Does St Joe Mercy Hospital System Livonia have an emergency room?

Yes. Medicare (CMS) data lists emergency services at St Joe Mercy Hospital System Livonia. In a medical emergency, call 911.

Where is St Joe Mercy Hospital System Livonia?

36475 Five Mile Road, Livonia, MI 48154, in Wayne County, Michigan.

What is the phone number of St Joe Mercy Hospital System Livonia?

(734) 655-4800, as listed by Medicare (CMS).

What is the Medicare star rating of St Joe Mercy Hospital System Livonia?

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

St Joe Mercy Hospital System Livonia

Quick answers

Does St Joe Mercy Hospital System Livonia have an emergency room?: Yes. Medicare (CMS) data lists emergency services at St Joe Mercy Hospital System Livonia. In a medical emergency, call 911.
Where is St Joe Mercy Hospital System Livonia?: 36475 Five Mile Road, Livonia, MI 48154, in Wayne County, Michigan.
What is the phone number of St Joe Mercy Hospital System Livonia?: (734) 655-4800, as listed by Medicare (CMS).
What is the Medicare star rating of St Joe Mercy Hospital System Livonia?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][6][8]

Emergency medicine
General medicine
Surgery (inpatient and outpatient)
Imaging / Radiology
Physical medicine and rehabilitation
Intensive care
Cancer care
Cardiovascular care
Senior services
Birthing and women's services
Inpatient behavioral health
Nuclear medicine

Procedures^[8]

X-ray
Fluoroscopy
Angiography (vascular interventional)
Bone density testing
CT/CTA
3D digital mammography
MRI/MRA
PET/CT
Ultrasound

Programs and centers^[5][6][7]

Cancer Center
Cardiac rehab
Inpatient behavioral health

Emergency care (hospital website)^[4]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level II

Doctors and clinicians (1,000)

1,000 doctors and other clinicians list St Joe Mercy Hospital System Livonia 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 976 more: the button below opens the full list.

Other emergency rooms nearby

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

Beaumont Hospital - Farmington Hills4.0 mi · Farmington Hills, MI · Acute Care Hospital
Garden City Hospital5.3 mi · Garden City, MI · Acute Care Hospital
Corewell Health Wayne Hospital8.6 mi · Wayne, MI · Acute Care Hospital
Ascension Providence Hospital, Southfield and Novi…9.5 mi · Southfield, MI · Acute Care Hospital
Sinai-Grace Hospital9.8 mi · Detroit, MI · Acute Care Hospital

Other hospitals nearby

Walter P Reuther Psychiatric Hospital7.2 mi · Westland, MI · Psychiatric Hospital
Straith Hospital for Special Surgery7.3 mi · Southfield, MI · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Majestic Care of Livonia0.4 mi · Livonia, MI · 3 of 5 stars
Regency at Livonia2.0 mi · Livonia, MI · 3 of 5 stars
Marywood Nursing Care Center2.0 mi · Livonia, MI · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Angela Hospice Home Care, Inc0.0 mi · Livonia, MI · 5 of 5 stars
Serenity Hospice Care0.0 mi · Livonia, MI
Caring Hospice of Michigan1.8 mi · Livonia, MI

All hospice providers in the state →

Home health agencies

E P I C Home Care0.0 mi · Livonia, MI
Home Care Connect0.0 mi · Livonia, MI
Liberty Home Care0.0 mi · Livonia, MI

All home health agencies in the state →

Dialysis facilities

Concerto Michigan LLC0.0 mi · Livonia, MI
DaVita Livonia Dialysis0.0 mi · Livonia, MI · 3 of 5 stars
Greenfield HS - Livonia0.0 mi · Livonia, MI · 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.

Genesys Surgery Center, LLC0.0 mi · Livonia, MI
Huron Gastro Center for Digestive Care0.0 mi · Livonia, MI
Livonia Outpatient Surgery Center1.8 mi · Livonia, MI

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

CHASS Westland3.7 mi · Westland, MI · Community health center
WCHC- Garden City Health Center5.4 mi · Garden City, MI · Community health center
Plum Hollow Center6.9 mi · Southfield, MI · Community health center

Clinics and urgent care

Doctors Urgent Care Livonia PC0.0 mi · Livonia, MI · Urgent care center
Faith Urgent Care PLLC0.0 mi · Livonia, MI · Urgent care center
Livonia Urgent Care & Medical Center PLLC0.0 mi · Livonia, MI · Urgent care center

Pharmacies

Bormans Inc0.0 mi · Livonia, MI · Community/retail pharmacy
Central Pharmacy - Livonia LLC0.0 mi · Livonia, MI · Community/retail pharmacy
Dearborn Drugs LLC0.0 mi · Livonia, MI · Community/retail pharmacy

Assisted living nearby

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

Bellcreek0.0 mi · Livonia, MI
Deforrest Senior Care0.0 mi · Livonia, MI
Fitzgerald0.0 mi · Livonia, MI
Freedom Residence0.0 mi · Livonia, MI

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 St Joe Mercy Hospital System Livonia 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)	2 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	1 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	67%National average: 72%
Would definitely recommend the hospital	65%National average: 71%
Nurses “always” communicated well	78%National average: 80%
Doctors “always” communicated well	71%National average: 80%
Staff “always” explained medicines before giving them	56%National average: 62%
Were given information about recovery at home	83%National average: 86%
Room and bathroom “always” clean	52%National average: 74%
Area around the room “always” quiet at night	50%National average: 60%
Completed surveys	617Response rate: 21%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.77No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.206Better than the national benchmark
Surgical site infections after colon surgery	0.857No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0No different from the national benchmark
MRSA bloodstream infections	0.888No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.475Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.6%
Deaths within 30 days: heart failure patients	11.2%
Deaths within 30 days: pneumonia patients	16.3%
Deaths within 30 days: COPD patients	7.9%
Deaths within 30 days: stroke patients	11.8%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.97No different from the national rate
Complications after hip or knee replacement	4.6%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	13.9%
Readmitted within 30 days: heart failure	21.7%
Readmitted within 30 days: pneumonia	17.4%
Readmitted within 30 days: COPD	21.5%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	6.3%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	241 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	56%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 Michigan Best hospitals in Michigan

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 77 common services exactly as St Joe Mercy Hospital System Livonia 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 →

