fidelis Exchange — Commercial: $81.50 UHC — Commercial: $139.10 UHC — Medicaid: $77.62
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prev visit new age 40-64	Not listed in the file	Not listed in the file	$94.07 – $206.24
Preventive checkup, new patient, age 40–64: rates for 7 insurance plans Aetna — Commercial: $127.26 BCBS — Commercial: $206.24 Cigna — Commercial: $162.81 Fidelis — Medicaid: $94.07 Fidelis Exchange — Commercial: $98.77 UHC — Commercial: $168.85 UHC — Medicaid: $94.07
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	$97.22
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan Martin's Point — Commercial: $97.22
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL 3 OF SERVICE	$227	$227	$113.50 – $227
Emergency room visit (moderate): rates for 10 insurance plans Aetna — Commercial: $205.44 Aetna — Medicare Advantage: $113.50 BCBS — Commercial: $214.97 CDPHP — Commercial: $215.65 CDPHP — Medicaid: $118.04 Cigna — Commercial: $220.19 MVP — Commercial: $198.40 MVP — Medicaid: $227 MVP Essential — Commercial: $227 UHC — Commercial: $215.65
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY LEVEL 3	$808.25	$808.25	$404.12 – $808.25
Emergency room visit (moderate): rates for 10 insurance plans Aetna — Commercial: $731.47 Aetna — Medicare Advantage: $404.12 BCBS — Commercial: $765.41 CDPHP — Commercial: $767.84 CDPHP — Medicaid: $420.29 Cigna — Commercial: $784 MVP — Commercial: $706.41 MVP — Medicaid: $808.25 MVP Essential — Commercial: $808.25 UHC — Commercial: $767.84
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM LEVEL 3	$237.50	$237.50	$118.75 – $237.50
Emergency room visit (moderate): rates for 10 insurance plans Aetna — Commercial: $214.94 Aetna — Medicare Advantage: $118.75 BCBS — Commercial: $224.91 CDPHP — Commercial: $225.62 CDPHP — Medicaid: $123.50 Cigna — Commercial: $230.38 MVP — Commercial: $207.58 MVP — Medicaid: $237.50 MVP Essential — Commercial: $237.50 UHC — Commercial: $225.62
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL 4 OF SERVICE	$340	$340	$170 – $340
Emergency room visit (moderately high): rates for 10 insurance plans Aetna — Commercial: $307.70 Aetna — Medicare Advantage: $170 BCBS — Commercial: $321.98 CDPHP — Commercial: $323 CDPHP — Medicaid: $176.80 Cigna — Commercial: $329.80 MVP — Commercial: $297.16 MVP — Medicaid: $340 MVP Essential — Commercial: $340 UHC — Commercial: $323
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY LEVEL 4	$1,131	$1,131	$565.50 – $1,131
Emergency room visit (moderately high): rates for 10 insurance plans Aetna — Commercial: $1,023.56 Aetna — Medicare Advantage: $565.50 BCBS — Commercial: $1,071.06 CDPHP — Commercial: $1,074.45 CDPHP — Medicaid: $588.12 Cigna — Commercial: $1,097.07 MVP — Commercial: $988.49 MVP — Medicaid: $1,131 MVP Essential — Commercial: $1,131 UHC — Commercial: $1,074.45
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM HOSPITALIST L4	$355.75	$355.75	$177.88 – $355.75
Emergency room visit (moderately high): rates for 10 insurance plans Aetna — Commercial: $321.95 Aetna — Medicare Advantage: $177.88 BCBS — Commercial: $336.90 CDPHP — Commercial: $337.96 CDPHP — Medicaid: $184.99 Cigna — Commercial: $345.08 MVP — Commercial: $310.93 MVP — Medicaid: $355.75 MVP Essential — Commercial: $355.75 UHC — Commercial: $337.96
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL 5 OF SERVICE	$477	$477	$238.50 – $477
Emergency room visit (high): rates for 10 insurance plans Aetna — Commercial: $431.68 Aetna — Medicare Advantage: $238.50 BCBS — Commercial: $451.72 CDPHP — Commercial: $453.15 CDPHP — Medicaid: $248.04 Cigna — Commercial: $462.69 MVP — Commercial: $416.90 MVP — Medicaid: $477 MVP Essential — Commercial: $477 UHC — Commercial: $453.15
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY LEVEL 5	$1,387.25	$1,387.25	$693.62 – $1,387.25
Emergency room visit (high): rates for 10 insurance plans Aetna — Commercial: $1,255.46 Aetna — Medicare Advantage: $693.62 BCBS — Commercial: $1,313.73 CDPHP — Commercial: $1,317.89 CDPHP — Medicaid: $721.37 Cigna — Commercial: $1,345.63 MVP — Commercial: $1,212.46 MVP — Medicaid: $1,387.25 MVP Essential — Commercial: $1,387.25 UHC — Commercial: $1,317.89
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HOSPITALIST EMERGENCY LEVEL 5	$499	$499	$249.50 – $499
Emergency room visit (high): rates for 10 insurance plans Aetna — Commercial: $451.60 Aetna — Medicare Advantage: $249.50 BCBS — Commercial: $472.55 CDPHP — Commercial: $474.05 CDPHP — Medicaid: $259.48 Cigna — Commercial: $484.03 MVP — Commercial: $436.13 MVP — Medicaid: $499 MVP Essential — Commercial: $499 UHC — Commercial: $474.05

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: LAB-BASIC METABOLIC PANEL	$115	$115	$57.50 – $115
Basic metabolic panel (blood test): rates for 10 insurance plans Aetna — Commercial: $104.08 Aetna — Medicare Advantage: $57.50 BCBS — Commercial: $108.90 CDPHP — Commercial: $109.25 CDPHP — Medicaid: $59.80 Cigna — Commercial: $111.55 MVP — Commercial: $100.51 MVP — Medicaid: $115 MVP Essential — Commercial: $115 UHC — Commercial: $109.25
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-BASIC METABOLIC PANEL	$115	$115	$48.76 – $111.55
Basic metabolic panel (blood test): rates for 8 insurance plans Aetna — Commercial: $104.08 Aetna — Medicare Advantage: $57.50 BCBS — Commercial: $108.90 CDPHP — Commercial: $109.25 Cigna — Commercial: $111.55 Martin's Point — Commercial: $48.76 MVP — Commercial: $100.51 UHC — Commercial: $109.25
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic metabolic pnl total ca	Not listed in the file	Not listed in the file	$8.25 – $8.66
Basic metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $8.46 BCBS — Medicare Advantage: $8.46 CDPHP — Medicare Advantage: $8.46 Fidelis — Medicaid: $8.25 Fidelis — Medicare Advantage: $8.46 Fidelis Exchange — Commercial: $8.66 Humana — Medicare Advantage: $8.46 Martin's Point — Commercial: $8.34 MVP — Medicare Advantage: $8.46 UHC — Medicaid: $8.25
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-COMP METABOLIC PANEL	$147.75	$147.75	$73.88 – $147.75
Comprehensive metabolic panel (blood test): rates for 10 insurance plans Aetna — Commercial: $133.71 Aetna — Medicare Advantage: $73.88 BCBS — Commercial: $139.92 CDPHP — Commercial: $140.36 CDPHP — Medicaid: $76.83 Cigna — Commercial: $143.32 MVP — Commercial: $129.13 MVP — Medicaid: $147.75 MVP Essential — Commercial: $147.75 UHC — Commercial: $140.36
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-COMP METABOLIC PANEL	$147.75	$147.75	$62.65 – $143.32
Comprehensive metabolic panel (blood test): rates for 8 insurance plans Aetna — Commercial: $133.71 Aetna — Medicare Advantage: $73.88 BCBS — Commercial: $139.92 CDPHP — Commercial: $140.36 Cigna — Commercial: $143.32 Martin's Point — Commercial: $62.65 MVP — Commercial: $129.13 UHC — Commercial: $140.36
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$10.30 – $10.82
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $10.56 BCBS — Medicare Advantage: $10.56 CDPHP — Medicare Advantage: $10.56 Fidelis — Medicaid: $10.30 Fidelis — Medicare Advantage: $10.56 Fidelis Exchange — Commercial: $10.82 Humana — Medicare Advantage: $10.56 Martin's Point — Commercial: $10.41 MVP — Medicare Advantage: $10.56 UHC — Medicaid: $10.30
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$35.86 – $68.86
Obstetric blood test panel: 10 of 18 insurance plan rates Aetna — Commercial: $47.81 Aetna — Medicare Advantage: $47.81 BCBS — Commercial: $68.86 BCBS — Medicare Advantage: $47.81 CDPHP — Commercial: $47.81 CDPHP — Medicare Advantage: $47.81 Fidelis — Medicaid: $46.61 Fidelis — Medicare Advantage: $47.81 Fidelis Exchange — Commercial: $48.94 Humana — Medicare Advantage: $47.81
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	$46.61 – $61.66
Obstetric blood test panel: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $47.81 BCBS — Medicare Advantage: $47.81 CDPHP — Medicare Advantage: $47.81 Fidelis — Medicaid: $46.61 Fidelis — Medicare Advantage: $47.81 Fidelis Exchange — Commercial: $48.94 Humana — Medicare Advantage: $47.81 Martin's Point — Commercial: $61.66 MVP — Medicare Advantage: $47.81 UHC — Medicaid: $46.61
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26\|TC In the file: Obstetric panel	Not listed in the file	Not listed in the file	$89.63
Obstetric blood test panel: rates for 1 insurance plan Cigna — Commercial: $89.63
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB LIPID PANEL (ARP)	$147.75	$147.75	$73.88 – $147.75
Cholesterol panel (lipid panel): rates for 10 insurance plans Aetna — Commercial: $133.71 Aetna — Medicare Advantage: $73.88 BCBS — Commercial: $139.92 CDPHP — Commercial: $140.36 CDPHP — Medicaid: $76.83 Cigna — Commercial: $143.32 MVP — Commercial: $129.13 MVP — Medicaid: $147.75 MVP Essential — Commercial: $147.75 UHC — Commercial: $140.36
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB LIPID PANEL (ARP)	$147.75	$147.75	$62.65 – $143.32
Cholesterol panel (lipid panel): rates for 8 insurance plans Aetna — Commercial: $133.71 Aetna — Medicare Advantage: $73.88 BCBS — Commercial: $139.92 CDPHP — Commercial: $140.36 Cigna — Commercial: $143.32 Martin's Point — Commercial: $62.65 MVP — Commercial: $129.13 UHC — Commercial: $140.36
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$13.06 – $13.71
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $13.39 BCBS — Medicare Advantage: $13.39 CDPHP — Medicare Advantage: $13.39 Fidelis — Medicaid: $13.06 Fidelis — Medicare Advantage: $13.39 Fidelis Exchange — Commercial: $13.71 Humana — Medicare Advantage: $13.39 Martin's Point — Commercial: $13.20 MVP — Medicare Advantage: $13.39 UHC — Medicaid: $13.06
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB RENAL FUNCTION PANEL	$106.50	$106.50	$53.25 – $106.50
Kidney function panel: rates for 10 insurance plans Aetna — Commercial: $96.38 Aetna — Medicare Advantage: $53.25 BCBS — Commercial: $100.86 CDPHP — Commercial: $101.18 CDPHP — Medicaid: $55.38 Cigna — Commercial: $103.30 MVP — Commercial: $93.08 MVP — Medicaid: $106.50 MVP Essential — Commercial: $106.50 UHC — Commercial: $101.18
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB RENAL FUNCTION PANEL	$106.50	$106.50	$45.16 – $103.30
Kidney function panel: rates for 8 insurance plans Aetna — Commercial: $96.38 Aetna — Medicare Advantage: $53.25 BCBS — Commercial: $100.86 CDPHP — Commercial: $101.18 Cigna — Commercial: $103.30 Martin's Point — Commercial: $45.16 MVP — Commercial: $93.08 UHC — Commercial: $101.18
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$8.46 – $8.88
Kidney function panel: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $8.68 BCBS — Medicare Advantage: $8.68 CDPHP — Medicare Advantage: $8.68 Fidelis — Medicaid: $8.46 Fidelis — Medicare Advantage: $8.68 Fidelis Exchange — Commercial: $8.88 Humana — Medicare Advantage: $8.68 Martin's Point — Commercial: $8.56 MVP — Medicare Advantage: $8.68 UHC — Medicaid: $8.46
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB HEPATIC FUNCTION PANEL	$127.25	$127.25	$63.62 – $127.25
Liver function panel: rates for 10 insurance plans Aetna — Commercial: $115.16 Aetna — Medicare Advantage: $63.62 BCBS — Commercial: $120.51 CDPHP — Commercial: $120.89 CDPHP — Medicaid: $66.17 Cigna — Commercial: $123.43 MVP — Commercial: $111.22 MVP — Medicaid: $127.25 MVP Essential — Commercial: $127.25 UHC — Commercial: $120.89
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB HEPATIC FUNCTION PANEL	$127.25	$127.25	$53.95 – $123.43
