Does St John's Episcopal Hospital at South Shore have an emergency room?

Yes. Medicare (CMS) data lists emergency services at St John's Episcopal Hospital at South Shore. In a medical emergency, call 911.

Where is St John's Episcopal Hospital at South Shore?

327 Beach 19th Street, Far Rockaway, NY 11691, in Queens County, New York.

What is the phone number of St John's Episcopal Hospital at South Shore?

(718) 869-7000, as listed by Medicare (CMS).

What is the Medicare star rating of St John's Episcopal Hospital at South Shore?

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

St John's Episcopal Hospital at South Shore

Quick answers

Does St John's Episcopal Hospital at South Shore have an emergency room?: Yes. Medicare (CMS) data lists emergency services at St John's Episcopal Hospital at South Shore. In a medical emergency, call 911.
Where is St John's Episcopal Hospital at South Shore?: 327 Beach 19th Street, Far Rockaway, NY 11691, in Queens County, New York.
What is the phone number of St John's Episcopal Hospital at South Shore?: (718) 869-7000, as listed by Medicare (CMS).
What is the Medicare star rating of St John's Episcopal Hospital at South Shore?: 1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[8][10]

Conditions treated^[8]

Heart attack
Sepsis
Stroke
Head injuries
Obstetric and gynecologic emergencies
Orthopedic injuries
Behavioral health emergencies
Headache
Abdominal pain

Treatments^[5][9][11]

IV clot-busting medication for stroke (thrombolytic)
Mechanical thrombectomy (via tertiary partner)
Hyperbaric oxygen therapy
Wound care

Procedures^[10]

CT scan
MRI
Ultrasound
Mammography
Nuclear medicine and cardiac stress testing
EEG
Bone densitometry
Interventional radiology

Programs and centers^{[5][7][11][12]}

Stroke services
Patient navigation program
Dialysis center

Emergency care (hospital website)^[4][5][6][8]

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Joint Commission Advanced Primary Stroke Center (Gold Seal)

Recognition^[6]

Joint Commission Gold Seal of Approval for hospital and laboratory accreditation
Joint Commission Gold Seal of Approval as an Advanced Primary Stroke Center
Planetree International Silver Certification for Person-Centered Care
Baby-Friendly USA designated hospital
ADCES Diabetes Education Accreditation Program (DEAP)

Doctors and clinicians (241)

241 doctors and other clinicians list St John's Episcopal Hospital at South Shore 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 217 more: the button below opens the full list.

Other emergency rooms nearby

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

Mount Sinai South Nassau6.5 mi · Oceanside, NY · Acute Care Hospital
Jamaica Hospital Medical Center7.9 mi · Jamaica, NY · Acute Care Hospital
Queens Hospital Center8.6 mi · Jamaica, NY · Acute Care Hospital
Brookdale Hospital Medical Center9.2 mi · Brooklyn, NY · Acute Care Hospital
New York Community Hospital of Brooklyn, Inc.10 mi · Brooklyn, NY · Acute Care Hospital

Other hospitals nearby

Creedmoor Psychiatric Center9.5 mi · Queens Village, NY · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Brookhaven Rehab & Health Care Center L L C0.1 mi · Far Rockaway, NY · 2 of 5 stars
Queens Nassau Rehabilitation and Nursing Center0.1 mi · Far Rockaway, NY · 4 of 5 stars
Haven Manor Health Care Center, LLC0.2 mi · Far Rockaway, NY · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Caring Hospice Services of New York, LLC10 mi · Brooklyn, NY
Comprehensive Comm Hospice of Parker Jewish Inst11 mi · New Hyde Park, NY
Hospice of New York, LLC14 mi · Long Island City, NY · 2 of 5 stars

All hospice providers in the state →

Home health agencies

Four Seasons Nursing & Rehabilitation Chha8.3 mi · Brooklyn, NY · 4 of 5 stars
Americare Certified Special Services, Inc Chha8.3 mi · Brooklyn, NY · 5 of 5 stars
Able Health Care Services Inc Chha9.9 mi · Hempstead, NY

All home health agencies in the state →

Dialysis facilities

Cassena Kidney Care at Peninsula0.5 mi · Far Rockaway, NY · 1 of 5 stars
Marjorie Basser Dialysis Center0.5 mi · Far Rockaway, NY · 3 of 5 stars
Rockaway Dialysis0.5 mi · Far Rockaway, NY · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Asc of Rockaway Beach5.4 mi · Rockaway Park, NY
Lynbrook SC, LLC5.8 mi · Lynbrook, NY
Physicians Choice Surgicenter6.3 mi · Howard Beach, NY

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Premium Health, Inc.0.1 mi · Far Rockaway, NY · Community health center
Premium Health, Inc.0.4 mi · Far Rockaway, NY · Community health center
Village Academy (27Q319)0.5 mi · Far Rockaway, NY · Community health center

Clinics and urgent care

Aijuan Wang Medicine PLLC0.5 mi · Far Rockaway, NY · Urgent care center
Hewlett Urgent Care PLLC2.4 mi · Cedarhurst, NY · Urgent care center
Upstate Urgent Care PLLC3.1 mi · Woodmere, NY · Urgent care center

Pharmacies

99 C & Pharmacy, Inc.0.5 mi · Far Rockaway, NY · Pharmacy
DHBP Corp0.5 mi · Far Rockaway, NY · Community/retail pharmacy
Episcopal Health Services Inc0.5 mi · Far Rockaway, NY · Community/retail pharmacy

Assisted living nearby

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

Central Assisted Living, LLC0.5 mi · Far Rockaway, NY
Central Townhouse0.5 mi · Far Rockaway, NY
Long Island Living Center0.5 mi · Far Rockaway, NY
New Haven Manor0.5 mi · Far Rockaway, NY