$ 19 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$249	Not listed in the file	$52.19 – $144.42
New patient office visit (about 30–44 minutes): 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $144.42 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $73.21 AETNA MEDICAID — MEDICAID: $52.19 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $73.21 AETNA MEDICARE TRANSPLANT — MEDICARE: $73.21 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $74.70 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $73.21 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $100.85 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $52.19 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $73.21
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$246	Not listed in the file	$57.90 – $184.73
New patient office visit (about 30–44 minutes): 10 of 838 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $116.80 AETNA DOMESTIC — AETNA: $143.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $116.80 AETNA MEDICARE TRANSPLANT — MEDICARE: $116.80 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $119.18 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $116.80 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $116.80 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $116.80 ALLY ALIGN CARE ADV — MEDICARE: $116.80 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $116.80
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$379	Not listed in the file	$84.99 – $219.82
New patient office visit (about 45–59 minutes): 10 of 838 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $119.20 AETNA DOMESTIC — AETNA: $173.27 AETNA MEDICAID — MEDICAID: $84.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $121.63 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $119.20 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $84.99 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $119.20 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $119.20 ALLY ALIGN CARE ADV — MEDICARE: $119.20
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$366	Not listed in the file	$94.06 – $278.95
New patient office visit (about 45–59 minutes): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $212.28 AETNA DOMESTIC — AETNA: $214.17 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $176.37 AETNA MEDICARE TRANSPLANT — MEDICARE: $176.37 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $143.75 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $242.96 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $143.75 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $143.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $176.37 AMERICAN HEALTH PLAN — MEDICARE: $176.37
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$479	Not listed in the file	$115 – $279.33
New patient office visit (about 60–74 minutes): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $226.08 ADMINISTRATIVE CONCEPTS — COFINITY: $277.82 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $164.12 AETNA — AETNA: $235.14 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $164.12 AETNA MEDICARE TRANSPLANT — MEDICARE: $164.12 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $115.66 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $164.12 ALLY ALIGN CARE ADV — MEDICARE: $164.12 AMERIBEN — COFINITY: $277.82
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$483	Not listed in the file	$115 – $374
New patient office visit (about 60–74 minutes): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $325.74 ADMINISTRATIVE CONCEPTS — COFINITY: $280.14 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $236.46 AETNA — AETNA: $283 AETNA DOMESTIC — AETNA: $283 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $236.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $241.29 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $236.46 ALLIED BENEFIT SYSTEMS — COFINITY: $280.14 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $325.74
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$182	Not listed in the file	$41.96 – $105.56
Established patient office visit (about 20–29 minutes): 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $105.56 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $57.95 AETNA — AETNA: $85.70 AETNA DOMESTIC — AETNA: $85.70 AETNA MEDICAID — MEDICAID: $41.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $57.95 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $59.13 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $57.95 ALLIED BENEFIT SYSTEMS — COFINITY: $105.56 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $79.83
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$263	Not listed in the file	$11.52 – $210.40
Established patient office visit (about 30–39 minutes): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $100.02 AETNA DOMESTIC — AETNA: $107.55 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $72.60 AETNA MEDICARE TRANSPLANT — MEDICARE: $72.60 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $72.60 ALLY ALIGN CARE ADV — MEDICARE: $72.60 AMERIBEN — COFINITY: $152.54 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $72.60 AMERICAN HEALTH PLAN — MEDICARE: $72.60 AMERICAN NATIONAL — COFINITY: $152.54
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$281	Not listed in the file	$14.03 – $211.54
Established patient office visit (about 30–39 minutes): 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $162.98 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $133.75 AETNA — AETNA: $163.74 AETNA DOMESTIC — AETNA: $163.74 AETNA MEDICAID — MEDICAID: $110.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $133.75 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $110.16 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $136.48 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $133.75 ALLIED BENEFIT SYSTEMS — COFINITY: $162.98
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee · modifier AS In the file: PR Visit Office Outpatient Established Moderate Level\|ASSISTANT AT SURGERY SERVICE	$33.12	$33.12	$11.52 – $210.40
Established patient office visit (about 30–39 minutes): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $18.83 AETNA DOMESTIC — AETNA: $20.24 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $13.67 AETNA MEDICARE TRANSPLANT — MEDICARE: $13.67 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $13.67 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $13.67 ALLY ALIGN CARE ADV — MEDICARE: $13.67 AMERIBEN — COFINITY: $19.21 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $13.67 AMERICAN HEALTH PLAN — MEDICARE: $13.67
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$199	Not listed in the file	$66.40 – $175
Preventive checkup, new patient, age 18–39: 10 of 621 insurance plan rates ACCLAIM — COFINITY: $115.42 ADMINISTRATIVE CONCEPTS — COFINITY: $115.42 AETNA — AETNA: $165.39 AETNA MEDICAID — MEDICAID: $86.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $82.73 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $86.18 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $86.18 ALLEGEANT — COFINITY: $115.42 ALLIED BENEFIT SYSTEMS — COFINITY: $115.42 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $113.97
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$209	Not listed in the file	$68.62 – $209
Preventive checkup, new patient, age 18–39: 10 of 621 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $182.72 ACCLAIM — COFINITY: $121.22 ADMINISTRATIVE CONCEPTS — COFINITY: $121.22 AETNA — AETNA: $209 AETNA MEDICAID — MEDICAID: $116.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.64 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $116.94 ALLEGEANT — COFINITY: $121.22 ALLIED BENEFIT SYSTEMS — COFINITY: $121.22 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $182.72
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$241	Not listed in the file	$66.40 – $213.03
Preventive checkup, new patient, age 40–64: 10 of 621 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $138.66 ADMINISTRATIVE CONCEPTS — COFINITY: $139.78 AETNA — AETNA: $200.46 AETNA DOMESTIC — AETNA: $200.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.66 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $104.46 ALLIED BENEFIT SYSTEMS — COFINITY: $139.78 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $138.66 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $104.46 AMERIBEN — COFINITY: $139.78
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$240	Not listed in the file	$104.96 – $240
Preventive checkup, new patient, age 40–64: 10 of 621 insurance plan rates ACCLAIM — COFINITY: $139.20 ADMINISTRATIVE CONCEPTS — COFINITY: $139.20 AETNA — AETNA: $240 AETNA DOMESTIC — AETNA: $240 AETNA MEDICAID — MEDICAID: $135.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $153.41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $135.21 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $135.21 ALLEGEANT — COFINITY: $139.20 ALLIED BENEFIT SYSTEMS — COFINITY: $139.20
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 Sane_Safe	$1,099	$714.35	$149.49 – $1,099
Emergency room visit (moderate): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $703.36 ACCESS HEALTH — COFINITY PPO: $697.87 ACCLAIM — COFINITY PPO: $697.87 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $469.27 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $697.87 AETNA — AETNA DOMINOS PPO: $482.46 AETNA — AETNA PPO: $637.42 AETNA — AETNA PREFERRED: $354.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $266.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $272.11
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 OB Triage	$1,099	$714.35	$149.49 – $1,099
Emergency room visit (moderate): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $703.36 ACCESS HEALTH — COFINITY PPO: $697.87 ACCLAIM — COFINITY PPO: $697.87 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $469.27 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $697.87 AETNA — AETNA DOMINOS PPO: $482.46 AETNA — AETNA PPO: $637.42 AETNA — AETNA PREFERRED: $354.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $266.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $272.11
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3	$1,099	$714.35	$149.49 – $1,099
Emergency room visit (moderate): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $703.36 ACCESS HEALTH — COFINITY PPO: $697.87 ACCLAIM — COFINITY PPO: $697.87 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $469.27 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $697.87 AETNA — AETNA DOMINOS PPO: $482.46 AETNA — AETNA PPO: $637.42 AETNA — AETNA PREFERRED: $354.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $266.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $272.11
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Full Trauma W/O Pre Notification Level 4	$19,861	$12,909.65	$228.50 – $19,861
Emergency room visit (moderately high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $12,711.04 ACCESS HEALTH — COFINITY PPO: $12,611.74 ACCLAIM — COFINITY PPO: $12,611.74 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $8,480.65 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $12,611.74 AETNA — AETNA DOMINOS PPO: $8,718.98 AETNA — AETNA PPO: $11,519.38 AETNA — AETNA PREFERRED: $6,415.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $407.62 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $415.94
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Partial Trauma W/O Pre Notification Level 4	$10,621	$6,903.65	$228.50 – $10,621
Emergency room visit (moderately high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $6,797.44 ACCESS HEALTH — COFINITY PPO: $6,744.34 ACCLAIM — COFINITY PPO: $6,744.34 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $4,535.17 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $6,744.34 AETNA — AETNA DOMINOS PPO: $4,662.62 AETNA — AETNA PPO: $6,160.18 AETNA — AETNA PREFERRED: $3,430.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $407.62 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $415.94
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Trauma Evaluation W/O Pre Notification Level 4	$5,643	$3,667.95	$228.50 – $5,643
Emergency room visit (moderately high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,611.52 ACCESS HEALTH — COFINITY PPO: $3,583.31 ACCLAIM — COFINITY PPO: $3,583.31 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,409.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,583.31 AETNA — AETNA DOMINOS PPO: $2,477.28 AETNA — AETNA PPO: $3,272.94 AETNA — AETNA PREFERRED: $1,822.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $407.62 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $415.94
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Trauma Evaluation W/O Pre Notification Level 5	$6,708	$4,360.20	$326.12 – $6,708
Emergency room visit (high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $4,293.12 ACCESS HEALTH — COFINITY PPO: $4,259.58 ACCLAIM — COFINITY PPO: $4,259.58 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,864.32 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4,259.58 AETNA — AETNA DOMINOS PPO: $2,944.81 AETNA — AETNA PPO: $3,890.64 AETNA — AETNA PREFERRED: $2,166.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $581.77 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $593.65
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5	$3,023	$1,964.95	$326.12 – $3,023
Emergency room visit (high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,934.72 ACCESS HEALTH — COFINITY PPO: $1,919.61 ACCLAIM — COFINITY PPO: $1,919.61 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,290.82 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,919.61 AETNA — AETNA DOMINOS PPO: $1,327.10 AETNA — AETNA PPO: $1,753.34 AETNA — AETNA PREFERRED: $976.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $581.77 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $593.65
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5 OB Triage	$3,023	$1,964.95	$326.12 – $3,023
Emergency room visit (high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,934.72 ACCESS HEALTH — COFINITY PPO: $1,919.61 ACCLAIM — COFINITY PPO: $1,919.61 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,290.82 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,919.61 AETNA — AETNA DOMINOS PPO: $1,327.10 AETNA — AETNA PPO: $1,753.34 AETNA — AETNA PREFERRED: $976.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $581.77 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $593.65