Liver function panel: rates for 8 insurance plans Aetna — Commercial: $115.16 Aetna — Medicare Advantage: $63.62 BCBS — Commercial: $120.51 CDPHP — Commercial: $120.89 Cigna — Commercial: $123.43 Martin's Point — Commercial: $53.95 MVP — Commercial: $111.22 UHC — Commercial: $120.89
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$6.13 – $11.85
Liver function panel: 10 of 18 insurance plan rates Aetna — Commercial: $8.17 Aetna — Medicare Advantage: $8.17 BCBS — Commercial: $11.85 BCBS — Medicare Advantage: $8.17 CDPHP — Commercial: $8.17 CDPHP — Medicare Advantage: $8.17 Fidelis — Medicaid: $7.97 Fidelis — Medicare Advantage: $8.17 Fidelis Exchange — Commercial: $8.37 Humana — Medicare Advantage: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-URINALYSIS W/SEDIMENT EXAM	$149	$149	$74.50 – $149
Urine test (automated, with microscope): rates for 10 insurance plans Aetna — Commercial: $134.84 Aetna — Medicare Advantage: $74.50 BCBS — Commercial: $141.10 CDPHP — Commercial: $141.55 CDPHP — Medicaid: $77.48 Cigna — Commercial: $144.53 MVP — Commercial: $130.23 MVP — Medicaid: $149 MVP Essential — Commercial: $149 UHC — Commercial: $141.55
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-URINALYSIS W/SEDIMENT EXAM	$149	$149	$63.18 – $144.53
Urine test (automated, with microscope): rates for 8 insurance plans Aetna — Commercial: $134.84 Aetna — Medicare Advantage: $74.50 BCBS — Commercial: $141.10 CDPHP — Commercial: $141.55 Cigna — Commercial: $144.53 Martin's Point — Commercial: $63.18 MVP — Commercial: $130.23 UHC — Commercial: $141.55
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$2.38 – $4.60
Urine test (automated, with microscope): 10 of 18 insurance plan rates Aetna — Commercial: $3.17 Aetna — Medicare Advantage: $3.17 BCBS — Commercial: $4.60 BCBS — Medicare Advantage: $3.17 CDPHP — Commercial: $3.17 CDPHP — Medicare Advantage: $3.17 Fidelis — Medicaid: $3.09 Fidelis — Medicare Advantage: $3.17 Fidelis Exchange — Commercial: $3.24 Humana — Medicare Advantage: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-URINE PH	$59.75	$59.75	$29.88 – $59.75
Urine test (manual, without microscope): rates for 10 insurance plans Aetna — Commercial: $54.07 Aetna — Medicare Advantage: $29.88 BCBS — Commercial: $56.58 CDPHP — Commercial: $56.76 CDPHP — Medicaid: $31.07 Cigna — Commercial: $57.96 MVP — Commercial: $52.22 MVP — Medicaid: $59.75 MVP Essential — Commercial: $59.75 UHC — Commercial: $56.76
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-ACETONE,URINE	$59.75	$59.75	$29.88 – $59.75
Urine test (manual, without microscope): rates for 10 insurance plans Aetna — Commercial: $54.07 Aetna — Medicare Advantage: $29.88 BCBS — Commercial: $56.58 CDPHP — Commercial: $56.76 CDPHP — Medicaid: $31.07 Cigna — Commercial: $57.96 MVP — Commercial: $52.22 MVP — Medicaid: $59.75 MVP Essential — Commercial: $59.75 UHC — Commercial: $56.76
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-URINE SPECIFIC GRAVITY	$59.75	$59.75	$29.88 – $59.75
Urine test (manual, without microscope): rates for 10 insurance plans Aetna — Commercial: $54.07 Aetna — Medicare Advantage: $29.88 BCBS — Commercial: $56.58 CDPHP — Commercial: $56.76 CDPHP — Medicaid: $31.07 Cigna — Commercial: $57.96 MVP — Commercial: $52.22 MVP — Medicaid: $59.75 MVP Essential — Commercial: $59.75 UHC — Commercial: $56.76
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-URINALYSIS, ROUTINE	$147.75	$147.75	$73.88 – $147.75
Urine test (automated, without microscope): rates for 10 insurance plans Aetna — Commercial: $133.71 Aetna — Medicare Advantage: $73.88 BCBS — Commercial: $139.92 CDPHP — Commercial: $140.36 CDPHP — Medicaid: $76.83 Cigna — Commercial: $143.32 MVP — Commercial: $129.13 MVP — Medicaid: $147.75 MVP Essential — Commercial: $147.75 UHC — Commercial: $140.36
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-URINALYSIS, ROUTINE	$147.75	$147.75	$62.65 – $143.32
Urine test (automated, without microscope): rates for 8 insurance plans Aetna — Commercial: $133.71 Aetna — Medicare Advantage: $73.88 BCBS — Commercial: $139.92 CDPHP — Commercial: $140.36 Cigna — Commercial: $143.32 Martin's Point — Commercial: $62.65 MVP — Commercial: $129.13 UHC — Commercial: $140.36
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$2.19 – $2.30
Urine test (automated, without microscope): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $2.25 BCBS — Medicare Advantage: $2.25 CDPHP — Medicare Advantage: $2.25 Fidelis — Medicaid: $2.19 Fidelis — Medicare Advantage: $2.25 Fidelis Exchange — Commercial: $2.30 Humana — Medicare Advantage: $2.25 Martin's Point — Commercial: $2.22 MVP — Medicare Advantage: $2.25 UHC — Medicaid: $2.19
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-PROSTATE ANTIGEN NON-SC	$333.25	$333.25	$166.62 – $333.25
PSA (prostate specific antigen) blood test: rates for 10 insurance plans Aetna — Commercial: $301.59 Aetna — Medicare Advantage: $166.62 BCBS — Commercial: $315.59 CDPHP — Commercial: $316.59 CDPHP — Medicaid: $173.29 Cigna — Commercial: $323.25 MVP — Commercial: $291.26 MVP — Medicaid: $333.25 MVP Essential — Commercial: $333.25 UHC — Commercial: $316.59
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LABS-PROSTATE SPECIFIC AG,TOT	$333.25	$333.25	$166.62 – $333.25
PSA (prostate specific antigen) blood test: rates for 10 insurance plans Aetna — Commercial: $301.59 Aetna — Medicare Advantage: $166.62 BCBS — Commercial: $315.59 CDPHP — Commercial: $316.59 CDPHP — Medicaid: $173.29 Cigna — Commercial: $323.25 MVP — Commercial: $291.26 MVP — Medicaid: $333.25 MVP Essential — Commercial: $333.25 UHC — Commercial: $316.59
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-PROSTATE ANTIGEN NON-SC	$333.25	$333.25	$141.30 – $323.25
PSA (prostate specific antigen) blood test: rates for 8 insurance plans Aetna — Commercial: $301.59 Aetna — Medicare Advantage: $166.62 BCBS — Commercial: $315.59 CDPHP — Commercial: $316.59 Cigna — Commercial: $323.25 Martin's Point — Commercial: $141.30 MVP — Commercial: $291.26 UHC — Commercial: $316.59
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-TSH	$268	$268	$134 – $268
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans Aetna — Commercial: $242.54 Aetna — Medicare Advantage: $134 BCBS — Commercial: $253.80 CDPHP — Commercial: $254.60 CDPHP — Medicaid: $139.36 Cigna — Commercial: $259.96 MVP — Commercial: $234.23 MVP — Medicaid: $268 MVP Essential — Commercial: $268 UHC — Commercial: $254.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-TSH	$268	$268	$113.63 – $259.96
Thyroid stimulating hormone (TSH) test: rates for 8 insurance plans Aetna — Commercial: $242.54 Aetna — Medicare Advantage: $134 BCBS — Commercial: $253.80 CDPHP — Commercial: $254.60 Cigna — Commercial: $259.96 Martin's Point — Commercial: $113.63 MVP — Commercial: $234.23 UHC — Commercial: $254.60
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone	Not listed in the file	Not listed in the file	$16.38 – $17.20
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $16.80 BCBS — Medicare Advantage: $16.80 CDPHP — Medicare Advantage: $16.80 Fidelis — Medicaid: $16.38 Fidelis — Medicare Advantage: $16.80 Fidelis Exchange — Commercial: $17.20 Humana — Medicare Advantage: $16.80 Martin's Point — Commercial: $16.56 MVP — Medicare Advantage: $16.80 UHC — Medicaid: $16.38
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB CBC+PLT W/DIFF (ELEC)	$140.25	$140.25	$70.12 – $140.25
Complete blood count (CBC) with differential: rates for 10 insurance plans Aetna — Commercial: $126.93 Aetna — Medicare Advantage: $70.12 BCBS — Commercial: $132.82 CDPHP — Commercial: $133.24 CDPHP — Medicaid: $72.93 Cigna — Commercial: $136.04 MVP — Commercial: $122.58 MVP — Medicaid: $140.25 MVP Essential — Commercial: $140.25 UHC — Commercial: $133.24
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SVRCC CBC+PLT w/DIFF (ELECTRON	$140.25	$140.25	$70.12 – $140.25
Complete blood count (CBC) with differential: rates for 10 insurance plans Aetna — Commercial: $126.93 Aetna — Medicare Advantage: $70.12 BCBS — Commercial: $132.82 CDPHP — Commercial: $133.24 CDPHP — Medicaid: $72.93 Cigna — Commercial: $136.04 MVP — Commercial: $122.58 MVP — Medicaid: $140.25 MVP Essential — Commercial: $140.25 UHC — Commercial: $133.24
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB CBC+PLT W/DIFF (ELEC)	$140.25	$140.25	$59.47 – $136.04
Complete blood count (CBC) with differential: rates for 8 insurance plans Aetna — Commercial: $126.93 Aetna — Medicare Advantage: $70.12 BCBS — Commercial: $132.82 CDPHP — Commercial: $133.24 Cigna — Commercial: $136.04 Martin's Point — Commercial: $59.47 MVP — Commercial: $122.58 UHC — Commercial: $133.24
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB CBC W/ PLATELETS	$79.75	$79.75	$39.88 – $79.75
Complete blood count (CBC), automated: rates for 10 insurance plans Aetna — Commercial: $72.17 Aetna — Medicare Advantage: $39.88 BCBS — Commercial: $75.52 CDPHP — Commercial: $75.76 CDPHP — Medicaid: $41.47 Cigna — Commercial: $77.36 MVP — Commercial: $69.70 MVP — Medicaid: $79.75 MVP Essential — Commercial: $79.75 UHC — Commercial: $75.76
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB CBC W/ PLATELETS	$79.75	$79.75	$33.81 – $77.36
Complete blood count (CBC), automated: rates for 8 insurance plans Aetna — Commercial: $72.17 Aetna — Medicare Advantage: $39.88 BCBS — Commercial: $75.52 CDPHP — Commercial: $75.76 Cigna — Commercial: $77.36 Martin's Point — Commercial: $33.81 MVP — Commercial: $69.70 UHC — Commercial: $75.76
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$4.85 – $9.38
Complete blood count (CBC), automated: 10 of 18 insurance plan rates Aetna — Commercial: $6.47 Aetna — Medicare Advantage: $6.47 BCBS — Commercial: $9.38 BCBS — Medicare Advantage: $6.47 CDPHP — Commercial: $6.47 CDPHP — Medicare Advantage: $6.47 Fidelis — Medicaid: $6.31 Fidelis — Medicare Advantage: $6.47 Fidelis Exchange — Commercial: $6.63 Humana — Medicare Advantage: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-PROTHROMBIN TIME	$43	$43	$21.50 – $43
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans Aetna — Commercial: $38.92 Aetna — Medicare Advantage: $21.50 BCBS — Commercial: $40.72 CDPHP — Commercial: $40.85 CDPHP — Medicaid: $22.36 Cigna — Commercial: $41.71 MVP — Commercial: $37.58 MVP — Medicaid: $43 MVP Essential — Commercial: $43 UHC — Commercial: $40.85
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SVRCC PROTIME-INR	$43	$43	$21.50 – $43
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans Aetna — Commercial: $38.92 Aetna — Medicare Advantage: $21.50 BCBS — Commercial: $40.72 CDPHP — Commercial: $40.85 CDPHP — Medicaid: $22.36 Cigna — Commercial: $41.71 MVP — Commercial: $37.58 MVP — Medicaid: $43 MVP Essential — Commercial: $43 UHC — Commercial: $40.85
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAB-PROTHROMBIN TIME	$43	$43	$18.23 – $41.71
Blood clotting time test (prothrombin time, PT): rates for 8 insurance plans Aetna — Commercial: $38.92 Aetna — Medicare Advantage: $21.50 BCBS — Commercial: $40.72 CDPHP — Commercial: $40.85 Cigna — Commercial: $41.71 Martin's Point — Commercial: $18.23 MVP — Commercial: $37.58 UHC — Commercial: $40.85
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LABS-APTT LUPUS ANTICOAG	$125.25	$125.25	$62.62 – $125.25
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans Aetna — Commercial: $113.35 Aetna — Medicare Advantage: $62.62 BCBS — Commercial: $118.61 CDPHP — Commercial: $118.99 CDPHP — Medicaid: $65.13 Cigna — Commercial: $121.49 MVP — Commercial: $109.47 MVP — Medicaid: $125.25 MVP Essential — Commercial: $125.25 UHC — Commercial: $118.99