About the Medicare star rating

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

Medicare quality data

What St John's Episcopal Hospital at South Shore 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	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	1 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	52%National average: 72%
Would definitely recommend the hospital	56%National average: 71%
Nurses “always” communicated well	68%National average: 80%
Doctors “always” communicated well	73%National average: 80%
Staff “always” explained medicines before giving them	51%National average: 62%
Were given information about recovery at home	79%National average: 86%
Room and bathroom “always” clean	74%National average: 74%
Area around the room “always” quiet at night	44%National average: 60%
Completed surveys	760Response rate: 24%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	1.294No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	1.383No different from the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.473Better 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	11.6%
Deaths within 30 days: heart failure patients	9.6%
Deaths within 30 days: pneumonia patients	25.8%
Deaths within 30 days: COPD patients	9.8%
Deaths within 30 days: stroke patients	14.9%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.26No different from the national rate
Complications after hip or knee replacement	6.5%

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	14.3%
Readmitted within 30 days: heart failure	23.3%
Readmitted within 30 days: pneumonia	20.3%
Readmitted within 30 days: COPD	22.5%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	6.7%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	233 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	51%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in New York Best hospitals in New York

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 52 common services exactly as St John's Episcopal Hospital at South Shore lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN	$456.33	$387.88	$66.04 – $179.03
New patient office visit (about 30–44 minutes): 10 of 30 insurance plan rates Aetna — Commercial: $111.40 Aetna — High Performance Network: $109.81 Aetna — Medicare: $79.57 Blue Cross — Medicare Advantage: $79.57 Centerlight — Medicare/Medicaid: $79.57 Centers Plan for Healthy Living — Medicare: $79.57 Elderplan — Medicare: $79.57 Emblem Health — HIP/GHI Medicare: $79.57 Fidelis — Medicare/Medicaid Advantage Plus: $79.57 Hamaspik — Medicare: $79.57
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW LOW 30 MIN	$456.33	$387.88	$62 – $179.03
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $79.57 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $79.57 Centerlight — Medicare/Medicaid: $79.57 Centers Plan for Healthy Living — Medicare: $79.57 Elderplan — Medicare: $79.57 Emblem Health — HIP/GHI Medicare: $79.57
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: OFFICE O/P NEW LOW 30 MIN	$456.33	$387.88	$62 – $179.03
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $79.57 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $79.57 Centerlight — Medicare/Medicaid: $79.57 Centers Plan for Healthy Living — Medicare: $79.57 Elderplan — Medicare: $79.57 Emblem Health — HIP/GHI Medicare: $79.57
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN	$573.20	$487.22	$107.92 – $292.54
New patient office visit (about 45–59 minutes): 10 of 31 insurance plan rates Aetna — Commercial: $182.03 Aetna — High Performance Network: $179.43 Aetna — Medicare: $130.02 Blue Cross — Medicare Advantage: $130.02 Centerlight — Medicare/Medicaid: $130.02 Centers Plan for Healthy Living — Medicare: $130.02 Elderplan — Medicare: $130.02 Emblem Health — HIP/GHI Medicare: $130.02 Fidelis — Medicare/Medicaid Advantage Plus: $130.02 Hamaspik — Medicare: $130.02
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW MOD 45 MIN	$573.20	$487.22	$62 – $292.54
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $130.02 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $130.02 Centerlight — Medicare/Medicaid: $130.02 Centers Plan for Healthy Living — Medicare: $130.02 Elderplan — Medicare: $130.02 Emblem Health — HIP/GHI Medicare: $130.02
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: OFFICE O/P NEW MOD 45 MIN	$573.20	$487.22	$62 – $292.54
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $130.02 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $130.02 Centerlight — Medicare/Medicaid: $130.02 Centers Plan for Healthy Living — Medicare: $130.02 Elderplan — Medicare: $130.02 Emblem Health — HIP/GHI Medicare: $130.02
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN	$601.02	$510.87	$148.44 – $402.39
New patient office visit (about 60–74 minutes): 10 of 31 insurance plan rates Aetna — Commercial: $250.38 Aetna — High Performance Network: $246.80 Aetna — Medicare: $178.84 Blue Cross — Medicare Advantage: $178.84 Centerlight — Medicare/Medicaid: $178.84 Centers Plan for Healthy Living — Medicare: $178.84 Elderplan — Medicare: $178.84 Emblem Health — HIP/GHI Medicare: $178.84 Fidelis — Medicare/Medicaid Advantage Plus: $178.84 Hamaspik — Medicare: $178.84
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: OFFICE O/P NEW HI 60 MIN	$695.63	$591.29	$62 – $402.39
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $178.84 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $178.84 Centerlight — Medicare/Medicaid: $178.84 Centers Plan for Healthy Living — Medicare: $178.84 Elderplan — Medicare: $178.84 Emblem Health — HIP/GHI Medicare: $178.84
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P NEW HI 60 MIN	$695.63	$591.29	$62 – $402.39
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $178.84 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $178.84 Centerlight — Medicare/Medicaid: $178.84 Centers Plan for Healthy Living — Medicare: $178.84 Elderplan — Medicare: $178.84 Emblem Health — HIP/GHI Medicare: $178.84