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	$105	$68.25	$4.63 – $105
Basic metabolic panel (blood test): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $67.20 ACCESS HEALTH — COFINITY PPO: $66.68 ACCLAIM — COFINITY PPO: $66.68 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $44.84 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $66.68 AETNA — AETNA DOMINOS PPO: $46.10 AETNA — AETNA PPO: $12.54 AETNA — AETNA PREFERRED: $33.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.29 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$127	$82.55	$5.77 – $127
Comprehensive metabolic panel (blood test): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $81.28 ACCESS HEALTH — COFINITY PPO: $80.65 ACCLAIM — COFINITY PPO: $80.65 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $54.23 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $80.65 AETNA — AETNA DOMINOS PPO: $55.75 AETNA — AETNA PPO: $15.65 AETNA — AETNA PREFERRED: $41.02 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	Not listed in the file	$363.35	$5.77 – $40.78
Comprehensive metabolic panel (blood test): 10 of 106 insurance plan rates AETNA — AETNA PPO: $15.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $10.56 ANGELA HOSPICE — ANGELA HOSPICE: $10.56 ASR HEALTH BENEFITS — HAP AHLIC: $40.78 BCBS GENERIC — BCBS TRAD / TRUST: $18.76 BCN DOMESTIC — BCN HMO: $18.76 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $18.76 BLUE CARE NETWORK — BCN HMO: $18.76 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $10.35
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Obstetric Panel	$269	$174.85	$26.14 – $269
Obstetric blood test panel: 10 of 255 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $172.16 ACCESS HEALTH — COFINITY PPO: $170.82 ACCLAIM — COFINITY PPO: $170.82 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $114.86 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $170.82 AETNA — AETNA PPO: $70.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $46.85 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $47.81 ALLEGEANT — COFINITY PPO: $170.82 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $114.86
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$112	$72.80	$7.32 – $112
Cholesterol panel (lipid panel): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $71.68 ACCESS HEALTH — COFINITY PPO: $71.12 ACCLAIM — COFINITY PPO: $71.12 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $47.82 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $71.12 AETNA — AETNA DOMINOS PPO: $49.17 AETNA — AETNA PPO: $19.84 AETNA — AETNA PREFERRED: $36.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Lipid Panel	Not listed in the file	$375.05	$7.32 – $50.01
Cholesterol panel (lipid panel): 10 of 106 insurance plan rates AETNA — AETNA PPO: $19.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39 ANGELA HOSPICE — ANGELA HOSPICE: $13.39 ASR HEALTH BENEFITS — HAP AHLIC: $50.01 BCBS GENERIC — BCBS TRAD / TRUST: $14.30 BCN DOMESTIC — BCN HMO: $14.30 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $14.30 BLUE CARE NETWORK — BCN HMO: $14.30 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $13.12
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$96	$62.40	$4.75 – $96
Kidney function panel: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $61.44 ACCESS HEALTH — COFINITY PPO: $60.96 ACCLAIM — COFINITY PPO: $60.96 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $40.99 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $60.96 AETNA — AETNA DOMINOS PPO: $42.14 AETNA — AETNA PPO: $12.87 AETNA — AETNA PREFERRED: $31.01 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.51 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.68
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$98	$63.70	$4.47 – $98
Liver function panel: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $62.72 ACCESS HEALTH — COFINITY PPO: $62.23 ACCLAIM — COFINITY PPO: $62.23 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $41.85 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $62.23 AETNA — AETNA DOMINOS PPO: $43.02 AETNA — AETNA PPO: $12.11 AETNA — AETNA PREFERRED: $31.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$52	$33.80	$1.73 – $52
Urine test (automated, with microscope): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $33.28 ACCESS HEALTH — COFINITY PPO: $33.02 ACCLAIM — COFINITY PPO: $33.02 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $22.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $33.02 AETNA — AETNA DOMINOS PPO: $22.83 AETNA — AETNA PPO: $4.70 AETNA — AETNA PREFERRED: $16.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	Not listed in the file	$330.85	$1.73 – $12.38
Urine test (automated, with microscope): 10 of 106 insurance plan rates AETNA — AETNA PPO: $4.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.17 ANGELA HOSPICE — ANGELA HOSPICE: $3.17 ASR HEALTH BENEFITS — HAP AHLIC: $12.38 BCBS GENERIC — BCBS TRAD / TRUST: $2.94 BCN DOMESTIC — BCN HMO: $2.94 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $2.94 BLUE CARE NETWORK — BCN HMO: $2.94 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3.11
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Non-Automated	$7	$7	$2.78 – $7
Urine test (manual, without microscope): 10 of 842 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $3.41 AETNA DOMESTIC — AETNA: $3.74 AETNA MEDICAID — MEDICAID: $2.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $3.41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $2.88 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $3.48 ALLIED BENEFIT SYSTEMS — COFINITY: $4.06 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $2.88 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $3.41
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Nonautomated	$12	$7.80	$1.90 – $12
Urine test (manual, without microscope): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $7.68 ACCESS HEALTH — COFINITY PPO: $7.62 ACCLAIM — COFINITY PPO: $7.62 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $5.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $7.62 AETNA — AETNA DOMINOS PPO: $5.27 AETNA — AETNA PPO: $5.16 AETNA — AETNA PREFERRED: $3.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Non-Automated	Not listed in the file	$9.11	$2.78 – $9.11
Urine test (manual, without microscope): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $6.38 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $3.41 AETNA MEDICAID — MEDICAID: $2.88 AETNA MEDICARE TRANSPLANT — MEDICARE: $3.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $2.88 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $3.48 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $3.41 ALLIED BENEFIT SYSTEMS — COFINITY: $5.28 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $2.88 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $3.41
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	$5	$5	$1.80 – $5
Urine test (automated, without microscope): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.50 AETNA DOMESTIC — AETNA: $2.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $2.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $2.21 AMERIBEN — COFINITY: $2.90 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $2.21 AMERICAN NATIONAL — COFINITY: $2.90 AMERIGROUP MEDICAID — MEDICAID: $1.87 AMERIHEALTH — COFINITY: $2.90
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$29	$18.85	$1.23 – $29
Urine test (automated, without microscope): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $18.56 ACCESS HEALTH — COFINITY PPO: $18.42 ACCLAIM — COFINITY PPO: $18.42 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $12.38 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $18.42 AETNA — AETNA DOMINOS PPO: $12.73 AETNA — AETNA PPO: $3.34 AETNA — AETNA PREFERRED: $9.37 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	Not listed in the file	$7.49	$1.80 – $7.49
Urine test (automated, without microscope): 10 of 842 insurance plan rates ACCLAIM — COFINITY: $4.34 ADMINISTRATIVE CONCEPTS — COFINITY: $4.34 AETNA — AETNA: $2.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $2.21 AETNA MEDICARE TRANSPLANT — MEDICARE: $2.21 ALLEGEANT — COFINITY: $4.34 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $5.24 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1.87 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $2.21
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 1012090 Prostate Specific Antigen Total	$79	$51.35	$10.05 – $79
PSA (prostate specific antigen) blood test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $50.56 ACCESS HEALTH — COFINITY PPO: $50.17 ACCLAIM — COFINITY PPO: $50.17 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $33.73 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $50.17 AETNA — AETNA DOMINOS PPO: $34.68 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $25.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde Prostate Specific Antigen Total Ultrasensitive	$24.95	$16.22	$7.04 – $72.03
PSA (prostate specific antigen) blood test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $15.97 ACCESS HEALTH — COFINITY PPO: $15.84 ACCLAIM — COFINITY PPO: $15.84 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $10.65 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $15.84 AETNA — AETNA DOMINOS PPO: $10.95 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $8.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$94	$61.10	$10.05 – $94
PSA (prostate specific antigen) blood test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $60.16 ACCESS HEALTH — COFINITY PPO: $59.69 ACCLAIM — COFINITY PPO: $59.69 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $40.14 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $59.69 AETNA — AETNA DOMINOS PPO: $41.27 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $30.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3400781 Thyroid Stimulating Hormone Hama Treated	$4.83	$3.14	$1.36 – $65.77
Thyroid stimulating hormone (TSH) test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.09 ACCESS HEALTH — COFINITY PPO: $3.07 ACCLAIM — COFINITY PPO: $3.07 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.06 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.07 AETNA — AETNA DOMINOS PPO: $2.12 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $1.56 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$99	$64.35	$9.18 – $99
Thyroid stimulating hormone (TSH) test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $63.36 ACCESS HEALTH — COFINITY PPO: $62.87 ACCLAIM — COFINITY PPO: $62.87 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $42.27 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $62.87 AETNA — AETNA DOMINOS PPO: $43.46 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $31.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3400781 Thyroid Stimulating Hormone	$4.83	$3.14	$1.36 – $65.77
Thyroid stimulating hormone (TSH) test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.09 ACCESS HEALTH — COFINITY PPO: $3.07 ACCLAIM — COFINITY PPO: $3.07 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.06 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.07 AETNA — AETNA DOMINOS PPO: $2.12 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $1.56 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$75	$48.75	$4.25 – $75
Complete blood count (CBC) with differential: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $48 ACCESS HEALTH — COFINITY PPO: $47.63 ACCLAIM — COFINITY PPO: $47.63 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $32.03 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $47.63 AETNA — AETNA DOMINOS PPO: $32.93 AETNA — AETNA PPO: $11.51 AETNA — AETNA PREFERRED: $24.23 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	Not listed in the file	$350.35	$4.25 – $30.40
Complete blood count (CBC) with differential: 10 of 106 insurance plan rates AETNA — AETNA PPO: $11.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7.77 ANGELA HOSPICE — ANGELA HOSPICE: $7.77 ASR HEALTH BENEFITS — HAP AHLIC: $30.40 BCBS GENERIC — BCBS TRAD / TRUST: $7.20 BCN DOMESTIC — BCN HMO: $7.20 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $7.20 BLUE CARE NETWORK — BCN HMO: $7.20 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $7.61
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$52	$33.80	$3.54 – $52
Complete blood count (CBC), automated: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $33.28 ACCESS HEALTH — COFINITY PPO: $33.02 ACCLAIM — COFINITY PPO: $33.02 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $22.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $33.02 AETNA — AETNA DOMINOS PPO: $22.83 AETNA — AETNA PPO: $9.59 AETNA — AETNA PREFERRED: $16.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated	Not listed in the file	$341.25	$3.54 – $18.20
Complete blood count (CBC), automated: 10 of 106 insurance plan rates AETNA — AETNA PPO: $9.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.47 ANGELA HOSPICE — ANGELA HOSPICE: $6.47 ASR HEALTH BENEFITS — HAP AHLIC: $18.20 BCBS GENERIC — BCBS TRAD / TRUST: $5.99 BCN DOMESTIC — BCN HMO: $5.99 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $5.99 BLUE CARE NETWORK — BCN HMO: $5.99 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $6.34
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Prothrombin Time	$9	$9	$3.43 – $9
Blood clotting time test (prothrombin time, PT): 10 of 842 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $5.22 AETNA — AETNA: $4.61 AETNA MEDICAID — MEDICAID: $3.55 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $3.55 ALLIED BENEFIT SYSTEMS — COFINITY: $5.22 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $6.30 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $3.55 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $3.55 AMERICAN FAMILY — COFINITY: $5.22 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $5.22
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Prothrombin Time	$43	$27.95	$2.35 – $43
Blood clotting time test (prothrombin time, PT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $27.52 ACCESS HEALTH — COFINITY PPO: $27.31 ACCLAIM — COFINITY PPO: $27.31 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $18.36 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $27.31 AETNA — AETNA DOMINOS PPO: $18.88 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $13.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3514930 Prothrombin Time	$6.67	$4.34	$1.88 – $15.38
Blood clotting time test (prothrombin time, PT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $4.27 ACCESS HEALTH — COFINITY PPO: $4.24 ACCLAIM — COFINITY PPO: $4.24 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.85 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4.24 AETNA — AETNA DOMINOS PPO: $2.93 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $2.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thromboplastin Time Partial (Ptt)	$70	$45.50	$3.29 – $70
Blood clotting test (partial thromboplastin time, PTT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $44.80 ACCESS HEALTH — COFINITY PPO: $44.45 ACCLAIM — COFINITY PPO: $44.45 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $29.89 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $44.45 AETNA — AETNA DOMINOS PPO: $30.73 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $22.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3502730 Thromboplastin Time Partial (Ptt)	$26.13	$16.98	$3.29 – $26.13
Blood clotting test (partial thromboplastin time, PTT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $16.72 ACCESS HEALTH — COFINITY PPO: $16.59 ACCLAIM — COFINITY PPO: $16.59 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $11.16 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $16.59 AETNA — AETNA DOMINOS PPO: $11.47 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $8.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3500044 Thromboplastin Time Partial (Ptt)	$20.63	$13.41	$3.29 – $23.49
Blood clotting test (partial thromboplastin time, PTT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $13.20 ACCESS HEALTH — COFINITY PPO: $13.10 ACCLAIM — COFINITY PPO: $13.10 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $8.81 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $13.10 AETNA — AETNA DOMINOS PPO: $9.06 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $6.66 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	$2,708	$1,760.20	$57.25 – $2,708
CT scan of the head or brain, without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,733.12 ACCESS HEALTH — COFINITY PPO: $1,719.58 ACCLAIM — COFINITY PPO: $1,719.58 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,156.32 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,719.58 AETNA — AETNA DOMINOS PPO: $1,188.81 AETNA — AETNA PPO: $83.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.13 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.21 ALLEGEANT — COFINITY PPO: $1,719.58
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	Not listed in the file	$1,760.20	$57.25 – $1,324.44
CT scan of the head or brain, without contrast: 10 of 106 insurance plan rates AETNA — AETNA PPO: $83.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.13 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.21 ANGELA HOSPICE — ANGELA HOSPICE: $104.21 ASR HEALTH BENEFITS — HAP AHLIC: $328.13 BCBS GENERIC — BCBS TRAD / TRUST: $109.18 BCN DOMESTIC — BCN HMO: $109.18 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $109.18 BLUE CARE NETWORK — BCN HMO: $109.18 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $102.13
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier NC In the file: HC CT Head/Brain W/O Contrast\|NC	Not listed in the file	$5,542.87	$57.25 – $1,324.44
CT scan of the head or brain, without contrast: 10 of 83 insurance plan rates AETNA — AETNA PPO: $213.72 ASR HEALTH BENEFITS — HAP AHLIC: $1,124.08 BCBS GENERIC — BCBS TRAD / TRUST: $317.43 BCN DOMESTIC — BCN HMO: $317.43 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $317.43 BLUE CARE NETWORK — BCN HMO: $317.43 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $317.43 BLUE CROSS - AL — BCBS TRAD / TRUST: $317.43 BLUE CROSS - AR — BCBS TRAD / TRUST: $317.43 BLUE CROSS - AZ — BCBS TRAD / TRUST: $317.43
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	$7,842	$5,097.30	$191.05 – $7,842
MRI of the brain, before and after contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $5,018.88 ACCESS HEALTH — COFINITY PPO: $4,979.67 ACCLAIM — COFINITY PPO: $4,979.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $3,348.53 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4,979.67 AETNA — AETNA DOMINOS PPO: $3,442.64 AETNA — AETNA PPO: $269.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $340.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $347.77 ALLEGEANT — COFINITY PPO: $4,979.67
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$366	$237.90	$28 – $366
Chest X-ray, 2 views: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $234.24 ACCESS HEALTH — COFINITY PPO: $232.41 ACCLAIM — COFINITY PPO: $232.41 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $156.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $232.41 AETNA — AETNA DOMINOS PPO: $160.67 AETNA — AETNA PPO: $81.12 AETNA — AETNA PREFERRED: $118.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $85.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $86.75
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Chest 2 Views	Not listed in the file	$237.90	$28 – $195.19
Chest X-ray, 2 views: 10 of 106 insurance plan rates AETNA — AETNA PPO: $81.12 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $85.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $86.75 ANGELA HOSPICE — ANGELA HOSPICE: $86.75 ASR HEALTH BENEFITS — HAP AHLIC: $43.42 BCBS GENERIC — BCBS TRAD / TRUST: $46.03 BCN DOMESTIC — BCN HMO: $46.03 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $46.03 BLUE CARE NETWORK — BCN HMO: $46.03 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $85.01
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26\|51 In the file: PR Xr Chest 2 Views\|PROFESSIONAL COMPONENT\|MULTIPLE PROCEDURES	$23	$23	$3.30 – $23
Chest X-ray, 2 views: 10 of 842 insurance plan rates ACCLAIM — COFINITY: $13.34 ADMINISTRATIVE CONCEPTS — COFINITY: $13.34 AETNA — AETNA: $7.99 AETNA MEDICAID — MEDICAID: $3.30 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $3.30 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $3.30 ALLEGEANT — COFINITY: $13.34 ALLIED BENEFIT SYSTEMS — COFINITY: $13.34 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $6.86 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $3.30
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	$474	$308.10	$47.21 – $474
X-ray of the lower spine, at least 4 views: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $303.36 ACCESS HEALTH — COFINITY PPO: $300.99 ACCLAIM — COFINITY PPO: $300.99 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $202.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $300.99 AETNA — AETNA DOMINOS PPO: $208.09 AETNA — AETNA PPO: $135.44 AETNA — AETNA PREFERRED: $153.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.13 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.21
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$4,569	$2,969.85	$130.66 – $4,569
MRI of the lower back (lumbar spine), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,924.16 ACCESS HEALTH — COFINITY PPO: $2,901.32 ACCLAIM — COFINITY PPO: $2,901.32 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,950.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,901.32 AETNA — AETNA DOMINOS PPO: $2,005.79 AETNA — AETNA PPO: $155.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $233.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.85 ALLEGEANT — COFINITY PPO: $2,901.32
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: HC MRI Lumbar Spine W/O Contrast\|REDUCED SERVICES	$4,569	$2,969.85	$130.66 – $4,569
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $233.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.85 ANGELA HOSPICE — ANGELA HOSPICE: $237.85 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $233.09 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $233.09 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $133.27 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $251.74 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTICS: $535.15 HAP MEDICAID — HAP CARESOURCE MEDICAID: $133.27 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $233.09
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$2,349	$1,526.85	$96.05 – $2,349
CT scan of the pelvis, with contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,503.36 ACCESS HEALTH — COFINITY PPO: $1,491.62 ACCLAIM — COFINITY PPO: $1,491.62 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,003.02 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,491.62 AETNA — AETNA DOMINOS PPO: $1,031.21 AETNA — AETNA PPO: $213.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $171.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $174.85 ALLEGEANT — COFINITY PPO: $1,491.62
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Rt	$3,851	$2,503.15	$130.66 – $3,851
MRI of a leg joint (such as the knee), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,464.64 ACCESS HEALTH — COFINITY PPO: $2,445.39 ACCLAIM — COFINITY PPO: $2,445.39 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,644.38 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,445.39 AETNA — AETNA DOMINOS PPO: $1,690.59 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $233.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.85 ALLEGEANT — COFINITY PPO: $2,445.39
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Bl	$5,777	$3,755.05	$130.66 – $5,777
MRI of a leg joint (such as the knee), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,697.28 ACCESS HEALTH — COFINITY PPO: $3,668.40 ACCLAIM — COFINITY PPO: $3,668.40 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,466.78 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,668.40 AETNA — AETNA DOMINOS PPO: $2,536.10 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $233.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.85 ALLEGEANT — COFINITY PPO: $3,668.40
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Lt	$3,851	$2,503.15	$130.66 – $3,851
MRI of a leg joint (such as the knee), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,464.64 ACCESS HEALTH — COFINITY PPO: $2,445.39 ACCLAIM — COFINITY PPO: $2,445.39 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,644.38 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,445.39 AETNA — AETNA DOMINOS PPO: $1,690.59 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $233.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.85 ALLEGEANT — COFINITY PPO: $2,445.39
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	$6,169	$4,009.85	$191.05 – $6,169
CT scan of the abdomen and pelvis, with contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,948.16 ACCESS HEALTH — COFINITY PPO: $3,917.32 ACCLAIM — COFINITY PPO: $3,917.32 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,634.16 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,917.32 AETNA — AETNA DOMINOS PPO: $2,708.19 AETNA — AETNA PPO: $278.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $340.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $347.77 ALLEGEANT — COFINITY PPO: $3,917.32
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	Not listed in the file	$4,305.60	$191.05 – $782.48
CT scan of the abdomen and pelvis, with contrast: 10 of 106 insurance plan rates AETNA — AETNA PPO: $278.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $340.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $347.77 ANGELA HOSPICE — ANGELA HOSPICE: $347.77 ASR HEALTH BENEFITS — HAP AHLIC: $619.13 BCBS GENERIC — BCBS TRAD / TRUST: $352.05 BCN DOMESTIC — BCN HMO: $352.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $352.05 BLUE CARE NETWORK — BCN HMO: $352.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $340.81
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$1,336	$868.40	$57.25 – $1,336
Ultrasound of the abdomen, complete: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $855.04 ACCESS HEALTH — COFINITY PPO: $848.36 ACCLAIM — COFINITY PPO: $848.36 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $570.47 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $848.36 AETNA — AETNA DOMINOS PPO: $586.50 AETNA — AETNA PPO: $87.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.13 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.21 ALLEGEANT — COFINITY PPO: $848.36
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$905	$588.25	$57.25 – $905
Pregnancy ultrasound (after the first trimester): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $579.20 ACCESS HEALTH — COFINITY PPO: $574.68 ACCLAIM — COFINITY PPO: $574.68 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $386.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $574.68 AETNA — AETNA DOMINOS PPO: $397.30 AETNA — AETNA PPO: $309.04 AETNA — AETNA PREFERRED: $292.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.13 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.21
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR US Pregnant Uterus >= 14 Weeks Single/1st Gestation\|PROFESSIONAL COMPONENT	$163	Not listed in the file	$30.03 – $163
Pregnancy ultrasound (after the first trimester): 10 of 840 insurance plan rates AETNA DOMESTIC — AETNA: $72.56 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $46.51 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $30.03 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $47.46 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $64.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $30.03 AMERICAN HEALTH PLAN — MEDICARE: $46.51 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $94.54 AMERICAN NATIONAL — COFINITY: $94.54 AMISH MENNONITE — MEDICAID: $30.03
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR US Pregnant Uterus >= 14 Weeks Single/1st Gestation\|PROFESSIONAL COMPONENT	Not listed in the file	Not listed in the file	$30.03 – $123.33
Pregnancy ultrasound (after the first trimester): 10 of 840 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $64.07 ACCLAIM — COFINITY: $71.53 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $46.51 AETNA MEDICARE TRANSPLANT — MEDICARE: $46.51 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $30.03 ALLEGEANT — COFINITY: $71.53 AMERIBEN — COFINITY: $71.53 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $46.51 AMERICAN HEALTH PLAN — MEDICARE: $46.51 AMERICAN NATIONAL — COFINITY: $71.53
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$1,113	$723.45	$57.25 – $1,113
Transvaginal ultrasound: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $712.32 ACCESS HEALTH — COFINITY PPO: $706.76 ACCLAIM — COFINITY PPO: $706.76 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $475.25 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $706.76 AETNA — AETNA DOMINOS PPO: $488.61 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $359.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.13 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.21
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR US Transvaginal Non Obstetric\|PROFESSIONAL COMPONENT	$72	Not listed in the file	$20.87 – $72
Transvaginal ultrasound: 10 of 840 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $41.76 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $32.35 AETNA — AETNA: $51.02 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $32.35 AETNA MEDICARE TRANSPLANT — MEDICARE: $32.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $33.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $32.35 ALLIED BENEFIT SYSTEMS — COFINITY: $41.76 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $32.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $32.35
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR US Transvaginal Non Obstetric\|PROFESSIONAL COMPONENT	Not listed in the file	Not listed in the file	$20.87 – $87.09
Transvaginal ultrasound: 10 of 840 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $44.56 ADMINISTRATIVE CONCEPTS — COFINITY: $50.51 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $32.35 AETNA — AETNA: $51.02 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $32.35 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $32.35 AETNA MEDICARE TRANSPLANT — MEDICARE: $32.35 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $20.87 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $33.01 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $44.56
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$562	$365.30	$45.59 – $562
Diagnostic mammogram, one breast: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $359.68 ACCESS HEALTH — COFINITY PPO: $356.87 ACCLAIM — COFINITY PPO: $356.87 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $239.97 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $356.87 AETNA — AETNA DOMINOS PPO: $246.72 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $181.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.73 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $83.40
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$562	$365.30	$45.59 – $562
Diagnostic mammogram, one breast: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $359.68 ACCESS HEALTH — COFINITY PPO: $356.87 ACCLAIM — COFINITY PPO: $356.87 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $239.97 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $356.87 AETNA — AETNA DOMINOS PPO: $246.72 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $181.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.73 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $83.40
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$843	$547.95	$58.59 – $843
Diagnostic mammogram, both breasts: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $539.52 ACCESS HEALTH — COFINITY PPO: $535.31 ACCLAIM — COFINITY PPO: $535.31 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $359.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $535.31 AETNA — AETNA DOMINOS PPO: $370.08 AETNA — AETNA PPO: $386.26 AETNA — AETNA PREFERRED: $272.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $105.03 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $107.17
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$402	$261.30	$48.24 – $402
Screening mammogram, both breasts: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $257.28 ACCESS HEALTH — COFINITY PPO: $255.27 ACCLAIM — COFINITY PPO: $255.27 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $171.65 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $255.27 AETNA — AETNA DOMINOS PPO: $176.48 AETNA — AETNA PPO: $320.36 AETNA — AETNA PREFERRED: $129.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $86.47 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $88.23
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$582	$378.30	$48.24 – $582
Screening mammogram, both breasts: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $372.48 ACCESS HEALTH — COFINITY PPO: $369.57 ACCLAIM — COFINITY PPO: $369.57 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $248.51 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $369.57 AETNA — AETNA DOMINOS PPO: $255.50 AETNA — AETNA PPO: $320.36 AETNA — AETNA PREFERRED: $187.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $86.47 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $88.23