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAB-PARTIAL THROMBOPLAST, TIME	$125.25	$125.25	$62.62 – $125.25
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans Aetna — Commercial: $113.35 Aetna — Medicare Advantage: $62.62 BCBS — Commercial: $118.61 CDPHP — Commercial: $118.99 CDPHP — Medicaid: $65.13 Cigna — Commercial: $121.49 MVP — Commercial: $109.47 MVP — Medicaid: $125.25 MVP Essential — Commercial: $125.25 UHC — Commercial: $118.99
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LABS-APTT LUPUS ANTICOAG	$125.25	$125.25	$53.11 – $121.49
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans Aetna — Commercial: $113.35 Aetna — Medicare Advantage: $62.62 BCBS — Commercial: $118.61 CDPHP — Commercial: $118.99 Cigna — Commercial: $121.49 Martin's Point — Commercial: $53.11 MVP — Commercial: $109.47 UHC — Commercial: $118.99

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: HEAD CT W/O CONTRAST CRITICAL	$2,634.75	$2,634.75	$1,317.38 – $2,634.75
CT scan of the head or brain, without contrast: rates for 10 insurance plans Aetna — Commercial: $2,384.45 Aetna — Medicare Advantage: $1,317.38 BCBS — Commercial: $2,495.11 CDPHP — Commercial: $2,503.01 CDPHP — Medicaid: $1,370.07 Cigna — Commercial: $2,555.71 MVP — Commercial: $2,302.77 MVP — Medicaid: $2,634.75 MVP Essential — Commercial: $2,634.75 UHC — Commercial: $2,503.01
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAT SCAN HEAD W/O CONTRAST LCD	$2,634.75	$2,634.75	$1,317.38 – $2,634.75
CT scan of the head or brain, without contrast: rates for 10 insurance plans Aetna — Commercial: $2,384.45 Aetna — Medicare Advantage: $1,317.38 BCBS — Commercial: $2,495.11 CDPHP — Commercial: $2,503.01 CDPHP — Medicaid: $1,370.07 Cigna — Commercial: $2,555.71 MVP — Commercial: $2,302.77 MVP — Medicaid: $2,634.75 MVP Essential — Commercial: $2,634.75 UHC — Commercial: $2,503.01
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEAD CT W/O CONTRAST CRITICAL	$2,634.75	$2,634.75	$1,117.13 – $2,555.71
CT scan of the head or brain, without contrast: rates for 8 insurance plans Aetna — Commercial: $2,384.45 Aetna — Medicare Advantage: $1,317.38 BCBS — Commercial: $2,495.11 CDPHP — Commercial: $2,503.01 Cigna — Commercial: $2,555.71 Martin's Point — Commercial: $1,117.13 MVP — Commercial: $2,302.77 UHC — Commercial: $2,503.01
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BRAIN W & W/O CONTRAST MRI LCD	$4,611.50	$4,611.50	$2,305.75 – $4,611.50
MRI of the brain, before and after contrast: rates for 10 insurance plans Aetna — Commercial: $4,173.41 Aetna — Medicare Advantage: $2,305.75 BCBS — Commercial: $4,367.09 CDPHP — Commercial: $4,380.92 CDPHP — Medicaid: $2,397.98 Cigna — Commercial: $4,473.16 MVP — Commercial: $4,030.45 MVP — Medicaid: $4,611.50 MVP Essential — Commercial: $4,611.50 UHC — Commercial: $4,380.92
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI PITUITARY W/WO CONTRAST	$4,611.50	$4,611.50	$2,305.75 – $4,611.50
MRI of the brain, before and after contrast: rates for 10 insurance plans Aetna — Commercial: $4,173.41 Aetna — Medicare Advantage: $2,305.75 BCBS — Commercial: $4,367.09 CDPHP — Commercial: $4,380.92 CDPHP — Medicaid: $2,397.98 Cigna — Commercial: $4,473.16 MVP — Commercial: $4,030.45 MVP — Medicaid: $4,611.50 MVP Essential — Commercial: $4,611.50 UHC — Commercial: $4,380.92
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IAC W/WO CONTRAST MRI LCD	$4,611.50	$4,611.50	$2,305.75 – $4,611.50
MRI of the brain, before and after contrast: rates for 10 insurance plans Aetna — Commercial: $4,173.41 Aetna — Medicare Advantage: $2,305.75 BCBS — Commercial: $4,367.09 CDPHP — Commercial: $4,380.92 CDPHP — Medicaid: $2,397.98 Cigna — Commercial: $4,473.16 MVP — Commercial: $4,030.45 MVP — Medicaid: $4,611.50 MVP Essential — Commercial: $4,611.50 UHC — Commercial: $4,380.92
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR CHEST PA/LAT 2V	$711.75	$711.75	$355.88 – $711.75
Chest X-ray, 2 views: rates for 10 insurance plans Aetna — Commercial: $644.13 Aetna — Medicare Advantage: $355.88 BCBS — Commercial: $674.03 CDPHP — Commercial: $676.16 CDPHP — Medicaid: $370.11 Cigna — Commercial: $690.40 MVP — Commercial: $622.07 MVP — Medicaid: $711.75 MVP Essential — Commercial: $711.75 UHC — Commercial: $676.16
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR CHEST 2V-INSPIRATE/EXPIRATE	$711.75	$711.75	$355.88 – $711.75
Chest X-ray, 2 views: rates for 10 insurance plans Aetna — Commercial: $644.13 Aetna — Medicare Advantage: $355.88 BCBS — Commercial: $674.03 CDPHP — Commercial: $676.16 CDPHP — Medicaid: $370.11 Cigna — Commercial: $690.40 MVP — Commercial: $622.07 MVP — Medicaid: $711.75 MVP Essential — Commercial: $711.75 UHC — Commercial: $676.16
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST OBLIQUES ONLY 2 VIEWS	$711.75	$711.75	$355.88 – $711.75
Chest X-ray, 2 views: rates for 10 insurance plans Aetna — Commercial: $644.13 Aetna — Medicare Advantage: $355.88 BCBS — Commercial: $674.03 CDPHP — Commercial: $676.16 CDPHP — Medicaid: $370.11 Cigna — Commercial: $690.40 MVP — Commercial: $622.07 MVP — Medicaid: $711.75 MVP Essential — Commercial: $711.75 UHC — Commercial: $676.16
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LSPINE WITH FLEX AND EXT	$811.50	$811.50	$405.75 – $811.50
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Aetna — Commercial: $734.41 Aetna — Medicare Advantage: $405.75 BCBS — Commercial: $768.49 CDPHP — Commercial: $770.92 CDPHP — Medicaid: $421.98 Cigna — Commercial: $787.16 MVP — Commercial: $709.25 MVP — Medicaid: $811.50 MVP Essential — Commercial: $811.50 UHC — Commercial: $770.92
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR LSPINE W/FLEX/EXT	$811.50	$811.50	$405.75 – $811.50
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Aetna — Commercial: $734.41 Aetna — Medicare Advantage: $405.75 BCBS — Commercial: $768.49 CDPHP — Commercial: $770.92 CDPHP — Medicaid: $421.98 Cigna — Commercial: $787.16 MVP — Commercial: $709.25 MVP — Medicaid: $811.50 MVP Essential — Commercial: $811.50 UHC — Commercial: $770.92
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBAR SPINE WITH OBLIQUES	$811.50	$811.50	$405.75 – $811.50
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Aetna — Commercial: $734.41 Aetna — Medicare Advantage: $405.75 BCBS — Commercial: $768.49 CDPHP — Commercial: $770.92 CDPHP — Medicaid: $421.98 Cigna — Commercial: $787.16 MVP — Commercial: $709.25 MVP — Medicaid: $811.50 MVP Essential — Commercial: $811.50 UHC — Commercial: $770.92
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBAR SPINE W/O CONTRAST MRI	$4,319.75	$4,319.75	$2,159.88 – $4,319.75
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans Aetna — Commercial: $3,909.37 Aetna — Medicare Advantage: $2,159.88 BCBS — Commercial: $4,090.80 CDPHP — Commercial: $4,103.76 CDPHP — Medicaid: $2,246.27 Cigna — Commercial: $4,190.16 MVP — Commercial: $3,775.46 MVP — Medicaid: $4,319.75 MVP Essential — Commercial: $4,319.75 UHC — Commercial: $4,103.76
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LSPINE MRI CRITICAL CORD COMPR	$4,319.75	$4,319.75	$2,159.88 – $4,319.75
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans Aetna — Commercial: $3,909.37 Aetna — Medicare Advantage: $2,159.88 BCBS — Commercial: $4,090.80 CDPHP — Commercial: $4,103.76 CDPHP — Medicaid: $2,246.27 Cigna — Commercial: $4,190.16 MVP — Commercial: $3,775.46 MVP — Medicaid: $4,319.75 MVP Essential — Commercial: $4,319.75 UHC — Commercial: $4,103.76
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LUMBAR SPINE W/O CONTRAST MRI	$4,319.75	$4,319.75	$1,831.57 – $4,190.16
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans Aetna — Commercial: $3,909.37 Aetna — Medicare Advantage: $2,159.88 BCBS — Commercial: $4,090.80 CDPHP — Commercial: $4,103.76 Cigna — Commercial: $4,190.16 Martin's Point — Commercial: $1,831.57 MVP — Commercial: $3,775.46 UHC — Commercial: $4,103.76
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LOWER ABDOMEN	$3,466.75	$3,466.75	$1,733.38 – $3,466.75
CT scan of the pelvis, with contrast: rates for 10 insurance plans Aetna — Commercial: $3,137.41 Aetna — Medicare Advantage: $1,733.38 BCBS — Commercial: $3,283.01 CDPHP — Commercial: $3,293.41 CDPHP — Medicaid: $1,802.71 Cigna — Commercial: $3,362.75 MVP — Commercial: $3,029.94 MVP — Medicaid: $3,466.75 MVP Essential — Commercial: $3,466.75 UHC — Commercial: $3,293.41
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APPENDIX PROTOCOL PELVIS W/CON	$3,466.75	$3,466.75	$1,733.38 – $3,466.75
CT scan of the pelvis, with contrast: rates for 10 insurance plans Aetna — Commercial: $3,137.41 Aetna — Medicare Advantage: $1,733.38 BCBS — Commercial: $3,283.01 CDPHP — Commercial: $3,293.41 CDPHP — Medicaid: $1,802.71 Cigna — Commercial: $3,362.75 MVP — Commercial: $3,029.94 MVP — Medicaid: $3,466.75 MVP Essential — Commercial: $3,466.75 UHC — Commercial: $3,293.41
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LOWER ABDOMEN	$3,466.75	$3,466.75	$1,469.90 – $3,362.75
CT scan of the pelvis, with contrast: rates for 8 insurance plans Aetna — Commercial: $3,137.41 Aetna — Medicare Advantage: $1,733.38 BCBS — Commercial: $3,283.01 CDPHP — Commercial: $3,293.41 Cigna — Commercial: $3,362.75 Martin's Point — Commercial: $1,469.90 MVP — Commercial: $3,029.94 UHC — Commercial: $3,293.41
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$625
MRI of a leg joint (such as the knee), without contrast: 10 of 13 insurance plan rates Aetna — Medicare Advantage: $275.78 BCBS — Medicare Advantage: $275.78 CDPHP — Medicare Advantage: $275.78 Fidelis — Medicaid: $186.85 Fidelis — Medicare Advantage: $275.78 Fidelis Exchange — Commercial: $196.19 Humana — Medicare Advantage: $275.78 Martin's Point — Commercial: $275.78 MVP — Commercial: $625 MVP — Medicare Advantage: $275.78
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$197.75
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan Aetna — Commercial: $197.75
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: ANKLE LEFT MRI W/O CONTRAST	$4,304.75	$4,304.75	$2,152.38 – $4,304.75
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans Aetna — Commercial: $3,895.80 Aetna — Medicare Advantage: $2,152.38 BCBS — Commercial: $4,076.60 CDPHP — Commercial: $4,089.51 CDPHP — Medicaid: $2,238.47 Cigna — Commercial: $4,175.61 MVP — Commercial: $3,762.35 MVP — Medicaid: $4,304.75 MVP Essential — Commercial: $4,304.75 UHC — Commercial: $4,089.51
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMEN PELVIS W/ IV CONTRAST	$5,024	$5,024	$2,512 – $5,024
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Aetna — Commercial: $4,546.72 Aetna — Medicare Advantage: $2,512 BCBS — Commercial: $4,757.73 CDPHP — Commercial: $4,772.80 CDPHP — Medicaid: $2,612.48 Cigna — Commercial: $4,873.28 MVP — Commercial: $4,390.98 MVP — Medicaid: $5,024 MVP Essential — Commercial: $5,024 UHC — Commercial: $4,772.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APPENDIX PROTOCOL ABD/PEL W/CO	$5,024	$5,024	$2,512 – $5,024
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Aetna — Commercial: $4,546.72 Aetna — Medicare Advantage: $2,512 BCBS — Commercial: $4,757.73 CDPHP — Commercial: $4,772.80 CDPHP — Medicaid: $2,612.48 Cigna — Commercial: $4,873.28 MVP — Commercial: $4,390.98 MVP — Medicaid: $5,024 MVP Essential — Commercial: $5,024 UHC — Commercial: $4,772.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIVERTICULITIS CT PROTOCOL	$5,024	$5,024	$2,512 – $5,024