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN	$325	$276.25	$52.76 – $210
Established patient office visit (about 20–29 minutes): 10 of 31 insurance plan rates Aetna — Commercial: $89 Aetna — High Performance Network: $87.73 Aetna — Medicare: $63.57 Blue Cross — Medicare Advantage: $63.57 Centerlight — Medicare/Medicaid: $63.57 Centers Plan for Healthy Living — Medicare: $63.57 Elderplan — Medicare: $63.57 Emblem Health — HIP/GHI Medicare: $63.57 Fidelis — Medicare/Medicaid Advantage Plus: $63.57 Hamaspik — Medicare: $63.57
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: OFFICE O/P EST LOW 20 MIN	$325	$276.25	$52.76 – $143.03
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $63.57 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $63.57 Centerlight — Medicare/Medicaid: $63.57 Centers Plan for Healthy Living — Medicare: $63.57 Elderplan — Medicare: $63.57 Emblem Health — HIP/GHI Medicare: $63.57
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: OFFICE O/P EST LOW 20 MIN	$325	$276.25	$52.76 – $143.03
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $63.57 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $63.57 Centerlight — Medicare/Medicaid: $63.57 Centers Plan for Healthy Living — Medicare: $63.57 Elderplan — Medicare: $63.57 Emblem Health — HIP/GHI Medicare: $63.57
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN	$359.50	$305.58	$77.63 – $210.44
Established patient office visit (about 30–39 minutes): 10 of 34 insurance plan rates Aetna — Commercial: $130.94 Aetna — High Performance Network: $129.07 Aetna — Medicare: $93.53 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $93.53 Centerlight — Medicare/Medicaid: $93.53 Centers Plan for Healthy Living — Medicare: $93.53 Elderplan — Medicare: $93.53 Emblem Health — HIP/GHI Medicare: $93.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: OFFICE O/P EST MOD 30 MIN	$359.50	$305.58	$77.63 – $210.44
Established patient office visit (about 30–39 minutes): 10 of 34 insurance plan rates Aetna — Commercial: $130.94 Aetna — High Performance Network: $129.07 Aetna — Medicare: $93.53 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $93.53 Centerlight — Medicare/Medicaid: $93.53 Centers Plan for Healthy Living — Medicare: $93.53 Elderplan — Medicare: $93.53 Emblem Health — HIP/GHI Medicare: $93.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: OFFICE O/P EST MOD 30 MIN	$359.50	$305.58	$62 – $210.44
Established patient office visit (about 30–39 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $93.53 Blue Cross — Blue Access/Small Group: $62 Blue Cross — EPO/HMO/Indemnity/PPO: $78.65 Blue Cross — Medicare Advantage: $93.53 Centerlight — Medicare/Medicaid: $93.53 Centers Plan for Healthy Living — Medicare: $93.53 Elderplan — Medicare: $93.53 Emblem Health — HIP/GHI Medicare: $93.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	$280.48	$238.41	$134 – $210
Preventive checkup, new patient, age 18–39: rates for 5 insurance plans 1199 National Benefit Fund — 1199 National Benefit Fund: $134 United Healthcare — Commercial: $210 Emblem Health — GHI PPO/EPO/HMO: 75% (a percentage in the contract, not a dollar amount) Magnacare — Commercial: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	$339.46	$288.54	$157 – $210
Preventive checkup, new patient, age 40–64: rates for 5 insurance plans 1199 National Benefit Fund — 1199 National Benefit Fund: $157 United Healthcare — Commercial: $210 Emblem Health — GHI PPO/EPO/HMO: 75% (a percentage in the contract, not a dollar amount) Magnacare — Commercial: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$1,834.22	$1,559.09	$66 – $1,619.11
Emergency room visit (moderate): 10 of 31 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $66 Aetna — Commercial: $740 Aetna — High Performance Network: $763 Aetna — Medicare: $340.75 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $340.75 Centerlight — Medicare/Medicaid: $340.75 Centers Plan for Healthy Living — Medicare: $340.75 Cigna — Commercial: $806
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPT VISIT LOW MDM	$2,006.74	$1,705.73	$66 – $1,619.11
Emergency room visit (moderate): 10 of 32 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $66 Aetna — Commercial: $740 Aetna — High Performance Network: $763 Aetna — Medicare: $340.75 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $340.75 Centerlight — Medicare/Medicaid: $340.75 Centers Plan for Healthy Living — Medicare: $340.75 Cigna — Commercial: $806
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$2,063.50	$1,753.98	$104 – $1,619.11
Emergency room visit (moderately high): 10 of 32 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $104 Aetna — Commercial: $740 Aetna — High Performance Network: $763 Aetna — Medicare: $520.86 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $520.86 Centerlight — Medicare/Medicaid: $520.86 Centers Plan for Healthy Living — Medicare: $520.86 Cigna — Commercial: $990
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	$2,292.78	$1,948.86	$161 – $1,619.11
Emergency room visit (high): 10 of 32 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $161 Aetna — Commercial: $740 Aetna — High Performance Network: $763 Aetna — Medicare: $743.39 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $743.39 Centerlight — Medicare/Medicaid: $743.39 Centers Plan for Healthy Living — Medicare: $743.39 Cigna — Commercial: $990
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPT VISIT HI MDM	$2,465.30	$2,095.51	$220.50 – $1,619.11
Emergency room visit (high): 10 of 32 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $801 Aetna — Commercial: $740 Aetna — High Performance Network: $763 Aetna — Medicare: $743.39 Blue Cross — Blue Access/Small Group: $1,271 Blue Cross — EPO/HMO/Indemnity/PPO: $1,619.11 Blue Cross — Medicare Advantage: $743.39 Centerlight — Medicare/Medicaid: $743.39 Centers Plan for Healthy Living — Medicare: $743.39 Cigna — Commercial: $990