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	$32	Not listed in the file	$9.16 – $32
Electrocardiogram (ECG/EKG) with reading: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $20.94 ACCLAIM — COFINITY: $18.56 AETNA MEDICAID — MEDICAID: $9.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $15.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $15.20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $9.16 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $15.20 ALLEGEANT — COFINITY: $18.56 ALLIED BENEFIT SYSTEMS — COFINITY: $18.56 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $9.16
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	$61	Not listed in the file	$11.11 – $61
Electrocardiogram (ECG/EKG) with reading: 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $20.94 ACCLAIM — COFINITY: $35.38 ADMINISTRATIVE CONCEPTS — COFINITY: $35.38 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $15.20 AETNA — AETNA: $26.92 AETNA DOMESTIC — AETNA: $26.92 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $15.20 AETNA MEDICARE TRANSPLANT — MEDICARE: $15.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $15.51 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $15.20
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR Lt Heart Catheterization Incl Intraproc Inj for Lt Ventriculography Img\|PROFESSIONAL COMPONENT	$462	Not listed in the file	$73.38 – $360.54
Left heart catheterization (diagnostic): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $267.96 ADMINISTRATIVE CONCEPTS — COFINITY: $267.96 AETNA — AETNA: $222.65 AETNA MEDICAID — MEDICAID: $73.38 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $121.84 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $73.38 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $73.38 ALLEGEANT — COFINITY: $267.96 ALLIED BENEFIT SYSTEMS — COFINITY: $267.96 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $167.84
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR Lt Heart Catheterization Incl Intraproc Inj for Lt Ventriculography Img\|PROFESSIONAL COMPONENT	Not listed in the file	Not listed in the file	$73.38 – $501.25
Left heart catheterization (diagnostic): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $167.84 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $121.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $121.84 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $167.84 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $121.84 ALLY ALIGN CARE ADV — MEDICARE: $121.84 AMERIBEN — COFINITY: $290.73 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $290.73 AMERICAN NATIONAL — COFINITY: $290.73
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Comprehensive Rt Atrial/Ventricular Pacing/Record W/O Arrhythmia	$14,876	$9,669.40	$910.87 – $17,493.67
Heart rhythm study (electrophysiology evaluation): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $9,520.64 ACCESS HEALTH — COFINITY PPO: $9,446.26 ACCLAIM — COFINITY PPO: $9,446.26 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $6,352.05 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $9,446.26 AETNA — AETNA DOMINOS PPO: $6,530.56 AETNA — AETNA PPO: $8,628.08 AETNA — AETNA PREFERRED: $4,804.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7,619.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7,774.96
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Electrophysiologic Comprehensive Transeptal Atrial Fibrillation	$38,048	$24,731.20	$373.84 – $58,623.94
Heart rhythm study with ablation for atrial fibrillation: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $24,350.72 ACCESS HEALTH — COFINITY PPO: $24,160.48 ACCLAIM — COFINITY PPO: $24,160.48 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $16,246.50 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $24,160.48 AETNA — AETNA DOMINOS PPO: $16,703.07 AETNA — AETNA PPO: $22,067.84 AETNA — AETNA PREFERRED: $12,289.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $25,533.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $26,055.08
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	$2,196	Not listed in the file	$295.22 – $1,293.31
Heart rhythm study with ablation for atrial fibrillation: 10 of 838 insurance plan rates ACCLAIM — COFINITY: $1,273.68 AETNA — AETNA: $907.84 AETNA DOMESTIC — AETNA: $907.84 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $437.05 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $295.22 ALLEGEANT — COFINITY: $1,273.68 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $602.06 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $437.05 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $295.22 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $437.05
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	Not listed in the file	Not listed in the file	$349.77 – $1,509.90
Heart rhythm study with ablation for atrial fibrillation: 10 of 571 insurance plan rates ACCLAIM — COFINITY: $1,509.90 ADMINISTRATIVE CONCEPTS — COFINITY: $1,509.90 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $437.05 AETNA — AETNA: $907.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $437.05 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $437.05 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $445.97 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $437.05 ALLEGEANT — COFINITY: $1,509.90 ALLIED BENEFIT SYSTEMS — COFINITY: $1,509.90
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$4,995	$3,246.75	$470.25 – $4,995
Sleep study (overnight, in a sleep lab): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,196.80 ACCESS HEALTH — COFINITY PPO: $3,171.83 ACCLAIM — COFINITY PPO: $3,171.83 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,132.87 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,171.83 AETNA — AETNA DOMINOS PPO: $2,192.81 AETNA — AETNA PPO: $2,897.10 AETNA — AETNA PREFERRED: $1,613.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $838.90 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $856.02