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Aetna — Commercial: $4,546.72 Aetna — Medicare Advantage: $2,512 BCBS — Commercial: $4,757.73 CDPHP — Commercial: $4,772.80 CDPHP — Medicaid: $2,612.48 Cigna — Commercial: $4,873.28 MVP — Commercial: $4,390.98 MVP — Medicaid: $5,024 MVP Essential — Commercial: $5,024 UHC — Commercial: $4,772.80
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ABDOMINAL COMPLETE ULTRASOUND	$1,183.50	$1,183.50	$591.75 – $1,183.50
Ultrasound of the abdomen, complete: rates for 10 insurance plans Aetna — Commercial: $1,071.07 Aetna — Medicare Advantage: $591.75 BCBS — Commercial: $1,120.77 CDPHP — Commercial: $1,124.32 CDPHP — Medicaid: $615.42 Cigna — Commercial: $1,147.99 MVP — Commercial: $1,034.38 MVP — Medicaid: $1,183.50 MVP Essential — Commercial: $1,183.50 UHC — Commercial: $1,124.32
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ABDOMINAL COMPLETE ULTRASOUND	$1,183.50	$1,183.50	$501.80 – $1,147.99
Ultrasound of the abdomen, complete: rates for 8 insurance plans Aetna — Commercial: $1,071.07 Aetna — Medicare Advantage: $591.75 BCBS — Commercial: $1,120.77 CDPHP — Commercial: $1,124.32 Cigna — Commercial: $1,147.99 Martin's Point — Commercial: $501.80 MVP — Commercial: $1,034.38 UHC — Commercial: $1,124.32
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$82.20 – $120.84
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $120.84 BCBS — Medicare Advantage: $120.84 CDPHP — Medicare Advantage: $120.84 Fidelis — Medicaid: $82.20 Fidelis — Medicare Advantage: $120.84 Fidelis Exchange — Commercial: $86.31 Humana — Medicare Advantage: $120.84 Martin's Point — Commercial: $120.84 MVP — Medicare Advantage: $120.84 UHC — Medicaid: $82.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG >14 WEEKS SINGLE COMP.	$1,193.50	$1,193.50	$596.75 – $1,193.50
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans Aetna — Commercial: $1,080.12 Aetna — Medicare Advantage: $596.75 BCBS — Commercial: $1,130.24 CDPHP — Commercial: $1,133.82 CDPHP — Medicaid: $620.62 Cigna — Commercial: $1,157.70 MVP — Commercial: $1,043.12 MVP — Medicaid: $1,193.50 MVP Essential — Commercial: $1,193.50 UHC — Commercial: $1,133.82
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PREG >14 WEEKS SINGLE COMP.	$1,193.50	$1,193.50	$506.04 – $1,157.70
Pregnancy ultrasound (after the first trimester): rates for 8 insurance plans Aetna — Commercial: $1,080.12 Aetna — Medicare Advantage: $596.75 BCBS — Commercial: $1,130.24 CDPHP — Commercial: $1,133.82 Cigna — Commercial: $1,157.70 Martin's Point — Commercial: $506.04 MVP — Commercial: $1,043.12 UHC — Commercial: $1,133.82
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$82.20 – $120.84
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $120.84 BCBS — Medicare Advantage: $120.84 CDPHP — Medicare Advantage: $120.84 Fidelis — Medicaid: $82.20 Fidelis — Medicare Advantage: $120.84 Fidelis Exchange — Commercial: $86.31 Humana — Medicare Advantage: $120.84 Martin's Point — Commercial: $120.84 MVP — Medicare Advantage: $120.84 UHC — Medicaid: $82.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL ULTRASOUND ED	$823	$823	$411.50 – $823
Transvaginal ultrasound: rates for 10 insurance plans Aetna — Commercial: $744.82 Aetna — Medicare Advantage: $411.50 BCBS — Commercial: $779.38 CDPHP — Commercial: $781.85 CDPHP — Medicaid: $427.96 Cigna — Commercial: $798.31 MVP — Commercial: $719.30 MVP — Medicaid: $823 MVP Essential — Commercial: $823 UHC — Commercial: $781.85
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL ULTRASOUND	$823	$823	$411.50 – $823
Transvaginal ultrasound: rates for 10 insurance plans Aetna — Commercial: $744.82 Aetna — Medicare Advantage: $411.50 BCBS — Commercial: $779.38 CDPHP — Commercial: $781.85 CDPHP — Medicaid: $427.96 Cigna — Commercial: $798.31 MVP — Commercial: $719.30 MVP — Medicaid: $823 MVP Essential — Commercial: $823 UHC — Commercial: $781.85
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TRANSVAGINAL ULTRASOUND ED	$823	$823	$348.95 – $798.31
Transvaginal ultrasound: rates for 8 insurance plans Aetna — Commercial: $744.82 Aetna — Medicare Advantage: $411.50 BCBS — Commercial: $779.38 CDPHP — Commercial: $781.85 Cigna — Commercial: $798.31 Martin's Point — Commercial: $348.95 MVP — Commercial: $719.30 UHC — Commercial: $781.85
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$75.36 – $85.15
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $85.15 BCBS — Medicare Advantage: $85.15 CDPHP — Medicare Advantage: $85.15 Fidelis — Medicaid: $75.36 Fidelis — Medicare Advantage: $85.15 Fidelis Exchange — Commercial: $79.13 Humana — Medicare Advantage: $85.15 Martin's Point — Commercial: $85.15 MVP — Medicare Advantage: $85.15 UHC — Medicaid: $75.36
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$120.35
Diagnostic mammogram, one breast: rates for 1 insurance plan Aetna — Commercial: $120.35
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: DX LT DIGITAL MAMMO /CAD	$750.50	$750.50	$375.25 – $750.50
Diagnostic mammogram, one breast: rates for 10 insurance plans Aetna — Commercial: $679.20 Aetna — Medicare Advantage: $375.25 BCBS — Commercial: $710.72 CDPHP — Commercial: $712.98 CDPHP — Medicaid: $390.26 Cigna — Commercial: $727.98 MVP — Commercial: $655.94 MVP — Medicaid: $750.50 MVP Essential — Commercial: $750.50 UHC — Commercial: $712.98
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX BILAT MAMM0 DIGITAL W/CAD	$900.25	$900.25	$450.12 – $900.25
Diagnostic mammogram, both breasts: rates for 10 insurance plans Aetna — Commercial: $814.73 Aetna — Medicare Advantage: $450.12 BCBS — Commercial: $852.54 CDPHP — Commercial: $855.24 CDPHP — Medicaid: $468.13 Cigna — Commercial: $873.24 MVP — Commercial: $786.82 MVP — Medicaid: $900.25 MVP Essential — Commercial: $900.25 UHC — Commercial: $855.24
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DX BILAT MAMM0 DIGITAL W/CAD	$900.25	$900.25	$381.71 – $873.24
Diagnostic mammogram, both breasts: rates for 8 insurance plans Aetna — Commercial: $814.73 Aetna — Medicare Advantage: $450.12 BCBS — Commercial: $852.54 CDPHP — Commercial: $855.24 Cigna — Commercial: $873.24 Martin's Point — Commercial: $381.71 MVP — Commercial: $786.82 UHC — Commercial: $855.24
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$96.06 – $109.13
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $109.13 BCBS — Medicare Advantage: $109.13 CDPHP — Medicare Advantage: $109.13 Fidelis — Medicaid: $96.06 Fidelis — Medicare Advantage: $109.13 Fidelis Exchange — Commercial: $100.86 Humana — Medicare Advantage: $109.13 Martin's Point — Commercial: $109.12 MVP — Medicare Advantage: $109.13 UHC — Medicaid: $96.06
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREEN BILAT MAMMO DIGITAL/CAD	$816.25	$816.25	$408.12 – $816.25
Screening mammogram, both breasts: rates for 10 insurance plans Aetna — Commercial: $738.71 Aetna — Medicare Advantage: $408.12 BCBS — Commercial: $772.99 CDPHP — Commercial: $775.44 CDPHP — Medicaid: $424.45 Cigna — Commercial: $791.76 MVP — Commercial: $713.40 MVP — Medicaid: $816.25 MVP Essential — Commercial: $816.25 UHC — Commercial: $775.44
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SCREEN BILAT MAMMO DIGITAL/CAD	$816.25	$816.25	$346.09 – $791.76
Screening mammogram, both breasts: rates for 8 insurance plans Aetna — Commercial: $738.71 Aetna — Medicare Advantage: $408.12 BCBS — Commercial: $772.99 CDPHP — Commercial: $775.44 Cigna — Commercial: $791.76 Martin's Point — Commercial: $346.09 MVP — Commercial: $713.40 UHC — Commercial: $775.44
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$79.52 – $90.12
Screening mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $90.11 BCBS — Medicare Advantage: $90.11 CDPHP — Medicare Advantage: $90.11 Fidelis — Medicaid: $79.52 Fidelis — Medicare Advantage: $90.11 Fidelis Exchange — Commercial: $83.50 Humana — Medicare Advantage: $90.11 Martin's Point — Commercial: $90.12 MVP — Medicare Advantage: $90.11 UHC — Medicaid: $79.52

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: Electrocardiogram complete	Not listed in the file	Not listed in the file	$9.65 – $25.58
Electrocardiogram (ECG/EKG) with reading: 10 of 19 insurance plan rates Aetna — Commercial: $13.54 Aetna — Medicare Advantage: $14.94 BCBS — Commercial: $25.58 BCBS — Medicare Advantage: $14.94 CDPHP — Commercial: $14.94 CDPHP — Medicare Advantage: $14.94 Cigna — Commercial: $23.29 Fidelis — Medicaid: $11.99 Fidelis — Medicare Advantage: $14.94 Fidelis Exchange — Commercial: $12.59
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	$11.99 – $14.94
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Fidelis — Medicaid: $11.99 Fidelis Exchange — Commercial: $12.59 Martin's Point — Commercial: $14.94 UHC — Medicaid: $11.99
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	$2,486.28 – $3,747.17
Left heart catheterization (diagnostic): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $3,747.17 BCBS — Medicare Advantage: $3,747.17 CDPHP — Medicare Advantage: $3,747.17 Fidelis — Medicaid: $2,486.28 Fidelis — Medicare Advantage: $3,747.17 Fidelis Exchange — Commercial: $2,610.59 Humana — Medicare Advantage: $3,747.17 Martin's Point — Commercial: $3,747.17 MVP — Medicare Advantage: $3,747.17 UHC — Medicaid: $2,486.28
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$811.85
Left heart catheterization (diagnostic): rates for 1 insurance plan Aetna — Commercial: $811.85
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$157.18 – $343.87
Left heart catheterization (diagnostic): 10 of 19 insurance plan rates Aetna — Commercial: $209.57 Aetna — Medicare Advantage: $216.55 BCBS — Commercial: $261.68 BCBS — Medicare Advantage: $216.55 CDPHP — Commercial: $216.55 CDPHP — Medicare Advantage: $216.55 Cigna — Commercial: $343.87 Fidelis — Medicaid: $184.11 Fidelis — Medicare Advantage: $216.55 Fidelis Exchange — Commercial: $193.32
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	$5,865.60 – $9,015.20
Heart rhythm study (electrophysiology evaluation): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $9,015.20 BCBS — Medicare Advantage: $9,015.20 CDPHP — Medicare Advantage: $9,015.20 Fidelis — Medicaid: $5,865.60 Fidelis — Medicare Advantage: $9,015.20 Fidelis Exchange — Commercial: $6,158.88 Humana — Medicare Advantage: $9,015.20 Martin's Point — Commercial: $9,015.20 MVP — Medicare Advantage: $9,015.20 UHC — Medicaid: $5,865.60
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$255.66 – $550.41
Heart rhythm study (electrophysiology evaluation): 10 of 19 insurance plan rates Aetna — Commercial: $340.88 Aetna — Medicare Advantage: $352.80 BCBS — Commercial: $542.02 BCBS — Medicare Advantage: $352.80 CDPHP — Commercial: $352.80 CDPHP — Medicare Advantage: $352.80 Cigna — Commercial: $550.41 Fidelis — Medicaid: $299.67 Fidelis — Medicare Advantage: $352.80 Fidelis Exchange — Commercial: $314.65
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier TC In the file: Comprehensive ep evaluation	Not listed in the file	Not listed in the file	$242.57 – $446.32
Heart rhythm study (electrophysiology evaluation): 10 of 15 insurance plan rates Aetna — Medicare Advantage: $323.42 BCBS — Commercial: $392.27 BCBS — Medicare Advantage: $323.42 CDPHP — Commercial: $323.42 CDPHP — Medicare Advantage: $323.42 Cigna — Commercial: $426.93 Fidelis — Medicare Advantage: $323.42 Humana — Medicare Advantage: $323.42 MVP — Commercial: $446.32 MVP — Medicaid: $242.57