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA	$61.22	$52.04	$8.04 – $19.60
Basic metabolic panel (blood test): 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Commercial: $11.84 Aetna — High Performance Network: $8.46 Aetna — Medicare: $8.46 Blue Cross — Blue Access/Small Group: $10.16 Blue Cross — EPO/HMO/Indemnity/PPO: $12.70 Blue Cross — Medicare Advantage: $8.46 Centerlight — Medicare/Medicaid: $8.46 Centers Plan for Healthy Living — Medicare: $8.46 Cigna — Commercial: $19.60
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$84.59	$71.90	$10.03 – $24.64
Comprehensive metabolic panel (blood test): 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $12 Aetna — Commercial: $14.78 Aetna — High Performance Network: $10.56 Aetna — Medicare: $10.56 Blue Cross — Blue Access/Small Group: $12.68 Blue Cross — EPO/HMO/Indemnity/PPO: $15.85 Blue Cross — Medicare Advantage: $10.56 Centerlight — Medicare/Medicaid: $10.56 Centers Plan for Healthy Living — Medicare: $10.56 Cigna — Commercial: $24.64
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$197	$167.45	$12.72 – $38.63
Cholesterol panel (lipid panel): 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $19 Aetna — Commercial: $18.75 Aetna — High Performance Network: $13.39 Aetna — Medicare: $13.39 Blue Cross — Blue Access/Small Group: $16.08 Blue Cross — EPO/HMO/Indemnity/PPO: $20.10 Blue Cross — Medicare Advantage: $13.39 Centerlight — Medicare/Medicaid: $13.39 Centers Plan for Healthy Living — Medicare: $13.39 Cigna — Commercial: $38.63
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$69.01	$58.66	$7.76 – $19.03
Liver function panel: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $11 Aetna — Commercial: $11.44 Aetna — High Performance Network: $8.17 Aetna — Medicare: $8.17 Blue Cross — Blue Access/Small Group: $9.81 Blue Cross — EPO/HMO/Indemnity/PPO: $12.26 Blue Cross — Medicare Advantage: $8.17 Centerlight — Medicare/Medicaid: $8.17 Centers Plan for Healthy Living — Medicare: $8.17 Cigna — Commercial: $19.03
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$37.84	$32.16	$2.14 – $5.04
Urine test (automated, without microscope): 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $4 Aetna — Commercial: $3.15 Aetna — High Performance Network: $2.25 Aetna — Medicare: $2.25 Blue Cross — Blue Access/Small Group: $2.70 Blue Cross — EPO/HMO/Indemnity/PPO: $3.38 Blue Cross — Medicare Advantage: $2.25 Centerlight — Medicare/Medicaid: $2.25 Centers Plan for Healthy Living — Medicare: $2.25 Cigna — Commercial: $5.04
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$207.02	$175.97	$17.47 – $42.55
PSA (prostate specific antigen) blood test: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $26 Aetna — Commercial: $25.75 Aetna — High Performance Network: $18.39 Aetna — Medicare: $18.39 Blue Cross — Blue Access/Small Group: $22.08 Blue Cross — EPO/HMO/Indemnity/PPO: $27.60 Blue Cross — Medicare Advantage: $18.39 Centerlight — Medicare/Medicaid: $18.39 Centers Plan for Healthy Living — Medicare: $18.39 Cigna — Commercial: $42.55
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$103.51	$87.98	$15.96 – $39.20
Thyroid stimulating hormone (TSH) test: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $24 Aetna — Commercial: $23.52 Aetna — High Performance Network: $16.80 Aetna — Medicare: $16.80 Blue Cross — Blue Access/Small Group: $20.17 Blue Cross — EPO/HMO/Indemnity/PPO: $25.22 Blue Cross — Medicare Advantage: $16.80 Centerlight — Medicare/Medicaid: $16.80 Centers Plan for Healthy Living — Medicare: $16.80 Cigna — Commercial: $39.20
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$62.33	$52.98	$7.38 – $17.91
Complete blood count (CBC) with differential: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $11 Aetna — Commercial: $10.88 Aetna — High Performance Network: $7.77 Aetna — Medicare: $7.77 Blue Cross — Blue Access/Small Group: $9.33 Blue Cross — EPO/HMO/Indemnity/PPO: $11.66 Blue Cross — Medicare Advantage: $7.77 Centerlight — Medicare/Medicaid: $7.77 Centers Plan for Healthy Living — Medicare: $7.77 Cigna — Commercial: $17.91
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$24.49	$20.82	$6.15 – $15.11
Complete blood count (CBC), automated: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Commercial: $9.06 Aetna — High Performance Network: $6.47 Aetna — Medicare: $6.47 Blue Cross — Blue Access/Small Group: $7.77 Blue Cross — EPO/HMO/Indemnity/PPO: $9.71 Blue Cross — Medicare Advantage: $6.47 Centerlight — Medicare/Medicaid: $6.47 Centers Plan for Healthy Living — Medicare: $6.47 Cigna — Commercial: $15.11
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$52.31	$44.46	$4.08 – $8.96
Blood clotting time test (prothrombin time, PT): 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $6 Aetna — Commercial: $6.01 Aetna — High Performance Network: $4.29 Aetna — Medicare: $4.29 Blue Cross — Blue Access/Small Group: $5.15 Blue Cross — EPO/HMO/Indemnity/PPO: $6.44 Blue Cross — Medicare Advantage: $4.29 Centerlight — Medicare/Medicaid: $4.29 Centers Plan for Healthy Living — Medicare: $4.29 Cigna — Commercial: $8.96
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$51.20	$43.52	$5.71 – $14
Blood clotting test (partial thromboplastin time, PTT): 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $9 Aetna — Commercial: $8.41 Aetna — High Performance Network: $6.01 Aetna — Medicare: $6.01 Blue Cross — Blue Access/Small Group: $7.22 Blue Cross — EPO/HMO/Indemnity/PPO: $9.02 Blue Cross — Medicare Advantage: $6.01 Centerlight — Medicare/Medicaid: $6.01 Centers Plan for Healthy Living — Medicare: $6.01 Cigna — Commercial: $14