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$220	$143	$15.83 – $220
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $140.80 ACCESS HEALTH — COFINITY PPO: $139.70 ACCLAIM — COFINITY PPO: $139.70 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $93.94 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $139.70 AETNA — AETNA DOMINOS PPO: $96.58 AETNA — AETNA PPO: $127.60 AETNA — AETNA PREFERRED: $71.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28.37 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$220	$143	$44.87 – $220
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $140.80 ACCESS HEALTH — COFINITY PPO: $139.70 ACCLAIM — COFINITY PPO: $139.70 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $93.94 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $139.70 AETNA — AETNA DOMINOS PPO: $96.58 AETNA — AETNA PPO: $127.60 AETNA — AETNA PREFERRED: $71.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28.37 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Therapeutic Procedure >=1 Area Therapeutic Exercises Each 15 Minutes	$45	Not listed in the file	$18.96 – $75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 835 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $33.06 ACCLAIM — COFINITY: $26.10 AETNA DOMESTIC — AETNA: $30.05 AETNA MEDICAID — MEDICAID: $18.96 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $24 AETNA MEDICARE TRANSPLANT — MEDICARE: $24 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $18.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $24 ALLEGEANT — COFINITY: $26.10 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $33.06
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$334	$217.10	$53.01 – $334
Physical therapy evaluation (low complexity): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $213.76 ACCESS HEALTH — COFINITY PPO: $212.09 ACCLAIM — COFINITY PPO: $212.09 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $142.62 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $212.09 AETNA — AETNA DOMINOS PPO: $146.63 AETNA — AETNA PPO: $193.72 AETNA — AETNA PREFERRED: $107.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Physical Therapy Evaluation Low Complex 20 Mins	$105	Not listed in the file	$60.90 – $105
Physical therapy evaluation (low complexity): 10 of 838 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $80.63 AETNA MEDICAID — MEDICAID: $64.54 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $80.63 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $64.54 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $82.28 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $80.63 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $64.54 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $80.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $64.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $80.63
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Physical Therapy Evaluation Low Complex 20 Mins	Not listed in the file	Not listed in the file	$62.04 – $106.97
Physical therapy evaluation (low complexity): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $62.04 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $94.86 AETNA DOMESTIC — AETNA: $102.51 AETNA MEDICARE TRANSPLANT — MEDICARE: $94.86 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $64.54 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $64.54 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $94.86 ALLEGEANT — COFINITY: $62.04 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $106.97 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $64.54
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$378	$245.70	$53.01 – $378
Physical therapy evaluation (moderate complexity): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $241.92 ACCESS HEALTH — COFINITY PPO: $240.03 ACCLAIM — COFINITY PPO: $240.03 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $161.41 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $240.03 AETNA — AETNA DOMINOS PPO: $165.94 AETNA — AETNA PPO: $219.24 AETNA — AETNA PREFERRED: $122.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$384	$249.60	$53.01 – $384
Physical therapy evaluation (high complexity): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $245.76 ACCESS HEALTH — COFINITY PPO: $243.84 ACCLAIM — COFINITY PPO: $243.84 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $163.97 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $243.84 AETNA — AETNA DOMINOS PPO: $168.58 AETNA — AETNA PPO: $222.72 AETNA — AETNA PREFERRED: $124.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 30 Minutes	$172	Not listed in the file	$46.98 – $172
Psychotherapy, 30 minutes: 10 of 840 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $115.21 ACCLAIM — COFINITY: $99.76 ADMINISTRATIVE CONCEPTS — COFINITY: $99.76 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $83.63 AETNA — AETNA: $124.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $83.63 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $83.63 AETNA MEDICARE TRANSPLANT — MEDICARE: $83.63 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $52.55 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $85.34
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 30 Minutes	Not listed in the file	Not listed in the file	$46.34 – $174.10
Psychotherapy, 30 minutes: 10 of 840 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $93.89 ACCLAIM — COFINITY: $100.98 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $68.16 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $68.16 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $68.16 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $68.16 ALLEGEANT — COFINITY: $100.98 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $93.89 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $68.16 ALLY ALIGN CARE ADV — MEDICARE: $68.16
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 45 Minutes	$227	Not listed in the file	$69.33 – $227
Psychotherapy, 45 minutes: 10 of 840 insurance plan rates AETNA — AETNA: $164.83 AETNA MEDICAID — MEDICAID: $69.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $111.12 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $69.33 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $69.33 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $69.33 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $111.12 AMERICAN HEALTH PLAN — MEDICARE: $111.12 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $131.66 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $69.33
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 45 Minutes	Not listed in the file	Not listed in the file	$61.15 – $225.19
Psychotherapy, 45 minutes: 10 of 840 insurance plan rates ACCLAIM — COFINITY: $130.61 AETNA — AETNA: $146.69 AETNA DOMESTIC — AETNA: $146.69 AETNA MEDICAID — MEDICAID: $61.15 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $90.27 AETNA MEDICARE TRANSPLANT — MEDICARE: $90.27 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $61.15 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $61.15 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $92.11 ALLEGEANT — COFINITY: $130.61
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 60 Minutes	$336	Not listed in the file	$99.75 – $336
Psychotherapy, 60 minutes: 10 of 840 insurance plan rates ACCLAIM — COFINITY: $194.88 ADMINISTRATIVE CONCEPTS — COFINITY: $194.88 AETNA — AETNA: $242.49 AETNA DOMESTIC — AETNA: $242.49 AETNA MEDICAID — MEDICAID: $102.74 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $162.74 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $102.74 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $166.06 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.74 ALLEGEANT — COFINITY: $194.88
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 60 Minutes	Not listed in the file	Not listed in the file	$90.56 – $315.42
Psychotherapy, 60 minutes: 10 of 840 insurance plan rates ACCLAIM — COFINITY: $182.94 ADMINISTRATIVE CONCEPTS — COFINITY: $182.94 AETNA — AETNA: $215.54 AETNA MEDICAID — MEDICAID: $90.56 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.56 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.56 ALLEGEANT — COFINITY: $182.94 ALLIED BENEFIT SYSTEMS — COFINITY: $182.94 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $182.84 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $90.56
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Drug Rehabilitation	$209	$135.85	$49.64 – $209
Group psychotherapy: 10 of 232 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $133.76 ACCESS HEALTH — COFINITY PPO: $132.72 ACCLAIM — COFINITY PPO: $132.72 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $89.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $132.72 AETNA — AETNA DOMINOS PPO: $91.75 AETNA — AETNA PPO: $121.22 AETNA — AETNA PREFERRED: $67.51 ALLEGEANT — COFINITY PPO: $132.72 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $89.24
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy	$185	$120.25	$49.64 – $195
Group psychotherapy: 10 of 232 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $118.40 ACCESS HEALTH — COFINITY PPO: $117.48 ACCLAIM — COFINITY PPO: $117.48 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $79 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $117.48 AETNA — AETNA DOMINOS PPO: $81.22 AETNA — AETNA PPO: $107.30 AETNA — AETNA PREFERRED: $59.76 ALLEGEANT — COFINITY PPO: $117.48 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $79
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Psychotherapy Group	$61	Not listed in the file	$18.75 – $61
Group psychotherapy: 10 of 840 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $40.99 ADMINISTRATIVE CONCEPTS — COFINITY: $35.38 AETNA — AETNA: $44.13 AETNA DOMESTIC — AETNA: $44.13 AETNA MEDICAID — MEDICAID: $18.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $29.75 ALLIED BENEFIT SYSTEMS — COFINITY: $35.38 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $40.99 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $18.75 AMERIBEN — COFINITY: $35.38