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Compre ep eval abltj atr fib	Not listed in the file	Not listed in the file	$595.43 – $1,559.05
Heart rhythm study with ablation for atrial fibrillation: 10 of 19 insurance plan rates Aetna — Commercial: $835.68 Aetna — Medicare Advantage: $740.89 BCBS — Commercial: $1,297.94 BCBS — Medicare Advantage: $740.89 CDPHP — Commercial: $740.89 CDPHP — Medicare Advantage: $740.89 Cigna — Commercial: $1,538.95 Fidelis — Medicaid: $734.90 Fidelis — Medicare Advantage: $740.89 Fidelis Exchange — Commercial: $771.65
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	$18,963.47 – $30,211.30
Heart rhythm study with ablation for atrial fibrillation: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $30,211.29 BCBS — Medicare Advantage: $30,211.29 CDPHP — Medicare Advantage: $30,211.29 Fidelis — Medicaid: $18,963.47 Fidelis — Medicare Advantage: $30,211.29 Fidelis Exchange — Commercial: $19,911.64 Humana — Medicare Advantage: $30,211.29 Martin's Point — Commercial: $30,211.30 MVP — Medicare Advantage: $30,211.29 UHC — Medicaid: $18,963.47
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY	$7,054.75	$7,054.75	$3,527.38 – $7,054.75
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans Aetna — Commercial: $6,384.55 Aetna — Medicare Advantage: $3,527.38 BCBS — Commercial: $6,680.85 CDPHP — Commercial: $6,702.01 CDPHP — Medicaid: $3,668.47 Cigna — Commercial: $6,843.11 MVP — Commercial: $6,165.85 MVP — Medicaid: $7,054.75 MVP Essential — Commercial: $7,054.75 UHC — Commercial: $6,702.01
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOMNOGRAPHY	$7,054.75	$7,054.75	$2,991.21 – $6,843.11
Sleep study (overnight, in a sleep lab): rates for 8 insurance plans Aetna — Commercial: $6,384.55 Aetna — Medicare Advantage: $3,527.38 BCBS — Commercial: $6,680.85 CDPHP — Commercial: $6,702.01 Cigna — Commercial: $6,843.11 Martin's Point — Commercial: $2,991.21 MVP — Commercial: $6,165.85 UHC — Commercial: $6,702.01
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$786.44 – $992.57
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $992.57 BCBS — Medicare Advantage: $992.57 CDPHP — Medicare Advantage: $992.57 Fidelis — Medicaid: $786.44 Fidelis — Medicare Advantage: $992.57 Fidelis Exchange — Commercial: $825.76 Humana — Medicare Advantage: $992.57 Martin's Point — Commercial: $992.57 MVP — Medicare Advantage: $992.57 UHC — Medicaid: $786.44

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC PROCEDURE(SPEECH)	$177.25	$177.25	$88.62 – $177.25
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans Aetna — Commercial: $160.41 Aetna — Medicare Advantage: $88.62 BCBS — Commercial: $167.86 CDPHP — Commercial: $168.39 CDPHP — Medicaid: $92.17 Cigna — Commercial: $171.93 MVP — Commercial: $154.92 MVP — Medicaid: $177.25 MVP Essential — Commercial: $177.25 UHC — Commercial: $168.39
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THERAPEUTIC PROCEDURE(SPEECH)	$177.25	$177.25	$75.15 – $171.93
Physical therapy: therapeutic exercise (each 15 minutes): rates for 8 insurance plans Aetna — Commercial: $160.41 Aetna — Medicare Advantage: $88.62 BCBS — Commercial: $167.86 CDPHP — Commercial: $168.39 Cigna — Commercial: $171.93 Martin's Point — Commercial: $75.15 MVP — Commercial: $154.92 UHC — Commercial: $168.39
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$20.33 – $44.41
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates Aetna — Commercial: $28.54 Aetna — Medicare Advantage: $28.76 BCBS — Commercial: $31.54 BCBS — Medicare Advantage: $28.76 CDPHP — Commercial: $28.76 CDPHP — Medicare Advantage: $28.76 Cigna — Commercial: $44.41 Fidelis — Medicaid: $25.20 Fidelis — Medicare Advantage: $28.76 Fidelis Exchange — Commercial: $26.46
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$69.16 – $134.19
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates Aetna — Commercial: $97.06 Aetna — Medicare Advantage: $97.24 BCBS — Commercial: $88.32 BCBS — Medicare Advantage: $97.24 CDPHP — Commercial: $97.24 CDPHP — Medicare Advantage: $97.24 Cigna — Commercial: $110.47 Fidelis — Medicaid: $85.69 Fidelis — Medicare Advantage: $97.24 Fidelis Exchange — Commercial: $89.97
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	$85.69 – $97.24
Physical therapy evaluation (low complexity): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $97.24 BCBS — Medicare Advantage: $97.24 CDPHP — Medicare Advantage: $97.24 Fidelis — Medicaid: $85.69 Fidelis — Medicare Advantage: $97.24 Fidelis Exchange — Commercial: $89.97 Humana — Medicare Advantage: $97.24 Martin's Point — Commercial: $97.23 MVP — Medicare Advantage: $97.24 UHC — Medicaid: $85.69
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVALUATION-LOW COMPEX DVHC	$354.25	$354.25	$177.12 – $354.25
Physical therapy evaluation (low complexity): rates for 10 insurance plans Aetna — Commercial: $320.60 Aetna — Medicare Advantage: $177.12 BCBS — Commercial: $335.47 CDPHP — Commercial: $336.54 CDPHP — Medicaid: $184.21 Cigna — Commercial: $343.62 MVP — Commercial: $309.61 MVP — Medicaid: $354.25 MVP Essential — Commercial: $354.25 UHC — Commercial: $336.54
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$69.16 – $134.19
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates Aetna — Commercial: $97.06 Aetna — Medicare Advantage: $97.24 BCBS — Commercial: $88.32 BCBS — Medicare Advantage: $97.24 CDPHP — Commercial: $97.24 CDPHP — Medicare Advantage: $97.24 Cigna — Commercial: $110.47 Fidelis — Medicaid: $85.69 Fidelis — Medicare Advantage: $97.24 Fidelis Exchange — Commercial: $89.97
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	$85.69 – $97.24
Physical therapy evaluation (moderate complexity): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $97.24 BCBS — Medicare Advantage: $97.24 CDPHP — Medicare Advantage: $97.24 Fidelis — Medicaid: $85.69 Fidelis — Medicare Advantage: $97.24 Fidelis Exchange — Commercial: $89.97 Humana — Medicare Advantage: $97.24 Martin's Point — Commercial: $97.23 MVP — Medicare Advantage: $97.24 UHC — Medicaid: $85.69
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVALUATION-MOD COMPEX DVHC	$354.25	$354.25	$177.12 – $354.25
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans Aetna — Commercial: $320.60 Aetna — Medicare Advantage: $177.12 BCBS — Commercial: $335.47 CDPHP — Commercial: $336.54 CDPHP — Medicaid: $184.21 Cigna — Commercial: $343.62 MVP — Commercial: $309.61 MVP — Medicaid: $354.25 MVP Essential — Commercial: $354.25 UHC — Commercial: $336.54
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$69.16 – $134.19
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates Aetna — Commercial: $97.06 Aetna — Medicare Advantage: $97.24 BCBS — Commercial: $88.32 BCBS — Medicare Advantage: $97.24 CDPHP — Commercial: $97.24 CDPHP — Medicare Advantage: $97.24 Cigna — Commercial: $110.47 Fidelis — Medicaid: $85.69 Fidelis — Medicare Advantage: $97.24 Fidelis Exchange — Commercial: $89.97
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	$85.69 – $97.24
Physical therapy evaluation (high complexity): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $97.24 BCBS — Medicare Advantage: $97.24 CDPHP — Medicare Advantage: $97.24 Fidelis — Medicaid: $85.69 Fidelis — Medicare Advantage: $97.24 Fidelis Exchange — Commercial: $89.97 Humana — Medicare Advantage: $97.24 Martin's Point — Commercial: $97.23 MVP — Medicare Advantage: $97.24 UHC — Medicaid: $85.69
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVALUATION-HIGH COMPL DVHC	$354.25	$354.25	$177.12 – $354.25
Physical therapy evaluation (high complexity): rates for 10 insurance plans Aetna — Commercial: $320.60 Aetna — Medicare Advantage: $177.12 BCBS — Commercial: $335.47 CDPHP — Commercial: $336.54 CDPHP — Medicaid: $184.21 Cigna — Commercial: $343.62 MVP — Commercial: $309.61 MVP — Medicaid: $354.25 MVP Essential — Commercial: $354.25 UHC — Commercial: $336.54
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psytx w pt 30 minutes	Not listed in the file	Not listed in the file	$55.70 – $95.59
Psychotherapy, 30 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $78.18 Aetna — Medicare Advantage: $69.27 BCBS — Commercial: $77.08 BCBS — Medicare Advantage: $69.27 CDPHP — Commercial: $69.27 CDPHP — Medicare Advantage: $69.27 Cigna — Commercial: $86.58 Fidelis — Medicaid: $59.63 Fidelis — Medicare Advantage: $69.27 Fidelis Exchange — Commercial: $62.61
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	$124.20 – $205.16
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $205.16 BCBS — Medicare Advantage: $205.16 CDPHP — Medicare Advantage: $205.16 Fidelis — Medicaid: $124.20 Fidelis — Medicare Advantage: $205.16 Fidelis Exchange — Commercial: $130.41 Humana — Medicare Advantage: $205.16 Martin's Point — Commercial: $205.16 MVP — Medicare Advantage: $205.16 UHC — Medicaid: $124.20
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psytx w pt 45 minutes	Not listed in the file	Not listed in the file	$73.54 – $126.23
Psychotherapy, 45 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $103.21 Aetna — Medicare Advantage: $91.47 BCBS — Commercial: $101.95 BCBS — Medicare Advantage: $91.47 CDPHP — Commercial: $91.47 CDPHP — Medicare Advantage: $91.47 Cigna — Commercial: $115.22 Fidelis — Medicaid: $78.70 Fidelis — Medicare Advantage: $91.47 Fidelis Exchange — Commercial: $82.64
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	$124.20 – $205.16
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $205.16 BCBS — Medicare Advantage: $205.16 CDPHP — Medicare Advantage: $205.16 Fidelis — Medicaid: $124.20 Fidelis — Medicare Advantage: $205.16 Fidelis Exchange — Commercial: $130.41 Humana — Medicare Advantage: $205.16 Martin's Point — Commercial: $205.16 MVP — Medicare Advantage: $205.16 UHC — Medicaid: $124.20
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Psytx w pt 60 minutes	Not listed in the file	Not listed in the file	$108.88 – $186.11
Psychotherapy, 60 minutes: 10 of 19 insurance plan rates Aetna — Commercial: $152.81 Aetna — Medicare Advantage: $134.86 BCBS — Commercial: $150.56 BCBS — Medicare Advantage: $134.86 CDPHP — Commercial: $134.86 CDPHP — Medicare Advantage: $134.86 Cigna — Commercial: $172.50 Fidelis — Medicaid: $116.43 Fidelis — Medicare Advantage: $134.86 Fidelis Exchange — Commercial: $122.25
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	$124.20 – $205.16
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $205.16 BCBS — Medicare Advantage: $205.16 CDPHP — Medicare Advantage: $205.16 Fidelis — Medicaid: $124.20 Fidelis — Medicare Advantage: $205.16 Fidelis Exchange — Commercial: $130.41 Humana — Medicare Advantage: $205.16 Martin's Point — Commercial: $205.16 MVP — Medicare Advantage: $205.16 UHC — Medicaid: $124.20
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Family psytx w/o pt 50 min	Not listed in the file	Not listed in the file	$69.57 – $142.24
Family psychotherapy, without the patient: 10 of 19 insurance plan rates Aetna — Commercial: $97.64 Aetna — Medicare Advantage: $98.64 BCBS — Commercial: $105.16 BCBS — Medicare Advantage: $98.64 CDPHP — Commercial: $98.64 CDPHP — Medicare Advantage: $98.64 Cigna — Commercial: $139.45 Fidelis — Medicaid: $85.07 Fidelis — Medicare Advantage: $98.64 Fidelis Exchange — Commercial: $89.32
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	$124.20 – $205.16