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT HEAD/BRAIN W/O DYE	$1,474.72	$1,253.51	$72 – $725
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $241 Aetna — Commercial: $650 Aetna — High Performance Network: $642 Aetna — Medicare: $130.50 Blue Cross — Blue Access/Small Group: $156.70 Blue Cross — EPO/HMO/Indemnity/PPO: $195.88 Blue Cross — Medicare Advantage: $130.50 Centerlight — Medicare/Medicaid: $130.50 Centers Plan for Healthy Living — Medicare: $130.50 Cigna — Commercial: $725
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI BRAIN STEM W/O & W/DYE	$7,034.16	$5,979.04	$300 – $1,268
MRI of the brain, before and after contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $1,268 Aetna — Commercial: $800 Aetna — High Performance Network: $790 Aetna — Medicare: $435.49 Blue Cross — Blue Access/Small Group: $522.94 Blue Cross — EPO/HMO/Indemnity/PPO: $653.67 Blue Cross — Medicare Advantage: $435.49 Centerlight — Medicare/Medicaid: $435.49 Centers Plan for Healthy Living — Medicare: $435.49 Cigna — Commercial: $1,248
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	$278.25	$236.51	$24 – $244.42
Chest X-ray, 2 views: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $24 Aetna — Commercial: $152.08 Aetna — High Performance Network: $128.18 Aetna — Medicare: $108.63 Blue Cross — Blue Access/Small Group: $130.44 Blue Cross — EPO/HMO/Indemnity/PPO: $163.05 Blue Cross — Medicare Advantage: $108.63 Centerlight — Medicare/Medicaid: $108.63 Centers Plan for Healthy Living — Medicare: $108.63 Elderplan — Medicare: $108.63
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$517.54	$439.91	$18 – $293.63
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $47 Aetna — Commercial: $161.82 Aetna — High Performance Network: $153.99 Aetna — Medicare: $130.50 Blue Cross — Blue Access/Small Group: $156.70 Blue Cross — EPO/HMO/Indemnity/PPO: $195.88 Blue Cross — Medicare Advantage: $130.50 Centerlight — Medicare/Medicaid: $130.50 Centers Plan for Healthy Living — Medicare: $130.50 Elderplan — Medicare: $130.50
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI LUMBAR SPINE W/O DYE	$3,611.68	$3,069.93	$247.21 – $2,523
MRI of the lower back (lumbar spine), without contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $634 Aetna — Commercial: $800 Aetna — High Performance Network: $790 Aetna — Medicare: $297.84 Blue Cross — Blue Access/Small Group: $357.65 Blue Cross — EPO/HMO/Indemnity/PPO: $447.06 Blue Cross — Medicare Advantage: $297.84 Centerlight — Medicare/Medicaid: $297.84 Centers Plan for Healthy Living — Medicare: $297.84 Cigna — Commercial: $1,248
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT PELVIS W/DYE	$2,098.01	$1,783.31	$102 – $725
CT scan of the pelvis, with contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $349 Aetna — Commercial: $650 Aetna — High Performance Network: $642 Aetna — Medicare: $218.95 Blue Cross — Blue Access/Small Group: $262.92 Blue Cross — EPO/HMO/Indemnity/PPO: $328.64 Blue Cross — Medicare Advantage: $218.95 Centerlight — Medicare/Medicaid: $218.95 Centers Plan for Healthy Living — Medicare: $218.95 Cigna — Commercial: $725
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,149.79	$2,677.32	$247.21 – $2,128
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $571 Aetna — Commercial: $800 Aetna — High Performance Network: $790 Aetna — Medicare: $297.84 Blue Cross — Blue Access/Small Group: $357.65 Blue Cross — EPO/HMO/Indemnity/PPO: $447.06 Blue Cross — Medicare Advantage: $297.84 Centerlight — Medicare/Medicaid: $297.84 Centers Plan for Healthy Living — Medicare: $297.84 Cigna — Commercial: $1,248
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_TC In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,149.79	$2,677.32	$247.21 – $2,128
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $571 Aetna — Commercial: $800 Aetna — High Performance Network: $790 Aetna — Medicare: $297.84 Blue Cross — Blue Access/Small Group: $357.65 Blue Cross — EPO/HMO/Indemnity/PPO: $447.06 Blue Cross — Medicare Advantage: $297.84 Centerlight — Medicare/Medicaid: $297.84 Centers Plan for Healthy Living — Medicare: $297.84 Cigna — Commercial: $1,248
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_TC In the file: MRI JNT OF LWR EXTRE W/O DYE	$1,892.10	$1,608.29	$247.21 – $2,128
MRI of a leg joint (such as the knee), without contrast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $571 Aetna — Commercial: $800 Aetna — High Performance Network: $790 Aetna — Medicare: $297.84 Blue Cross — Blue Access/Small Group: $357.65 Blue Cross — EPO/HMO/Indemnity/PPO: $447.06 Blue Cross — Medicare Advantage: $297.84 Centerlight — Medicare/Medicaid: $297.84 Centers Plan for Healthy Living — Medicare: $297.84 Cigna — Commercial: $1,248