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$854	Not listed in the file	$135.90 – $1,078.80
Removal of breast growth (open surgery): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $495.32 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $213.26 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $135.90 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $135.90 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $217.61 ALLEGEANT — COFINITY: $495.32 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $135.90 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $135.90 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $213.26 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $495.32
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt	Not listed in the file	$15,396.43	$1,027.63 – $8,781.83
Removal of breast growth (open surgery): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,824.97 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,903.03 ANGELA HOSPICE — ANGELA HOSPICE: $3,903.03 ASR HEALTH BENEFITS — HAP AHLIC: $1,459.89 BCBS GENERIC — BCBS TRAD / TRUST: $3,307.64 BCN DOMESTIC — BCN HMO: $3,307.64 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,307.64 BLUE CARE NETWORK — BCN HMO: $3,307.64 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,824.97 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,307.64
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	Not listed in the file	Not listed in the file	$163.20 – $1,465.08
Removal of breast growth (open surgery): 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $623.21 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $291.43 AETNA — AETNA: $404.47 AETNA DOMESTIC — AETNA: $404.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $291.43 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $168.06 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $297.38 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $291.43 ALLIED BENEFIT SYSTEMS — COFINITY: $623.21 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $401.47
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$3,261	Not listed in the file	$23.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,237.50
Total hip replacement: 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $1,891.38 AETNA — AETNA: $1,094.30 AETNA DOMESTIC — AETNA: $1,094.30 AETNA MEDICAID — MEDICAID: $414.61 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $414.61 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $414.61 ALLIED BENEFIT SYSTEMS — COFINITY: $1,891.38 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $837.45 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $414.61 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $414.61
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH)	Not listed in the file	$36,996.99	$2,767.78 – $28,795.55
Total hip replacement: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,542.06 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $12,798.02 ANGELA HOSPICE — ANGELA HOSPICE: $12,798.02 ASR HEALTH BENEFITS — HAP AHLIC: $4,404.03 BCBS GENERIC — BCBS TRAD / TRUST: $21,425.88 BCN DOMESTIC — BCN HMO: $21,425.88 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $21,425.88 BLUE CARE NETWORK — BCN HMO: $21,425.88 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $12,542.06 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $21,425.88
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	Not listed in the file	Not listed in the file	$13.99 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,350
Total hip replacement: 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $837.45 ACCLAIM — COFINITY: $2,363.91 AETNA DOMESTIC — AETNA: $1,094.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $607.93 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $607.93 AETNA MEDICARE TRANSPLANT — MEDICARE: $607.93 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $620.33 ALLEGEANT — COFINITY: $2,363.91 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $607.93 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $607.93
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$3,403	Not listed in the file	$23.83 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,231.50
Total knee replacement: 10 of 838 insurance plan rates ACCLAIM — COFINITY: $1,973.74 ADMINISTRATIVE CONCEPTS — COFINITY: $1,973.74 AETNA MEDICAID — MEDICAID: $414.07 AETNA MEDICARE TRANSPLANT — MEDICARE: $606.74 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $414.07 ALLEGEANT — COFINITY: $1,973.74 ALLIED BENEFIT SYSTEMS — COFINITY: $1,973.74 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $835.81 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $414.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $414.07
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH)	Not listed in the file	$37,229.22	$2,764.23 – $28,795.55
Total knee replacement: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,542.06 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $12,798.02 ANGELA HOSPICE — ANGELA HOSPICE: $12,798.02 ASR HEALTH BENEFITS — HAP AHLIC: $4,703.79 BCBS GENERIC — BCBS TRAD / TRUST: $20,893.56 BCN DOMESTIC — BCN HMO: $20,893.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $20,893.56 BLUE CARE NETWORK — BCN HMO: $20,893.56 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $12,542.06 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $20,893.56
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	Not listed in the file	Not listed in the file	$16.12 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $8,600.34
Total knee replacement: 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $835.81 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $606.74 AETNA — AETNA: $1,093.18 AETNA DOMESTIC — AETNA: $1,093.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $606.74 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $606.74 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $619.12 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $606.74 ALLIED BENEFIT SYSTEMS — COFINITY: $2,327.45 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $606.74
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty	$1,010	Not listed in the file	$6.25 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,010
Shoulder arthroscopy: shaving of shoulder bone: 10 of 838 insurance plan rates ACCLAIM — COFINITY: $585.80 ADMINISTRATIVE CONCEPTS — COFINITY: $585.80 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $133.16 AETNA — AETNA: $249.82 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $109.70 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $133.16 ALLEGEANT — COFINITY: $585.80 ALLIED BENEFIT SYSTEMS — COFINITY: $585.80 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $183.44 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $109.70
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH)	Not listed in the file	$27,298.97	$339.91 – $16,274.78
Shoulder arthroscopy: shaving of shoulder bone: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7,088.57 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7,233.23 ANGELA HOSPICE — ANGELA HOSPICE: $7,233.23 ASR HEALTH BENEFITS — HAP AHLIC: $547.87 BCBS GENERIC — BCBS TRAD / TRUST: $3,789.97 BCN DOMESTIC — BCN HMO: $3,789.97 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,789.97 BLUE CARE NETWORK — BCN HMO: $3,789.97 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $7,088.57 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,789.97
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty	Not listed in the file	Not listed in the file	$8.49 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,020.26
Shoulder arthroscopy: shaving of shoulder bone: 10 of 571 insurance plan rates ACCLAIM — COFINITY: $591.75 ADMINISTRATIVE CONCEPTS — COFINITY: $591.75 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $156.66 AETNA — AETNA: $293.90 AETNA DOMESTIC — AETNA: $293.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $156.66 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $159.86 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $156.66 ALLEGEANT — COFINITY: $591.75 ALLIED BENEFIT SYSTEMS — COFINITY: $591.75
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,288	Not listed in the file	$10.31 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,830
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $747.04 ADMINISTRATIVE CONCEPTS — COFINITY: $747.04 AETNA — AETNA: $460.55 AETNA MEDICAID — MEDICAID: $177.22 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $177.22 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $177.22 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $264.46 ALLEGEANT — COFINITY: $747.04 ALLIED BENEFIT SYSTEMS — COFINITY: $747.04 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $364.31
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH)	Not listed in the file	$17,328.84	$1,170.67 – $7,338.69
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,196.41 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,261.64 ANGELA HOSPICE — ANGELA HOSPICE: $3,261.64 ASR HEALTH BENEFITS — HAP AHLIC: $1,656.34 BCBS GENERIC — BCBS TRAD / TRUST: $3,796.88 BCN DOMESTIC — BCN HMO: $3,796.88 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,796.88 BLUE CARE NETWORK — BCN HMO: $3,796.88 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,196.41 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,796.88
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	Not listed in the file	Not listed in the file	$4.97 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,702.25
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $364.31 ADMINISTRATIVE CONCEPTS — COFINITY: $837.14 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $264.46 AETNA — AETNA: $460.55 AETNA DOMESTIC — AETNA: $460.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $264.46 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $264.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $269.86 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $264.46 ALLIED BENEFIT SYSTEMS — COFINITY: $837.14
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Tonsillectomy & Adenoidectomy Younger Than Age 12	Not listed in the file	$14,337.58	$625.04 – $13,277.44
Removal of tonsils and adenoids (under age 12): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,783.06 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $5,901.08 ANGELA HOSPICE — ANGELA HOSPICE: $5,901.08 ASR HEALTH BENEFITS — HAP AHLIC: $882.97 BCBS GENERIC — BCBS TRAD / TRUST: $3,329.46 BCN DOMESTIC — BCN HMO: $3,329.46 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,329.46 BLUE CARE NETWORK — BCN HMO: $3,329.46 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $5,783.06 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,329.46
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$354	Not listed in the file	$3.42 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $246.61
Upper GI endoscopy (diagnostic): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $205.32 ADMINISTRATIVE CONCEPTS — COFINITY: $205.32 AETNA — AETNA: $180.54 AETNA MEDICAID — MEDICAID: $38.88 AETNA MEDICARE TRANSPLANT — MEDICARE: $56.28 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $38.88 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $38.88 ALLEGEANT — COFINITY: $205.32 ALLIED BENEFIT SYSTEMS — COFINITY: $205.32 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $77.53
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	Not listed in the file	$3,690.05	$496.67 – $2,034.25
Upper GI endoscopy (diagnostic): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $886.03 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $904.11 ANGELA HOSPICE — ANGELA HOSPICE: $904.11 ASR HEALTH BENEFITS — HAP AHLIC: $888.56 BCBS GENERIC — BCBS TRAD / TRUST: $822.43 BCN DOMESTIC — BCN HMO: $822.43 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $822.43 BLUE CARE NETWORK — BCN HMO: $822.43 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $886.03 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $822.43
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	Not listed in the file	Not listed in the file	$4.09 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $400.56
Upper GI endoscopy (diagnostic): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $215.90 ACCLAIM — COFINITY: $232.32 ADMINISTRATIVE CONCEPTS — COFINITY: $232.32 AETNA — AETNA: $180.54 AETNA MEDICAID — MEDICAID: $90.95 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $156.73 AETNA MEDICARE TRANSPLANT — MEDICARE: $156.73 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.95 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.95 ALLEGEANT — COFINITY: $232.32
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$282	Not listed in the file	$43.67 – $283.36
Upper GI endoscopy with biopsy: 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $163.56 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $62.96 AETNA — AETNA: $158.67 AETNA DOMESTIC — AETNA: $158.67 AETNA MEDICAID — MEDICAID: $43.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $62.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $43.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $64.24 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $62.96 ALLIED BENEFIT SYSTEMS — COFINITY: $163.56
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	Not listed in the file	$6,083.25	$449.17 – $2,034.25
Upper GI endoscopy with biopsy: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $886.03 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $904.11 ANGELA HOSPICE — ANGELA HOSPICE: $904.11 ASR HEALTH BENEFITS — HAP AHLIC: $1,025.06 BCBS GENERIC — BCBS TRAD / TRUST: $998.10 BCN DOMESTIC — BCN HMO: $998.10 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $998.10 BLUE CARE NETWORK — BCN HMO: $998.10 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $886.03 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $998.10
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	Not listed in the file	Not listed in the file	$95.32 – $447.16
Upper GI endoscopy with biopsy: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $279.05 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $202.57 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $117.58 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $117.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $117.58 AMERIBEN — COFINITY: $257.91 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $202.57 AMERICAN HEALTH PLAN — MEDICARE: $202.57 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $257.91 AMERICAN NATIONAL — COFINITY: $257.91
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$369	Not listed in the file	$58.36 – $250.11
Colonoscopy (diagnostic): 10 of 838 insurance plan rates ACCLAIM — COFINITY: $214.02 AETNA — AETNA: $200.06 AETNA MEDICAID — MEDICAID: $58.36 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.52 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.52 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $58.36 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $58.36 ALLEGEANT — COFINITY: $214.02 ALLIED BENEFIT SYSTEMS — COFINITY: $214.02 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $116.43
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	Not listed in the file	$4,294.65	$509.25 – $2,085.78
Colonoscopy (diagnostic): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $908.47 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $927.01 ANGELA HOSPICE — ANGELA HOSPICE: $927.01 ASR HEALTH BENEFITS — HAP AHLIC: $1,181.97 BCBS GENERIC — BCBS TRAD / TRUST: $931.56 BCN DOMESTIC — BCN HMO: $931.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $931.56 BLUE CARE NETWORK — BCN HMO: $931.56 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $908.47 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $931.56
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	Not listed in the file	Not listed in the file	$107.89 – $548.77
Colonoscopy (diagnostic): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $255.46 ACCLAIM — COFINITY: $329.06 ADMINISTRATIVE CONCEPTS — COFINITY: $329.06 AETNA — AETNA: $200.06 AETNA MEDICAID — MEDICAID: $107.89 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $185.45 AETNA MEDICARE TRANSPLANT — MEDICARE: $185.45 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $107.89 ALLEGEANT — COFINITY: $329.06 ALLIED BENEFIT SYSTEMS — COFINITY: $329.06
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$403	Not listed in the file	$63.48 – $269.18
Colonoscopy with biopsy: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $125.31 AETNA MEDICAID — MEDICAID: $63.48 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $63.48 ALLIED BENEFIT SYSTEMS — COFINITY: $233.74 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $125.31 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $63.48 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $90.97 AMERIBEN — COFINITY: $233.74 AMERICAN FAMILY — COFINITY: $233.74 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $90.97
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	Not listed in the file	$6,012.37	$655.29 – $2,683.92
Colonoscopy with biopsy: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,168.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,192.85 ANGELA HOSPICE — ANGELA HOSPICE: $1,192.85 ASR HEALTH BENEFITS — HAP AHLIC: $1,408.20 BCBS GENERIC — BCBS TRAD / TRUST: $1,022.05 BCN DOMESTIC — BCN HMO: $1,022.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,022.05 BLUE CARE NETWORK — BCN HMO: $1,022.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,168.99 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,022.05
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	Not listed in the file	Not listed in the file	$125.25 – $679.03
Colonoscopy with biopsy: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $322.43 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $234.06 AETNA DOMESTIC — AETNA: $239.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $234.06 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $234.06 AETNA MEDICARE TRANSPLANT — MEDICARE: $234.06 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $238.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $234.06 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $234.06 ALLY ALIGN CARE ADV — MEDICARE: $234.06
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$506	Not listed in the file	$79.98 – $435.19
Colonoscopy with removal of polyps (snare): 10 of 838 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $114.24 AETNA DOMESTIC — AETNA: $284.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $114.24 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $79.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $116.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $114.24 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $114.24 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $114.24 ALLY ALIGN CARE ADV — MEDICARE: $114.24 AMERIBEN — COFINITY: $293.48
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)	Not listed in the file	$5,671.15	$625.84 – $2,683.92
Colonoscopy with removal of polyps (snare): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,168.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,192.85 ANGELA HOSPICE — ANGELA HOSPICE: $1,192.85 ASR HEALTH BENEFITS — HAP AHLIC: $1,588.13 BCBS GENERIC — BCBS TRAD / TRUST: $1,022.05 BCN DOMESTIC — BCN HMO: $1,022.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,022.05 BLUE CARE NETWORK — BCN HMO: $1,022.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,168.99 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,022.05
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	Not listed in the file	Not listed in the file	$143.35 – $725.48
Colonoscopy with removal of polyps (snare): 10 of 838 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $245.16 AETNA — AETNA: $284.43 AETNA DOMESTIC — AETNA: $284.43 AETNA MEDICAID — MEDICAID: $143.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $245.16 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $143.35 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $245.16 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $337.73 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $143.35 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $245.16
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	$769	Not listed in the file	$58.47 – $446.02
Screening colonoscopy (not high risk): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $116.82 ACCLAIM — COFINITY: $446.02 ADMINISTRATIVE CONCEPTS — COFINITY: $446.02 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $84.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $84.80 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.80 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.80 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $58.47 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.80 ALLEGEANT — COFINITY: $446.02
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	Not listed in the file	$4,134.52	$509.25 – $2,085.78
Screening colonoscopy (not high risk): 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $908.47 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $927.01 ANGELA HOSPICE — ANGELA HOSPICE: $927.01 ASR HEALTH BENEFITS — HAP AHLIC: $1,181.97 BCBS GENERIC — BCBS TRAD / TRUST: $931.56 BCN DOMESTIC — BCN HMO: $931.56 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $931.56 BLUE CARE NETWORK — BCN HMO: $931.56 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $908.47 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $931.56
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	Not listed in the file	Not listed in the file	$89.53 – $549.58
Screening colonoscopy (not high risk): 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $255.84 ACCLAIM — COFINITY: $334.80 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $185.72 AETNA DOMESTIC — AETNA: $261.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $185.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $185.72 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $107.99 ALLEGEANT — COFINITY: $334.80 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $185.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $107.99
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,541	Not listed in the file	$12.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $993.98
Gallbladder removal by laparoscope: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $462.72 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $335.90 AETNA DOMESTIC — AETNA: $574.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $335.90 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $342.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $335.90 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $335.90 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $335.90 ALLY ALIGN CARE ADV — MEDICARE: $335.90 AMERIBEN — COFINITY: $893.78
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)	Not listed in the file	$28,384.47	$1,438.76 – $13,559.36
Gallbladder removal by laparoscope: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,905.85 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6,026.38 ANGELA HOSPICE — ANGELA HOSPICE: $6,026.38 ASR HEALTH BENEFITS — HAP AHLIC: $2,286.06 BCBS GENERIC — BCBS TRAD / TRUST: $5,987.71 BCN DOMESTIC — BCN HMO: $5,987.71 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $5,987.71 BLUE CARE NETWORK — BCN HMO: $5,987.71 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $5,905.85 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $5,987.71
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	Not listed in the file	Not listed in the file	$6.70 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,786.44
Gallbladder removal by laparoscope: 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $462.72 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $335.90 AETNA DOMESTIC — AETNA: $574.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $335.90 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $335.90 AETNA MEDICARE TRANSPLANT — MEDICARE: $335.90 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $342.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $335.90 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $335.90 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $335.90
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,199	Not listed in the file	$9.77 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,735.50
Groin (inguinal) hernia repair, age 5 or older: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $369.98 ACCLAIM — COFINITY: $695.42 ADMINISTRATIVE CONCEPTS — COFINITY: $695.42 AETNA — AETNA: $381.92 AETNA MEDICAID — MEDICAID: $169.76 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $268.58 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $169.76 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $169.76 ALLEGEANT — COFINITY: $695.42 ALLIED BENEFIT SYSTEMS — COFINITY: $695.42
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH)	Not listed in the file	$20,581.57	$1,139.81 – $13,616.26
Groin (inguinal) hernia repair, age 5 or older: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,497.68 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,569.06 ANGELA HOSPICE — ANGELA HOSPICE: $3,569.06 ASR HEALTH BENEFITS — HAP AHLIC: $1,580.63 BCBS GENERIC — BCBS TRAD / TRUST: $4,527.85 BCN DOMESTIC — BCN HMO: $4,527.85 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $4,527.85 BLUE CARE NETWORK — BCN HMO: $4,527.85 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,497.68 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $4,527.85
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	Not listed in the file	Not listed in the file	$5.21 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,272
Groin (inguinal) hernia repair, age 5 or older: 10 of 571 insurance plan rates ACCLAIM — COFINITY: $804.27 ADMINISTRATIVE CONCEPTS — COFINITY: $804.27 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $268.58 AETNA — AETNA: $381.92 AETNA DOMESTIC — AETNA: $381.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $268.58 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $274.06 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $268.58 ALLEGEANT — COFINITY: $804.27 ALLIED BENEFIT SYSTEMS — COFINITY: $804.27
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$2,159	$1,403.35	$462.46 – $2,159
Prostate biopsy: 10 of 247 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,381.76 ACCESS HEALTH — COFINITY PPO: $1,370.97 ACCLAIM — COFINITY PPO: $1,370.97 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $921.89 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,370.97 AETNA — AETNA DOMINOS PPO: $947.80 AETNA — AETNA PPO: $1,252.22 AETNA — AETNA PREFERRED: $697.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $820.42 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,835.15
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	Not listed in the file	$14,954.15	$50.91 – $1,842.48
Prostate biopsy: 10 of 87 insurance plan rates ANGELA HOSPICE — ANGELA HOSPICE: $51.95 ASR HEALTH BENEFITS — HAP AHLIC: $653.27 BCBS GENERIC — BCBS TRAD / TRUST: $1,842.48 BCN DOMESTIC — BCN HMO: $1,842.48 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,842.48 BLUE CARE NETWORK — BCN HMO: $1,842.48 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $50.91 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,842.48 BLUE CROSS - AL — BCBS TRAD / TRUST: $1,842.48 BLUE CROSS - AR — BCBS TRAD / TRUST: $1,842.48
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$684	Not listed in the file	$6.37 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $396.72
Hysteroscopy with biopsy of the uterus lining: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $148.07 ACCLAIM — COFINITY: $396.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.49 AETNA MEDICARE TRANSPLANT — MEDICARE: $107.49 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $73.91 ALLEGEANT — COFINITY: $396.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $73.91 AMERIBEN — COFINITY: $396.72 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $107.49 AMERICAN HEALTH PLAN — MEDICARE: $107.49
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	Not listed in the file	$18,757.81	$1,143.57 – $13,559.36
Hysteroscopy with biopsy of the uterus lining: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,162.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,226.87 ANGELA HOSPICE — ANGELA HOSPICE: $3,226.87 ASR HEALTH BENEFITS — HAP AHLIC: $1,143.57 BCBS GENERIC — BCBS TRAD / TRUST: $3,830.44 BCN DOMESTIC — BCN HMO: $3,830.44 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,830.44 BLUE CARE NETWORK — BCN HMO: $3,830.44 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,162.34 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,830.44
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	Not listed in the file	Not listed in the file	$8.81 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,810.35
Hysteroscopy with biopsy of the uterus lining: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $842.75 ACCLAIM — COFINITY: $1,650.82 ADMINISTRATIVE CONCEPTS — COFINITY: $1,650.82 AETNA — AETNA: $678.99 AETNA MEDICAID — MEDICAID: $397.46 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $611.78 AETNA MEDICARE TRANSPLANT — MEDICARE: $611.78 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $397.46 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $611.78 ALLIED BENEFIT SYSTEMS — COFINITY: $1,650.82
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance	$1,717	$1,116.05	$386.55 – $1,717
Spinal injection, lower back (epidural), with imaging guidance: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,098.88 ACCESS HEALTH — COFINITY PPO: $1,090.30 ACCLAIM — COFINITY PPO: $1,090.30 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $733.16 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,090.30 AETNA — AETNA DOMINOS PPO: $753.76 AETNA — AETNA PPO: $995.86 AETNA — AETNA PREFERRED: $554.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $689.57 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $703.65
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl	$3,822	$2,484.30	$484.35 – $3,822
Nerve root injection, lower back, with imaging guidance: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,446.08 ACCESS HEALTH — COFINITY PPO: $2,426.97 ACCLAIM — COFINITY PPO: $2,426.97 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,631.99 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,426.97 AETNA — AETNA DOMINOS PPO: $1,677.86 AETNA — AETNA PPO: $2,216.76 AETNA — AETNA PREFERRED: $1,234.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $864.04 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $881.67
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$918	Not listed in the file	$122.01 – $1,492.50
Carpal tunnel release: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $295.58 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $214.57 AETNA MEDICARE TRANSPLANT — MEDICARE: $214.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $214.57 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $214.57 ALLY ALIGN CARE ADV — MEDICARE: $214.57 AMERIBEN — COFINITY: $532.44 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $214.57 AMERICAN HEALTH PLAN — MEDICARE: $214.57 AMERICAN NATIONAL — COFINITY: $532.44
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Neuroplasty Median Nerve Carpal Rt	Not listed in the file	$11,647.93	$975.18 – $4,379.72
Carpal tunnel release: 10 of 102 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,907.61 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,946.54 ANGELA HOSPICE — ANGELA HOSPICE: $1,946.54 ASR HEALTH BENEFITS — HAP AHLIC: $1,282.08 BCBS GENERIC — BCBS TRAD / TRUST: $2,372.52 BCN DOMESTIC — BCN HMO: $2,372.52 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $2,372.52 BLUE CARE NETWORK — BCN HMO: $2,372.52 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,907.61 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $2,372.52
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	Not listed in the file	Not listed in the file	$146.12 – $2,137.13
Carpal tunnel release: 10 of 838 insurance plan rates ACCLAIM — COFINITY: $673.88 ADMINISTRATIVE CONCEPTS — COFINITY: $673.88 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $146.12 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $146.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $247.63 ALLEGEANT — COFINITY: $673.88 ALLIED BENEFIT SYSTEMS — COFINITY: $673.88 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $334.30 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $146.12 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $242.68