Family psychotherapy, without the patient: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $205.16 BCBS — Medicare Advantage: $205.16 CDPHP — Medicare Advantage: $205.16 Fidelis — Medicaid: $124.20 Fidelis — Medicare Advantage: $205.16 Fidelis Exchange — Commercial: $130.41 Humana — Medicare Advantage: $205.16 Martin's Point — Commercial: $205.16 MVP — Medicare Advantage: $205.16 UHC — Medicaid: $124.20
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Family psytx w/pt 50 min	Not listed in the file	Not listed in the file	$72.56 – $147.80
Family psychotherapy, with the patient: 10 of 19 insurance plan rates Aetna — Commercial: $101.84 Aetna — Medicare Advantage: $102.48 BCBS — Commercial: $108.45 BCBS — Medicare Advantage: $102.48 CDPHP — Commercial: $102.48 CDPHP — Medicare Advantage: $102.48 Cigna — Commercial: $144.35 Fidelis — Medicaid: $88.75 Fidelis — Medicare Advantage: $102.48 Fidelis Exchange — Commercial: $93.19
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	$124.20 – $205.16
Family psychotherapy, with the patient: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $205.16 BCBS — Medicare Advantage: $205.16 CDPHP — Medicare Advantage: $205.16 Fidelis — Medicaid: $124.20 Fidelis — Medicare Advantage: $205.16 Fidelis Exchange — Commercial: $130.41 Humana — Medicare Advantage: $205.16 Martin's Point — Commercial: $205.16 MVP — Medicare Advantage: $205.16 UHC — Medicaid: $124.20
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Group psychotherapy	Not listed in the file	Not listed in the file	$19.79 – $40.58
Group psychotherapy: 10 of 19 insurance plan rates Aetna — Commercial: $27.78 Aetna — Medicare Advantage: $24.20 BCBS — Commercial: $40.58 BCBS — Medicare Advantage: $24.20 CDPHP — Commercial: $24.20 CDPHP — Medicare Advantage: $24.20 Cigna — Commercial: $34.53 Fidelis — Medicaid: $20.92 Fidelis — Medicare Advantage: $24.20 Fidelis Exchange — Commercial: $21.97
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	$71.50 – $117.42
Group psychotherapy: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $117.42 BCBS — Medicare Advantage: $117.42 CDPHP — Medicare Advantage: $117.42 Fidelis — Medicaid: $71.50 Fidelis — Medicare Advantage: $117.42 Fidelis Exchange — Commercial: $75.08 Humana — Medicare Advantage: $117.42 Martin's Point — Commercial: $117.42 MVP — Medicare Advantage: $117.42 UHC — Medicaid: $71.50

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	$2,960.03 – $4,525.63
Removal of breast growth (open surgery): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $4,525.63 BCBS — Medicare Advantage: $4,525.63 CDPHP — Medicare Advantage: $4,525.63 Fidelis — Medicaid: $2,960.03 Fidelis — Medicare Advantage: $4,525.63 Fidelis Exchange — Commercial: $3,108.03 Humana — Medicare Advantage: $4,525.63 Martin's Point — Commercial: $4,525.63 MVP — Medicare Advantage: $4,525.63 UHC — Medicaid: $2,960.03
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$485.76
Removal of breast growth (open surgery): rates for 1 insurance plan Aetna — Commercial: $485.76
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$0.71 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $410.98
Removal of breast growth (open surgery): 10 of 19 insurance plan rates Aetna — Commercial: $276.02 Aetna — Medicare Advantage: $271.38 BCBS — Commercial: $402.64 BCBS — Medicare Advantage: $271.38 CDPHP — Commercial: $271.38 CDPHP — Medicare Advantage: $271.38 Cigna — Commercial: $399.23 Fidelis — Medicaid: $0.71 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $271.38 Fidelis Exchange — Commercial: $0.75 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$9,946.05 – $14,839.52
Total hip replacement: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $14,839.52 BCBS — Medicare Advantage: $14,839.52 CDPHP — Medicare Advantage: $14,839.52 Fidelis — Medicaid: $9,946.05 Fidelis — Medicare Advantage: $14,839.52 Fidelis Exchange — Commercial: $10,443.35 Humana — Medicare Advantage: $14,839.52 Martin's Point — Commercial: $14,839.52 MVP — Medicare Advantage: $14,839.52 UHC — Medicaid: $9,946.05
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$1,193.57
Total hip replacement: rates for 1 insurance plan Aetna — Commercial: $1,193.57
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$0.69 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,711.91
Total hip replacement: 10 of 19 insurance plan rates Aetna — Commercial: $823.56 Aetna — Medicare Advantage: $753 BCBS — Commercial: $1,711.91 BCBS — Medicare Advantage: $753 CDPHP — Commercial: $753 CDPHP — Medicare Advantage: $753 Cigna — Commercial: $1,282.19 Fidelis — Medicaid: $0.69 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $753 Fidelis Exchange — Commercial: $0.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$9,946.05 – $14,839.52
Total knee replacement: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $14,839.52 BCBS — Medicare Advantage: $14,839.52 CDPHP — Medicare Advantage: $14,839.52 Fidelis — Medicaid: $9,946.05 Fidelis — Medicare Advantage: $14,839.52 Fidelis Exchange — Commercial: $10,443.35 Humana — Medicare Advantage: $14,839.52 Martin's Point — Commercial: $14,839.52 MVP — Medicare Advantage: $14,839.52 UHC — Medicaid: $9,946.05
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$1,192.12
Total knee replacement: rates for 1 insurance plan Aetna — Commercial: $1,192.12
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$0.69 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,827.06
Total knee replacement: 10 of 19 insurance plan rates Aetna — Commercial: $822.56 Aetna — Medicare Advantage: $751.51 BCBS — Commercial: $1,827.06 BCBS — Medicare Advantage: $751.51 CDPHP — Commercial: $751.51 CDPHP — Medicare Advantage: $751.51 Cigna — Commercial: $1,281.84 Fidelis — Medicaid: $0.69 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $751.51 Fidelis Exchange — Commercial: $0.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$138.25 – $157.03
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans Aetna — Commercial: $157.03 Fidelis — Medicaid: $138.25 Fidelis Exchange — Commercial: $145.16 UHC — Medicaid: $138.25
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 50 In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$167.83 – $837.11
Shoulder arthroscopy: shaving of shoulder bone: 10 of 16 insurance plan rates Aetna — Commercial: $235.55 Aetna — Medicare Advantage: $206.64 BCBS — Commercial: $837.11 BCBS — Medicare Advantage: $206.64 CDPHP — Commercial: $206.64 CDPHP — Medicare Advantage: $206.64 Cigna — Commercial: $361.16 Fidelis — Medicare Advantage: $206.64 Humana — Medicare Advantage: $206.64 MVP — Commercial: $285.16
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 80\|81\|82 In the file: Sho arthrs srg decompression	Not listed in the file	Not listed in the file	$21.48 – $89.29
Shoulder arthroscopy: shaving of shoulder bone: 10 of 11 insurance plan rates Aetna — Commercial: $25.12 Aetna — Medicare Advantage: $22.04 BCBS — Commercial: $89.29 CDPHP — Commercial: $22.04 CDPHP — Medicare Advantage: $22.04 Cigna — Commercial: $38.52 Humana — Medicare Advantage: $22.04 MVP — Commercial: $30.42 MVP Essential — Commercial: $21.48 UHC — Commercial: $38.99
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	$2,508.08 – $3,781.93
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $3,781.93 BCBS — Medicare Advantage: $3,781.93 CDPHP — Medicare Advantage: $3,781.93 Fidelis — Medicaid: $2,508.08 Fidelis — Medicare Advantage: $3,781.93 Fidelis Exchange — Commercial: $2,633.48 Humana — Medicare Advantage: $3,781.93 Martin's Point — Commercial: $3,781.93 MVP — Medicare Advantage: $3,781.93 UHC — Medicaid: $2,508.08
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Arthrs kne srg mnisectmy m/l	Not listed in the file	Not listed in the file	$514.71
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 1 insurance plan Aetna — Commercial: $514.71
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Arthrs kne srg mnisectmy m/l	Not listed in the file	Not listed in the file	$0.69 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $730.56
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 19 insurance plan rates Aetna — Commercial: $355.15 Aetna — Medicare Advantage: $338.24 BCBS — Commercial: $730.56 BCBS — Medicare Advantage: $338.24 CDPHP — Commercial: $338.24 CDPHP — Medicare Advantage: $338.24 Cigna — Commercial: $513.66 Fidelis — Medicaid: $0.69 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $338.24 Fidelis Exchange — Commercial: $0.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$4,572.81 – $6,842.41
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $6,842.41 BCBS — Medicare Advantage: $6,842.41 CDPHP — Medicare Advantage: $6,842.41 Fidelis — Medicaid: $4,572.81 Fidelis — Medicare Advantage: $6,842.41 Fidelis Exchange — Commercial: $4,801.45 Humana — Medicare Advantage: $6,842.41 Martin's Point — Commercial: $6,842.41 MVP — Medicare Advantage: $6,842.41 UHC — Medicaid: $4,572.81
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$277.13
Removal of tonsils and adenoids (under age 12): rates for 1 insurance plan Aetna — Commercial: $277.13
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$0.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $357.41
Removal of tonsils and adenoids (under age 12): 10 of 19 insurance plan rates Aetna — Commercial: $224.48 Aetna — Medicare Advantage: $202.57 BCBS — Commercial: $357.41 BCBS — Medicare Advantage: $202.57 CDPHP — Commercial: $202.57 CDPHP — Medicare Advantage: $202.57 Cigna — Commercial: $328.60 Fidelis — Medicaid: $0.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $202.57 Fidelis Exchange — Commercial: $0.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Panendoscopy dx	$2,379.50	$2,379.50	$1,189.75 – $2,379.50
Upper GI endoscopy (diagnostic): rates for 10 insurance plans Aetna — Commercial: $2,153.45 Aetna — Medicare Advantage: $1,189.75 BCBS — Commercial: $2,253.39 CDPHP — Commercial: $2,260.52 CDPHP — Medicaid: $1,237.34 Cigna — Commercial: $2,308.11 MVP — Commercial: $2,079.68 MVP — Medicaid: $2,379.50 MVP Essential — Commercial: $2,379.50 UHC — Commercial: $2,260.52
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UPPER GASTROINTESTINAL ENDO	$709.50	$709.50	$354.75 – $709.50
Upper GI endoscopy (diagnostic): rates for 10 insurance plans Aetna — Commercial: $642.10 Aetna — Medicare Advantage: $354.75 BCBS — Commercial: $671.90 CDPHP — Commercial: $674.02 CDPHP — Medicaid: $368.94 Cigna — Commercial: $688.22 MVP — Commercial: $620.10 MVP — Medicaid: $709.50 MVP Essential — Commercial: $709.50 UHC — Commercial: $674.02
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Panendoscopy dx	$2,379.50	$2,379.50	$1,008.91 – $2,308.11
Upper GI endoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial: $2,153.45 Aetna — Medicare Advantage: $1,189.75 BCBS — Commercial: $2,253.39 CDPHP — Commercial: $2,260.52 Cigna — Commercial: $2,308.11 Martin's Point — Commercial: $1,008.91 MVP — Commercial: $2,079.68 UHC — Commercial: $2,260.52
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD WITH BIOPSY	$1,966.50	$1,966.50	$983.25 – $1,966.50
Upper GI endoscopy with biopsy: rates for 10 insurance plans Aetna — Commercial: $1,779.68 Aetna — Medicare Advantage: $983.25 BCBS — Commercial: $1,862.28 CDPHP — Commercial: $1,868.18 CDPHP — Medicaid: $1,022.58 Cigna — Commercial: $1,907.50 MVP — Commercial: $1,718.72 MVP — Medicaid: $1,966.50 MVP Essential — Commercial: $1,966.50 UHC — Commercial: $1,868.18
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UP GASTROINTESTINAL ENDO W BIO	$815.75	$815.75	$407.88 – $815.75