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT ABD & PELVIS W/CONTRAST	$2,248.26	$1,911.02	$64.76 – $979.85
CT scan of the abdomen and pelvis, with contrast: 10 of 34 insurance plan rates Aetna — Commercial: $650 Aetna — High Performance Network: $642 Aetna — Medicare: $435.49 Blue Cross — Blue Access/Small Group: $522.94 Blue Cross — EPO/HMO/Indemnity/PPO: $653.67 Blue Cross — Medicare Advantage: $435.49 Centerlight — Medicare/Medicaid: $435.49 Centers Plan for Healthy Living — Medicare: $435.49 Cigna — Commercial: $725 Elderplan — Medicare: $435.49
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$1,183.12	$1,005.65	$101 – $438
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $101 Aetna — Commercial: $161.82 Aetna — High Performance Network: $153.99 Aetna — Medicare: $130.50 Blue Cross — Blue Access/Small Group: $156.70 Blue Cross — EPO/HMO/Indemnity/PPO: $195.88 Blue Cross — Medicare Advantage: $130.50 Centerlight — Medicare/Medicaid: $130.50 Centers Plan for Healthy Living — Medicare: $130.50 Cigna — Commercial: $208.59
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: OB US >= 14 WKS SNGL FETUS	$461.89	$392.61	$33 – $438
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $108 Aetna — Commercial: $161.82 Aetna — High Performance Network: $153.99 Aetna — Medicare: $130.50 Blue Cross — Blue Access/Small Group: $156.70 Blue Cross — EPO/HMO/Indemnity/PPO: $195.88 Blue Cross — Medicare Advantage: $130.50 Centerlight — Medicare/Medicaid: $130.50 Centers Plan for Healthy Living — Medicare: $130.50 Elderplan — Medicare: $130.50
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: TRANSVAGINAL US NON-OB	$598.79	$508.97	$36 – $438
Transvaginal ultrasound: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $78 Aetna — Commercial: $161.82 Aetna — High Performance Network: $153.99 Aetna — Medicare: $130.50 Blue Cross — Blue Access/Small Group: $156.70 Blue Cross — EPO/HMO/Indemnity/PPO: $195.88 Blue Cross — Medicare Advantage: $130.50 Centerlight — Medicare/Medicaid: $130.50 Centers Plan for Healthy Living — Medicare: $130.50 Elderplan — Medicare: $130.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_TC In the file: DX MAMMO INCL CAD UNI	$416.26	$353.82	$37.74 – $112
Diagnostic mammogram, one breast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $112 Aetna — Commercial: $51.99 Aetna — High Performance Network: $49.48 Aetna — Medicare: $41.93 Blue Cross — Blue Access/Small Group: $50.35 Blue Cross — EPO/HMO/Indemnity/PPO: $62.94 Blue Cross — Medicare Advantage: $41.93 Centerlight — Medicare/Medicaid: $41.93 Centers Plan for Healthy Living — Medicare: $41.93 Elderplan — Medicare: $41.93
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: DX MAMMO INCL CAD UNI	$416.26	$353.82	$37.74 – $112
Diagnostic mammogram, one breast: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $112 Aetna — Commercial: $51.99 Aetna — High Performance Network: $49.48 Aetna — Medicare: $41.93 Blue Cross — Blue Access/Small Group: $50.35 Blue Cross — EPO/HMO/Indemnity/PPO: $62.94 Blue Cross — Medicare Advantage: $41.93 Centerlight — Medicare/Medicaid: $41.93 Centers Plan for Healthy Living — Medicare: $41.93 Elderplan — Medicare: $41.93
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DX MAMMO INCL CAD BI	$511.98	$435.18	$46.38 – $143
Diagnostic mammogram, both breasts: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $143 Aetna — Commercial: $63.90 Aetna — High Performance Network: $60.81 Aetna — Medicare: $51.53 Blue Cross — Blue Access/Small Group: $61.88 Blue Cross — EPO/HMO/Indemnity/PPO: $77.35 Blue Cross — Medicare Advantage: $51.53 Centerlight — Medicare/Medicaid: $51.53 Centers Plan for Healthy Living — Medicare: $51.53 Elderplan — Medicare: $51.53
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_TC In the file: SCR MAMMO BI INCL CAD	$240.41	$204.35	$34.99 – $118
Screening mammogram, both breasts: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $118 Aetna — Commercial: $48.21 Aetna — High Performance Network: $45.88 Aetna — Medicare: $38.88 Blue Cross — Blue Access/Small Group: $46.69 Blue Cross — EPO/HMO/Indemnity/PPO: $58.36 Blue Cross — Medicare Advantage: $38.88 Centerlight — Medicare/Medicaid: $38.88 Centers Plan for Healthy Living — Medicare: $38.88 Elderplan — Medicare: $38.88
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: SCR MAMMO BI INCL CAD	$240.41	$204.35	$34.99 – $118
Screening mammogram, both breasts: 10 of 34 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $118 Aetna — Commercial: $48.21 Aetna — High Performance Network: $45.88 Aetna — Medicare: $38.88 Blue Cross — Blue Access/Small Group: $46.69 Blue Cross — EPO/HMO/Indemnity/PPO: $58.36 Blue Cross — Medicare Advantage: $38.88 Centerlight — Medicare/Medicaid: $38.88 Centers Plan for Healthy Living — Medicare: $38.88 Elderplan — Medicare: $38.88