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	$4,354	Not listed in the file	$772.38 – $2,999.28
Vaginal delivery, with care before and after: 10 of 838 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,642.61 ACCLAIM — COFINITY: $2,525.32 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,192.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,110.37 ALLEGEANT — COFINITY: $2,525.32 AMERIBEN — COFINITY: $2,525.32 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $1,192.41 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $2,525.32 AMERICAN NATIONAL — COFINITY: $2,525.32 AMERIGROUP MEDICAID — MEDICAID: $1,110.37
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	Not listed in the file	Not listed in the file	$839.77 – $3,528.56
Vaginal delivery, with care before and after: 10 of 571 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $3,247.08 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,192.41 AETNA — AETNA: $1,842.82 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,192.41 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,192.41 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,216.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,192.41 ALLIED BENEFIT SYSTEMS — COFINITY: $3,247.08 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,642.61
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	$4,753	Not listed in the file	$37.48 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,984.82
Cesarean delivery (C-section), with care before and after: 10 of 838 insurance plan rates ACCLAIM — COFINITY: $2,756.74 AETNA MEDICAID — MEDICAID: $1,237.88 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,346.60 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,237.88 ALLEGEANT — COFINITY: $2,756.74 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,237.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $1,237.88 AMERICAN HEALTH PLAN — MEDICARE: $1,346.60 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $2,756.74 AMERIHEALTH MEDICARE — MEDICARE: $1,346.60
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	Not listed in the file	Not listed in the file	$21.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,984.82
Cesarean delivery (C-section), with care before and after: 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,855 ACCLAIM — COFINITY: $3,565.46 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,346.60 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,346.60 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,346.60 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,346.60 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,374.08 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,346.60 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,855
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 80 In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care\|ASSISTANT SURGEON	$937.60	$937.60	$37.48 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,984.82
Cesarean delivery (C-section), with care before and after: 10 of 842 insurance plan rates AETNA MEDICAID — MEDICAID: $198.06 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $215.46 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $198.06 ALLEGEANT — COFINITY: $543.81 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $198.06 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $198.06 AMERICAN HEALTH PLAN — MEDICARE: $215.46 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $543.81 AMERIHEALTH MEDICARE — MEDICARE: $215.46 ANDRIE INC — WORKERS COMP: $421.61
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	$4,470	Not listed in the file	$944.29 – $3,761.26
Vaginal delivery after a previous C-section, with care before and after: 10 of 838 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $2,592.60 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,271.05 AETNA — AETNA: $1,842.82 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICAID — MEDICAID: $1,167.90 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,296.99 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,271.05 ALLIED BENEFIT SYSTEMS — COFINITY: $2,592.60 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,167.90 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $1,271.05
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	Not listed in the file	Not listed in the file	$886.89 – $3,761.26
Vaginal delivery after a previous C-section, with care before and after: 10 of 571 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,750.93 ACCLAIM — COFINITY: $3,429.28 ADMINISTRATIVE CONCEPTS — COFINITY: $3,429.28 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,271.05 AETNA — AETNA: $1,842.82 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,271.05 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,271.05 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,271.05 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,296.99