Upper GI endoscopy with biopsy: rates for 10 insurance plans Aetna — Commercial: $738.25 Aetna — Medicare Advantage: $407.88 BCBS — Commercial: $772.52 CDPHP — Commercial: $774.96 CDPHP — Medicaid: $424.19 Cigna — Commercial: $791.28 MVP — Commercial: $712.97 MVP — Medicaid: $815.75 MVP Essential — Commercial: $815.75 UHC — Commercial: $774.96
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD WITH BIOPSY	$1,966.50	$1,966.50	$833.80 – $1,907.50
Upper GI endoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial: $1,779.68 Aetna — Medicare Advantage: $983.25 BCBS — Commercial: $1,862.28 CDPHP — Commercial: $1,868.18 Cigna — Commercial: $1,907.50 Martin's Point — Commercial: $833.80 MVP — Commercial: $1,718.72 UHC — Commercial: $1,868.18
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLEX DIAG W/WO	$927.25	$927.25	$463.62 – $927.25
Colonoscopy (diagnostic): rates for 10 insurance plans Aetna — Commercial: $839.16 Aetna — Medicare Advantage: $463.62 BCBS — Commercial: $878.11 CDPHP — Commercial: $880.89 CDPHP — Medicaid: $482.17 Cigna — Commercial: $899.43 MVP — Commercial: $810.42 MVP — Medicaid: $927.25 MVP Essential — Commercial: $927.25 UHC — Commercial: $880.89
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY FLEX DIAG W/WO	$927.25	$927.25	$393.15 – $899.43
Colonoscopy (diagnostic): rates for 8 insurance plans Aetna — Commercial: $839.16 Aetna — Medicare Advantage: $463.62 BCBS — Commercial: $878.11 CDPHP — Commercial: $880.89 Cigna — Commercial: $899.43 Martin's Point — Commercial: $393.15 MVP — Commercial: $810.42 UHC — Commercial: $880.89
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$704.75 – $1,074.89
Colonoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,074.89 BCBS — Medicare Advantage: $1,074.89 CDPHP — Medicare Advantage: $1,074.89 Fidelis — Medicaid: $704.75 Fidelis — Medicare Advantage: $1,074.89 Fidelis Exchange — Commercial: $739.99 Humana — Medicare Advantage: $1,074.89 Martin's Point — Commercial: $1,074.89 MVP — Medicare Advantage: $1,074.89 UHC — Medicaid: $704.75
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W BIOPSY SING/MULT	$1,105	$1,105	$552.50 – $1,105
Colonoscopy with biopsy: rates for 10 insurance plans Aetna — Commercial: $1,000.02 Aetna — Medicare Advantage: $552.50 BCBS — Commercial: $1,046.44 CDPHP — Commercial: $1,049.75 CDPHP — Medicaid: $574.60 Cigna — Commercial: $1,071.85 MVP — Commercial: $965.77 MVP — Medicaid: $1,105 MVP Essential — Commercial: $1,105 UHC — Commercial: $1,049.75
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W BIOPSY SING/MULT	$1,105	$1,105	$468.52 – $1,071.85
Colonoscopy with biopsy: rates for 8 insurance plans Aetna — Commercial: $1,000.02 Aetna — Medicare Advantage: $552.50 BCBS — Commercial: $1,046.44 CDPHP — Commercial: $1,049.75 Cigna — Commercial: $1,071.85 Martin's Point — Commercial: $468.52 MVP — Commercial: $965.77 UHC — Commercial: $1,049.75
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$162.87 – $650
Colonoscopy with biopsy: 10 of 19 insurance plan rates Aetna — Commercial: $405.36 Aetna — Medicare Advantage: $170.29 BCBS — Commercial: $650 BCBS — Medicare Advantage: $170.29 CDPHP — Commercial: $170.29 CDPHP — Medicare Advantage: $170.29 Cigna — Commercial: $289.49 Fidelis — Medicaid: $162.87 Fidelis — Medicare Advantage: $170.29 Fidelis Exchange — Commercial: $171.01
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W REM TUMOR,LESION	$1,241.25	$1,241.25	$620.62 – $1,241.25
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans Aetna — Commercial: $1,123.33 Aetna — Medicare Advantage: $620.62 BCBS — Commercial: $1,175.46 CDPHP — Commercial: $1,179.19 CDPHP — Medicaid: $645.45 Cigna — Commercial: $1,204.01 MVP — Commercial: $1,084.85 MVP — Medicaid: $1,241.25 MVP Essential — Commercial: $1,241.25 UHC — Commercial: $1,179.19
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W REM TUMOR,LESION	$1,241.25	$1,241.25	$526.29 – $1,204.01
Colonoscopy with removal of polyps (snare): rates for 8 insurance plans Aetna — Commercial: $1,123.33 Aetna — Medicare Advantage: $620.62 BCBS — Commercial: $1,175.46 CDPHP — Commercial: $1,179.19 Cigna — Commercial: $1,204.01 Martin's Point — Commercial: $526.29 MVP — Commercial: $1,084.85 UHC — Commercial: $1,179.19
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$205.62 – $733.05
Colonoscopy with removal of polyps (snare): 10 of 19 insurance plan rates Aetna — Commercial: $424.77 Aetna — Medicare Advantage: $214.46 BCBS — Commercial: $733.05 BCBS — Medicare Advantage: $214.46 CDPHP — Commercial: $214.46 CDPHP — Medicare Advantage: $214.46 Cigna — Commercial: $365.39 Fidelis — Medicaid: $205.62 Fidelis — Medicare Advantage: $214.46 Fidelis Exchange — Commercial: $215.90
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$169 – $418.45
Ultrasound of the lower bowel by endoscope: 10 of 19 insurance plan rates Aetna — Commercial: $237.19 Aetna — Medicare Advantage: $217.45 BCBS — Commercial: $418.45 BCBS — Medicare Advantage: $217.45 CDPHP — Commercial: $217.45 CDPHP — Medicare Advantage: $217.45 Cigna — Commercial: $370.12 Fidelis — Medicaid: $208.73 Fidelis — Medicare Advantage: $217.45 Fidelis Exchange — Commercial: $219.17
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	$911.43 – $1,383.13
Ultrasound of the lower bowel by endoscope: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,383.13 BCBS — Medicare Advantage: $1,383.13 CDPHP — Medicare Advantage: $1,383.13 Fidelis — Medicaid: $911.43 Fidelis — Medicare Advantage: $1,383.13 Fidelis Exchange — Commercial: $957 Humana — Medicare Advantage: $1,383.13 Martin's Point — Commercial: $1,383.13 MVP — Medicare Advantage: $1,383.13 UHC — Medicaid: $911.43
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CA SCR NOT HI RISK	$927.25	$927.25	$463.62 – $927.25
Screening colonoscopy (not high risk): rates for 10 insurance plans Aetna — Commercial: $839.16 Aetna — Medicare Advantage: $463.62 BCBS — Commercial: $878.11 CDPHP — Commercial: $880.89 CDPHP — Medicaid: $482.17 Cigna — Commercial: $899.43 MVP — Commercial: $810.42 MVP — Medicaid: $927.25 MVP Essential — Commercial: $927.25 UHC — Commercial: $880.89
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLORECTAL CA SCR NOT HI RISK	$927.25	$927.25	$393.15 – $899.43
Screening colonoscopy (not high risk): rates for 8 insurance plans Aetna — Commercial: $839.16 Aetna — Medicare Advantage: $463.62 BCBS — Commercial: $878.11 CDPHP — Commercial: $880.89 Cigna — Commercial: $899.43 Martin's Point — Commercial: $393.15 MVP — Commercial: $810.42 UHC — Commercial: $880.89
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$704.75 – $1,074.89
Screening colonoscopy (not high risk): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $1,074.89 BCBS — Medicare Advantage: $1,074.89 CDPHP — Medicare Advantage: $1,074.89 Fidelis — Medicaid: $704.75 Fidelis — Medicare Advantage: $1,074.89 Fidelis Exchange — Commercial: $739.99 Humana — Medicare Advantage: $1,074.89 Martin's Point — Commercial: $1,074.89 MVP — Medicare Advantage: $1,074.89 UHC — Medicaid: $704.75
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	$4,509.96 – $6,987.69
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $6,987.69 BCBS — Medicare Advantage: $6,987.69 CDPHP — Medicare Advantage: $6,987.69 Fidelis — Medicaid: $4,509.96 Fidelis — Medicare Advantage: $6,987.69 Fidelis Exchange — Commercial: $4,735.46 Humana — Medicare Advantage: $6,987.69 Martin's Point — Commercial: $6,987.69 MVP — Medicare Advantage: $6,987.69 UHC — Medicaid: $4,509.96
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$606.44
Gallbladder removal by laparoscope: rates for 1 insurance plan Aetna — Commercial: $606.44
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$0.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $770.93
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates Aetna — Commercial: $491.22 Aetna — Medicare Advantage: $474.55 BCBS — Commercial: $770.93 BCBS — Medicare Advantage: $474.55 CDPHP — Commercial: $474.55 CDPHP — Medicare Advantage: $474.55 Cigna — Commercial: $726.93 Fidelis — Medicaid: $0.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $474.55 Fidelis Exchange — Commercial: $0.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$2,727.96 – $4,138.39
Groin (inguinal) hernia repair, age 5 or older: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $4,138.39 BCBS — Medicare Advantage: $4,138.39 CDPHP — Medicare Advantage: $4,138.39 Fidelis — Medicaid: $2,727.96 Fidelis — Medicare Advantage: $4,138.39 Fidelis Exchange — Commercial: $2,864.36 Humana — Medicare Advantage: $4,138.39 Martin's Point — Commercial: $4,138.39 MVP — Medicare Advantage: $4,138.39 UHC — Medicaid: $2,727.96
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$483.22
Groin (inguinal) hernia repair, age 5 or older: rates for 1 insurance plan Aetna — Commercial: $483.22
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$0.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $590.25
Groin (inguinal) hernia repair, age 5 or older: 10 of 19 insurance plan rates Aetna — Commercial: $391.41 Aetna — Medicare Advantage: $382.64 BCBS — Commercial: $543.26 BCBS — Medicare Advantage: $382.64 CDPHP — Commercial: $382.64 CDPHP — Medicare Advantage: $382.64 Cigna — Commercial: $575.84 Fidelis — Medicaid: $0.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $382.64 Fidelis Exchange — Commercial: $0.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$105.57 – $325.04
Prostate biopsy: rates for 7 insurance plans BCBS — Commercial: $325.04 Cigna — Commercial: $192.40 Fidelis — Medicaid: $105.57 Fidelis Exchange — Commercial: $110.85 MVP — Medicaid: $162.24 MVP Essential — Commercial: $194.69 UHC — Medicaid: $105.57
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	$1,583.50 – $1,662.68
Prostate biopsy: rates for 3 insurance plans Fidelis — Medicaid: $1,583.50 Fidelis Exchange — Commercial: $1,662.68 UHC — Medicaid: $1,583.50
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	$8,047.87 – $12,286.44
Prostate removal by laparoscope (radical prostatectomy): 10 of 12 insurance plan rates Aetna — Medicare Advantage: $12,286.44 BCBS — Medicare Advantage: $12,286.44 CDPHP — Medicare Advantage: $12,286.44 Fidelis — Medicaid: $8,047.87 Fidelis — Medicare Advantage: $12,286.44 Fidelis Exchange — Commercial: $8,450.26 Humana — Medicare Advantage: $12,286.44 Martin's Point — Commercial: $12,286.43 MVP — Medicare Advantage: $12,286.44 UHC — Medicaid: $8,047.87
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Laps surg prst8ect rpbic rad	Not listed in the file	Not listed in the file	$1,111.60
Prostate removal by laparoscope (radical prostatectomy): rates for 1 insurance plan Aetna — Commercial: $1,111.60
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Laps surg prst8ect rpbic rad	Not listed in the file	Not listed in the file	$0.83 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,038.70
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates Aetna — Commercial: $922.63 Aetna — Medicare Advantage: $857.06 BCBS — Commercial: $2,038.70 BCBS — Medicare Advantage: $857.06 CDPHP — Commercial: $857.06 CDPHP — Medicare Advantage: $857.06 Cigna — Commercial: $1,612.75 Fidelis — Medicaid: $0.83 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $857.06 Fidelis Exchange — Commercial: $0.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$2,457.78 – $3,741.61
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $3,741.61 BCBS — Medicare Advantage: $3,741.61 CDPHP — Medicare Advantage: $3,741.61 Fidelis — Medicaid: $2,457.78 Fidelis — Medicare Advantage: $3,741.61 Fidelis Exchange — Commercial: $2,580.67 Humana — Medicare Advantage: $3,741.61 Martin's Point — Commercial: $3,741.61 MVP — Medicare Advantage: $3,741.61 UHC — Medicaid: $2,457.78