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	$50.09	$42.58	$32 – $148
Electrocardiogram (ECG/EKG) with reading: rates for 5 insurance plans 1199 National Benefit Fund — 1199 National Benefit Fund: $32 United Healthcare — Commercial: $148 Cigna — Commercial: 70% (a percentage in the contract, not a dollar amount) Emblem Health — GHI PPO/EPO/HMO: 75% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPEUTIC EXERCISES	$132.45	$112.58	$27.11 – $174
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $45.72 Aetna — High Performance Network: $45.07 Aetna — Medicare: $32.66 Blue Cross — Blue Access/Small Group: $39.22 Blue Cross — EPO/HMO/Indemnity/PPO: $49.02 Blue Cross — Medicare Advantage: $32.66 Centerlight — Medicare/Medicaid: $32.66 Centers Plan for Healthy Living — Medicare: $32.66 Elderplan — Medicare: $32.66 Emblem Health — HIP/GHI Medicare: $32.66
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPEUTIC EXERCISES	$132.45	$112.58	$27.11 – $174
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna — Commercial: $45.72 Aetna — High Performance Network: $45.07 Aetna — Medicare: $32.66 Blue Cross — Blue Access/Small Group: $39.22 Blue Cross — EPO/HMO/Indemnity/PPO: $49.02 Blue Cross — Medicare Advantage: $32.66 Centerlight — Medicare/Medicaid: $32.66 Centers Plan for Healthy Living — Medicare: $32.66 Elderplan — Medicare: $32.66 Emblem Health — HIP/GHI Medicare: $32.66
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX 20 MIN	$400.68	$340.58	$91.04 – $246.80
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna — Commercial: $153.57 Aetna — High Performance Network: $151.37 Aetna — Medicare: $109.69 Blue Cross — Blue Access/Small Group: $131.72 Blue Cross — EPO/HMO/Indemnity/PPO: $164.64 Blue Cross — Medicare Advantage: $109.69 Centerlight — Medicare/Medicaid: $109.69 Centers Plan for Healthy Living — Medicare: $109.69 Elderplan — Medicare: $109.69 Emblem Health — HIP/GHI Medicare: $109.69
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN	$471.91	$401.12	$91.04 – $246.80
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates Aetna — Commercial: $153.57 Aetna — High Performance Network: $151.37 Aetna — Medicare: $109.69 Blue Cross — Blue Access/Small Group: $131.72 Blue Cross — EPO/HMO/Indemnity/PPO: $164.64 Blue Cross — Medicare Advantage: $109.69 Centerlight — Medicare/Medicaid: $109.69 Centers Plan for Healthy Living — Medicare: $109.69 Elderplan — Medicare: $109.69 Emblem Health — HIP/GHI Medicare: $109.69
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN	$560.95	$476.81	$91.04 – $246.80
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates Aetna — Commercial: $153.57 Aetna — High Performance Network: $151.37 Aetna — Medicare: $109.69 Blue Cross — Blue Access/Small Group: $131.72 Blue Cross — EPO/HMO/Indemnity/PPO: $164.64 Blue Cross — Medicare Advantage: $109.69 Centerlight — Medicare/Medicaid: $109.69 Centers Plan for Healthy Living — Medicare: $109.69 Elderplan — Medicare: $109.69 Emblem Health — HIP/GHI Medicare: $109.69
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES	$497.51	$422.88	$71 – $498.51
Psychotherapy, 30 minutes: 10 of 33 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $71 Aetna — Commercial: $105 Aetna — High Performance Network: $104 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $72 Blue Cross — EPO/HMO/Indemnity/PPO: $89.30 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 93 In the file: PSYTX W PT 30 MINUTES	$497.51	$422.88	$72 – $498.51
Psychotherapy, 30 minutes: 10 of 34 insurance plan rates Aetna — Commercial: $310.18 Aetna — High Performance Network: $305.75 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $72 Blue Cross — EPO/HMO/Indemnity/PPO: $89.30 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier U4 In the file: PSYTX W PT 30 MINUTES	$249.31	$211.91	$72 – $498.51
Psychotherapy, 30 minutes: 10 of 33 insurance plan rates Aetna — Commercial: $105 Aetna — High Performance Network: $104 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $72 Blue Cross — EPO/HMO/Indemnity/PPO: $89.30 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES	$578.76	$491.95	$100 – $498.51
Psychotherapy, 45 minutes: 10 of 33 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $100 Aetna — Commercial: $140 Aetna — High Performance Network: $138 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $147 Blue Cross — EPO/HMO/Indemnity/PPO: $183.02 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: PSYTX W PT 45 MINUTES	$340.58	$289.49	$109 – $498.51
Psychotherapy, 45 minutes: 10 of 33 insurance plan rates Aetna — Commercial: $110 Aetna — High Performance Network: $109 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $147 Blue Cross — EPO/HMO/Indemnity/PPO: $183.02 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier U4 In the file: PSYTX W PT 45 MINUTES	$340.58	$289.49	$138 – $498.51
Psychotherapy, 45 minutes: 10 of 33 insurance plan rates Aetna — Commercial: $140 Aetna — High Performance Network: $138 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $147 Blue Cross — EPO/HMO/Indemnity/PPO: $183.02 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	$660.01	$561.01	$127 – $498.51
Psychotherapy, 60 minutes: 10 of 33 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $127 Aetna — Commercial: $183 Aetna — High Performance Network: $181 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $147 Blue Cross — EPO/HMO/Indemnity/PPO: $183.02 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier U4 In the file: PSYTX W PT 60 MINUTES	$723.45	$614.93	$147 – $498.51
Psychotherapy, 60 minutes: 10 of 33 insurance plan rates Aetna — Commercial: $183 Aetna — High Performance Network: $181 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $147 Blue Cross — EPO/HMO/Indemnity/PPO: $183.02 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/O PT 50 MIN	$497.51	$422.88	$75 – $498.51
Family psychotherapy, without the patient: 10 of 33 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $75 Aetna — Commercial: $164 Aetna — High Performance Network: $162 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $152 Blue Cross — EPO/HMO/Indemnity/PPO: $189.63 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95_U4 In the file: FAMILY PSYTX W/O PT 50 MIN	$382.87	$325.44	$152 – $498.51
Family psychotherapy, without the patient: 10 of 33 insurance plan rates Aetna — Commercial: $164 Aetna — High Performance Network: $162 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $152 Blue Cross — EPO/HMO/Indemnity/PPO: $189.63 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier U4 In the file: FAMILY PSYTX W/O PT 50 MIN	$382.87	$325.44	$152 – $498.51
Family psychotherapy, without the patient: 10 of 33 insurance plan rates Aetna — Commercial: $164 Aetna — High Performance Network: $162 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $152 Blue Cross — EPO/HMO/Indemnity/PPO: $189.63 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYTX W/PT 50 MIN	$995.02	$845.77	$75 – $498.51
Family psychotherapy, with the patient: 10 of 33 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $75 Aetna — Commercial: $177 Aetna — High Performance Network: $175 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $152 Blue Cross — EPO/HMO/Indemnity/PPO: $189.63 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 95 In the file: FAMILY PSYTX W/PT 50 MIN	$995.02	$845.77	$152 – $498.51
Family psychotherapy, with the patient: 10 of 33 insurance plan rates Aetna — Commercial: $177 Aetna — High Performance Network: $175 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $152 Blue Cross — EPO/HMO/Indemnity/PPO: $189.63 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier U4 In the file: FAMILY PSYTX W/PT 50 MIN	$693.40	$589.39	$152 – $498.51
Family psychotherapy, with the patient: 10 of 33 insurance plan rates Aetna — Commercial: $177 Aetna — High Performance Network: $175 Aetna — Medicare: $221.56 Blue Cross — Blue Access/Small Group: $152 Blue Cross — EPO/HMO/Indemnity/PPO: $189.63 Blue Cross — Medicare Advantage: $221.56 Centerlight — Medicare/Medicaid: $221.56 Centers Plan for Healthy Living — Medicare: $221.56 Elderplan — Medicare: $221.56 Emblem Health — HIP/GHI Medicare: $221.56
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	$333.90	$283.82	$35 – $285.32
Group psychotherapy: 10 of 33 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $35 Aetna — Commercial: $42 Aetna — High Performance Network: $41 Aetna — Medicare: $126.81 Blue Cross — Blue Access/Small Group: $119 Blue Cross — EPO/HMO/Indemnity/PPO: $148.84 Blue Cross — Medicare Advantage: $126.81 Centerlight — Medicare/Medicaid: $126.81 Centers Plan for Healthy Living — Medicare: $126.81 Elderplan — Medicare: $126.81
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier U4 In the file: GROUP PSYCHOTHERAPY	$243.75	$207.19	$41 – $285.32
Group psychotherapy: 10 of 33 insurance plan rates Aetna — Commercial: $42 Aetna — High Performance Network: $41 Aetna — Medicare: $126.81 Blue Cross — Blue Access/Small Group: $119 Blue Cross — EPO/HMO/Indemnity/PPO: $148.84 Blue Cross — Medicare Advantage: $126.81 Centerlight — Medicare/Medicaid: $126.81 Centers Plan for Healthy Living — Medicare: $126.81 Elderplan — Medicare: $126.81 Emblem Health — HIP/GHI Medicare: $126.81
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 93 In the file: GROUP PSYCHOTHERAPY	$333.90	$283.82	$105.25 – $285.32
Group psychotherapy: 10 of 33 insurance plan rates Aetna — Commercial: $177.53 Aetna — High Performance Network: $175 Aetna — Medicare: $126.81 Blue Cross — Medicare Advantage: $126.81 Centerlight — Medicare/Medicaid: $126.81 Centers Plan for Healthy Living — Medicare: $126.81 Elderplan — Medicare: $126.81 Emblem Health — HIP/GHI Medicare: $126.81 Fidelis — Medicare/Medicaid Advantage Plus: $126.81 Hamaspik — Medicare: $126.81