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	$56,250.71	$975.75 – $45,903.07
Hip or knee replacement (major joint of the leg), without major complications: 10 of 102 insurance plan rates AETNA — AETNA PPO: $30,474.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,845.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $14,128.56 ANGELA HOSPICE — ANGELA HOSPICE: $975.75 ASR HEALTH BENEFITS — HAP AHLIC: $33,213.73 BCBS GENERIC — BCBS TRAD / TRUST: $45,903.07 BCN DOMESTIC — BCN HMO: $45,903.07 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $45,903.07 BLUE CARE NETWORK — BCN HMO: $45,903.07 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $13,845.99
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	$54,610.74	$975.75 – $49,028
Neck (cervical) spinal fusion, without complications: 10 of 102 insurance plan rates AETNA — AETNA PPO: $38,570.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17,450.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $17,806.61 ANGELA HOSPICE — ANGELA HOSPICE: $975.75 ASR HEALTH BENEFITS — HAP AHLIC: $42,036.74 BCBS GENERIC — BCBS TRAD / TRUST: $49,028 BCN DOMESTIC — BCN HMO: $49,028 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $49,028 BLUE CARE NETWORK — BCN HMO: $49,028 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $17,450.48
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	$34,441.82	$975.75 – $28,920.25
Uterus and ovary surgery (not for cancer), without complications: 10 of 102 insurance plan rates AETNA — AETNA PPO: $19,601.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9,004.85 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $9,188.62 ANGELA HOSPICE — ANGELA HOSPICE: $975.75 ASR HEALTH BENEFITS — HAP AHLIC: $21,363.61 BCBS GENERIC — BCBS TRAD / TRUST: $28,920.25 BCN DOMESTIC — BCN HMO: $28,920.25 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $28,920.25 BLUE CARE NETWORK — BCN HMO: $28,920.25 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $9,004.85

Source: St Joe Mercy Hospital System Livonia’s standard charges file (hpt.trinity-health.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 2026; retrieved November 5, 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	36475 Five Mile Road, Livonia, MI 48154
County	Wayne County
State	Michigan
Phone	(734) 655‑4800
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	230002
Name in Medicare records	ST JOE MERCY HOSPITAL SYSTEM LIVONIA
Profile level	Medicare data + hospital website
Name on the hospital’s website	Trinity Health Livonia Hospital
Official website	trinityhealthmichigan.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 ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

Trinity Health Livonia Hospital — trinityhealthmichigan.org
Trinity Health Inpatient Behavioral Health - Livonia Hospital — trinityhealthmichigan.org
Trinity Health Cancer Center - Livonia Hospital — trinityhealthmichigan.org
Trinity Health Cardiac Rehab - Livonia Hospital — trinityhealthmichigan.org
Trinity Health Imaging - Livonia Hospital — trinityhealthmichigan.org