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$187.39 – $1,188.76
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans Aetna — Commercial: $1,188.76 Fidelis — Medicaid: $187.39 Fidelis Exchange — Commercial: $196.76 UHC — Medicaid: $187.39
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 62 In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$119.10 – $938.84
Hysteroscopy with biopsy of the uterus lining: 10 of 16 insurance plan rates Aetna — Commercial: $132.03 Aetna — Medicare Advantage: $119.10 BCBS — Commercial: $938.84 BCBS — Medicare Advantage: $119.10 CDPHP — Commercial: $119.10 CDPHP — Medicare Advantage: $119.10 Cigna — Commercial: $224.48 Fidelis — Medicare Advantage: $119.10 Humana — Medicare Advantage: $119.10 MVP — Commercial: $164.35
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAUDAL EPIDURAL STEROID INJECT	$2,856	$2,856	$1,428 – $2,856
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Aetna — Commercial: $2,584.68 Aetna — Medicare Advantage: $1,428 BCBS — Commercial: $2,704.63 CDPHP — Commercial: $2,713.20 CDPHP — Medicaid: $1,485.12 Cigna — Commercial: $2,770.32 MVP — Commercial: $2,496.14 MVP — Medicaid: $2,856 MVP Essential — Commercial: $2,856 UHC — Commercial: $2,713.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBAR INTERLAMINAR EPID L2-3	$2,856	$2,856	$1,428 – $2,856
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Aetna — Commercial: $2,584.68 Aetna — Medicare Advantage: $1,428 BCBS — Commercial: $2,704.63 CDPHP — Commercial: $2,713.20 CDPHP — Medicaid: $1,485.12 Cigna — Commercial: $2,770.32 MVP — Commercial: $2,496.14 MVP — Medicaid: $2,856 MVP Essential — Commercial: $2,856 UHC — Commercial: $2,713.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBAR INTERLAMINAR EPIDURAL	$2,856	$2,856	$1,428 – $2,856
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Aetna — Commercial: $2,584.68 Aetna — Medicare Advantage: $1,428 BCBS — Commercial: $2,704.63 CDPHP — Commercial: $2,713.20 CDPHP — Medicaid: $1,485.12 Cigna — Commercial: $2,770.32 MVP — Commercial: $2,496.14 MVP — Medicaid: $2,856 MVP Essential — Commercial: $2,856 UHC — Commercial: $2,713.20
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EPIDURAL LS TRANSFORAMINAL	$4,399.75	$4,399.75	$2,199.88 – $4,399.75
Nerve root injection, lower back, with imaging guidance: rates for 10 insurance plans Aetna — Commercial: $3,981.77 Aetna — Medicare Advantage: $2,199.88 BCBS — Commercial: $4,166.56 CDPHP — Commercial: $4,179.76 CDPHP — Medicaid: $2,287.87 Cigna — Commercial: $4,267.76 MVP — Commercial: $3,845.38 MVP — Medicaid: $4,399.75 MVP Essential — Commercial: $4,399.75 UHC — Commercial: $4,179.76
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LS TRANSFORAMINAL EPIDURAL INJ	$550	$550	$275 – $550
Nerve root injection, lower back, with imaging guidance: rates for 10 insurance plans Aetna — Commercial: $497.75 Aetna — Medicare Advantage: $275 BCBS — Commercial: $520.85 CDPHP — Commercial: $522.50 CDPHP — Medicaid: $286 Cigna — Commercial: $533.50 MVP — Commercial: $480.70 MVP — Medicaid: $550 MVP Essential — Commercial: $550 UHC — Commercial: $522.50
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR GUIDE LS TRANSFORAMINAL INJ	$4,399.75	$4,399.75	$2,199.88 – $4,399.75
Nerve root injection, lower back, with imaging guidance: rates for 10 insurance plans Aetna — Commercial: $3,981.77 Aetna — Medicare Advantage: $2,199.88 BCBS — Commercial: $4,166.56 CDPHP — Commercial: $4,179.76 CDPHP — Medicaid: $2,287.87 Cigna — Commercial: $4,267.76 MVP — Commercial: $3,845.38 MVP — Medicaid: $4,399.75 MVP Essential — Commercial: $4,399.75 UHC — Commercial: $4,179.76
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	$1,509.49 – $2,257.05
Carpal tunnel release: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $2,257.05 BCBS — Medicare Advantage: $2,257.05 CDPHP — Medicare Advantage: $2,257.05 Fidelis — Medicaid: $1,509.49 Fidelis — Medicare Advantage: $2,257.05 Fidelis Exchange — Commercial: $1,584.96 Humana — Medicare Advantage: $2,257.05 Martin's Point — Commercial: $2,257.05 MVP — Medicare Advantage: $2,257.05 UHC — Medicaid: $1,509.49
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$426.60
Carpal tunnel release: rates for 1 insurance plan Aetna — Commercial: $426.60
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$0.76 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $727.14
Carpal tunnel release: 10 of 19 insurance plan rates Aetna — Commercial: $318.60 Aetna — Medicare Advantage: $307.47 BCBS — Commercial: $727.14 BCBS — Medicare Advantage: $307.47 CDPHP — Commercial: $307.47 CDPHP — Medicare Advantage: $307.47 Cigna — Commercial: $444.77 Fidelis — Medicaid: $0.76 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $307.47 Fidelis Exchange — Commercial: $0.80 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$424.07 – $635.71
Laser treatment of clouding after cataract surgery: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $635.71 BCBS — Medicare Advantage: $635.71 CDPHP — Medicare Advantage: $635.71 Fidelis — Medicaid: $424.07 Fidelis — Medicare Advantage: $635.71 Fidelis Exchange — Commercial: $445.27 Humana — Medicare Advantage: $635.71 Martin's Point — Commercial: $635.71 MVP — Medicare Advantage: $635.71 UHC — Medicaid: $424.07
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$314.60
Laser treatment of clouding after cataract surgery: rates for 1 insurance plan Aetna — Commercial: $314.60
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$0.70 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $325.64
Laser treatment of clouding after cataract surgery: 10 of 19 insurance plan rates Aetna — Commercial: $205.60 Aetna — Medicare Advantage: $188.68 BCBS — Commercial: $325.64 BCBS — Medicare Advantage: $188.68 CDPHP — Commercial: $188.68 CDPHP — Medicare Advantage: $188.68 Cigna — Commercial: $300.48 Fidelis — Medicaid: $0.70 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $188.68 Fidelis Exchange — Commercial: $0.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
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	$1,763 – $2,667.49
Cataract removal with lens implant: 10 of 12 insurance plan rates Aetna — Medicare Advantage: $2,667.49 BCBS — Medicare Advantage: $2,667.49 CDPHP — Medicare Advantage: $2,667.49 Fidelis — Medicaid: $1,763 Fidelis — Medicare Advantage: $2,667.49 Fidelis Exchange — Commercial: $1,851.15 Humana — Medicare Advantage: $2,667.49 Martin's Point — Commercial: $2,667.49 MVP — Medicare Advantage: $2,667.49 UHC — Medicaid: $1,763
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$511.31
Cataract removal with lens implant: rates for 1 insurance plan Aetna — Commercial: $511.31
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 78 In the file: Xcapsl ctrc rmvl w/o ecp	Not listed in the file	Not listed in the file	$0.70 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $936.29
Cataract removal with lens implant: 10 of 19 insurance plan rates Aetna — Commercial: $357.92 Aetna — Medicare Advantage: $316.15 BCBS — Commercial: $936.29 BCBS — Medicare Advantage: $316.15 CDPHP — Commercial: $316.15 CDPHP — Medicare Advantage: $316.15 Cigna — Commercial: $616.41 Fidelis — Medicaid: $0.70 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Fidelis — Medicare Advantage: $316.15 Fidelis Exchange — Commercial: $0.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)

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: Obstetrical care	Not listed in the file	Not listed in the file	$1,562.36 – $2,945.71
Vaginal delivery, with care before and after: 10 of 19 insurance plan rates Aetna — Commercial: $2,192.79 Aetna — Medicare Advantage: $2,034.30 BCBS — Commercial: $2,544.17 BCBS — Medicare Advantage: $2,034.30 CDPHP — Commercial: $2,034.30 CDPHP — Medicare Advantage: $2,034.30 Cigna — Commercial: $2,834.07 Fidelis — Medicaid: $1,934.29 Fidelis — Medicare Advantage: $2,034.30 Fidelis Exchange — Commercial: $2,031
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	$1,934.29 – $2,031
Vaginal delivery, with care before and after: rates for 3 insurance plans Fidelis — Medicaid: $1,934.29 Fidelis Exchange — Commercial: $2,031 UHC — Medicaid: $1,934.29
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$1,723.19 – $3,251.39
Cesarean delivery (C-section), with care before and after: 10 of 19 insurance plan rates Aetna — Commercial: $2,418.50 Aetna — Medicare Advantage: $2,252.16 BCBS — Commercial: $2,796 BCBS — Medicare Advantage: $2,252.16 CDPHP — Commercial: $2,252.16 CDPHP — Medicare Advantage: $2,252.16 Cigna — Commercial: $3,138.08 Fidelis — Medicaid: $2,133.20 Fidelis — Medicare Advantage: $2,252.16 Fidelis Exchange — Commercial: $2,239.86
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$2,133.20 – $2,239.86
Cesarean delivery (C-section), with care before and after: rates for 3 insurance plans Fidelis — Medicaid: $2,133.20 Fidelis Exchange — Commercial: $2,239.86 UHC — Medicaid: $2,133.20
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$1,623.44 – $3,082.03
Vaginal delivery after a previous C-section, with care before and after: 10 of 19 insurance plan rates Aetna — Commercial: $2,278.50 Aetna — Medicare Advantage: $2,119.23 BCBS — Commercial: $2,404.27 BCBS — Medicare Advantage: $2,119.23 CDPHP — Commercial: $2,119.23 CDPHP — Medicare Advantage: $2,119.23 Cigna — Commercial: $2,973.36 Fidelis — Medicaid: $2,009.69 Fidelis — Medicare Advantage: $2,119.23 Fidelis Exchange — Commercial: $2,110.17
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	$2,009.69 – $2,110.17
Vaginal delivery after a previous C-section, with care before and after: rates for 3 insurance plans Fidelis — Medicaid: $2,009.69 Fidelis Exchange — Commercial: $2,110.17 UHC — Medicaid: $2,009.69

Source: Southwestern Vermont Medical Center’s standard charges file (svmc.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 15, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	100 Hospital Drive, Bennington, VT 05201
County	Bennington County
State	Vermont
Phone	(802) 442‑6361
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	470012
Name in Medicare records	SOUTHWESTERN VERMONT MEDICAL CENTER
Profile level	Medicare data + hospital website
Name on the hospital’s website	Southwestern Vermont Medical Center (Bennington Campus)
Official website	svmc.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.

Bennington Campus — svmc.org
Locations & Directions | Southwestern Vermont Medical Center — svmc.org
Kendall Emergency Department | Health Services | Southwestern Vermont Medical Center — svmc.org
Dartmouth Cancer Center Bennington | Health Services | Southwestern Vermont Medical Center — svmc.org
Parking at the Hospital | Patients & Visitors | Southwestern Vermont Medical Center — svmc.org
Cardiology and Vascular Surgery | Health Services | Southwestern Vermont Medical Center — svmc.org
Rehabilitation | Health Services | Southwestern Vermont Medical Center — svmc.org
Breast Health and Imaging Center | Health Services | Southwestern Vermont Medical Center — svmc.org
Breast Care Program | Health Services | Southwestern Vermont Medical Center — svmc.org
Awards and Accreditations | About | Southwestern Vermont Medical Center — svmc.org
Patient Safety and Care Quality | About | Southwestern Vermont Medical Center — svmc.org
Imaging | Health Services | Southwestern Vermont Medical Center — svmc.org