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	$6,805.99	$5,785.09	$99 – $5,227
Prostate biopsy: rates for 9 insurance plans 1199 National Benefit Fund — 1199 National Benefit Fund: $99 Aetna — High Performance Network: $2,865 Blue Cross — Blue Access/Small Group: $1,932 Blue Cross — EPO/HMO/Indemnity/PPO: $2,414.48 Cigna — Commercial: $3,338 Emblem Health — GHI PPO/EPO/HMO: $5,227 Magnacare — Commercial: $3,121 United Healthcare — Commercial: $3,394 Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount)

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	$7,317.98	$6,220.28	$1,434 – $5,227
Cesarean delivery (C-section), with care before and after: 10 of 29 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $3,000 Aetna — Commercial: $4,024.43 Aetna — High Performance Network: $2,865 Aetna — Medicare: $2,874.59 Blue Cross — Blue Access/Small Group: $1,434 Blue Cross — EPO/HMO/Indemnity/PPO: $1,975.68 Blue Cross — Medicare Advantage: $2,874.59 Centerlight — Medicare/Medicaid: $2,874.59 Centers Plan for Healthy Living — Medicare: $2,874.59 Cigna — Commercial: $3,338

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$103,990.60 – $230,217.34
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $130,608.34 Aetna — Commercial: $121,316.25 Aetna — High Performance Network: $124,344.77 Aetna — Medicare: $131,712.26 Blue Cross — Blue Access/Small Group: $129,797.64 Blue Cross — EPO/HMO/Indemnity/PPO: $171,986.46 Blue Cross — Medicare Advantage: $131,712.26 Centerlight — Medicare/Medicaid: $131,712.26 Centers Plan for Healthy Living — Medicare: $131,712.26 Cigna — Commercial: $131,621.70
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$20,316.26 – $44,976.72
Hip or knee replacement (major joint of the leg), without major complications: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $25,516.47 Aetna — Commercial: $23,521.25 Aetna — High Performance Network: $24,292.78 Aetna — Medicare: $26,310.85 Blue Cross — Blue Access/Small Group: $25,358.09 Blue Cross — EPO/HMO/Indemnity/PPO: $33,600.36 Blue Cross — Medicare Advantage: $26,310.85 Centerlight — Medicare/Medicaid: $26,310.85 Centers Plan for Healthy Living — Medicare: $26,310.85 Cigna — Commercial: $25,714.45
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$25,508.74 – $56,471.96
Neck (cervical) spinal fusion, without complications: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $32,038.02 Aetna — Commercial: $30,757.50 Aetna — High Performance Network: $30,501.58 Aetna — Medicare: $33,187.41 Blue Cross — Blue Access/Small Group: $31,839.16 Blue Cross — EPO/HMO/Indemnity/PPO: $42,188.01 Blue Cross — Medicare Advantage: $33,187.41 Centerlight — Medicare/Medicaid: $33,187.41 Centers Plan for Healthy Living — Medicare: $33,187.41 Cigna — Commercial: $32,286.60
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$12,915.99 – $28,593.79
Uterus and ovary surgery (not for cancer), without complications: 10 of 30 insurance plan rates 1199 National Benefit Fund — 1199 National Benefit Fund: $16,222.01 Aetna — Commercial: $14,525 Aetna — High Performance Network: $15,444.05 Aetna — Medicare: $17,075.03 Blue Cross — Blue Access/Small Group: $16,121.32 Blue Cross — EPO/HMO/Indemnity/PPO: $21,361.31 Blue Cross — Medicare Advantage: $17,075.03 Centerlight — Medicare/Medicaid: $17,075.03 Centers Plan for Healthy Living — Medicare: $17,075.03 Cigna — Commercial: $16,347.87

Source: St John's Episcopal Hospital at South Shore’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 7, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	327 Beach 19th Street, Far Rockaway, NY 11691
County	Queens County
State	New York
Phone	(718) 869‑7000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	1 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	330395
Name in Medicare records	ST JOHN'S EPISCOPAL HOSPITAL AT SOUTH SHORE
Profile level	Medicare data + hospital website
Name on the hospital’s website	St. John's Episcopal Hospital
Official website	ehs.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

St. John's Episcopal Hospital — ehs.org
Contact Details and Information | Episcopal Health Services — ehs.org
Awards and Quality Recognition | Episcopal Health Services — ehs.org
Patient Navigation Program | Episcopal Health Services — ehs.org
Emergency Medicine - 24/7 Care | Episcopal Health Services — ehs.org
Ambulatory/Outpatient Care | Episcopal Health Services — ehs.org
Diagnostic Imaging, MRI, EEG and Radiology Services | EHS — ehs.org
Stroke Services | Episcopal Health Services — ehs.org
Dialysis Center and Kidney Disease Care Services | EHS — ehs.org