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Acute Care Hospital

St Joseph's University Medical Center Inc

Paterson, New Jersey · Passaic County · Emergency services listed

Summary

St Joseph's University Medical Center Inc is an acute care hospital in Paterson, New Jersey. Its official website lists an emergency room (Medicare data does not list emergency services). CMS overall star rating: 3 of 5 stars. Its official website lists 18 services, specialties and programs. Medicare lists 1,192 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(973) 754‑2010 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-11-02). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
651Beds (hospital website)
1,192Doctors and clinicians
18Services listed

Quick answers

Does St Joseph's University Medical Center Inc have an emergency room?
Yes. The hospital’s official website lists an emergency room at St Joseph's University Medical Center Inc (trauma center: Level II (state-designated; also ACS-verified)). Medicare (CMS) data does not list emergency services for it. In a medical emergency, call 911.
Where is St Joseph's University Medical Center Inc?
703 Main St, Paterson, NJ 07503, in Passaic County, New Jersey.
What is the phone number of St Joseph's University Medical Center Inc?
(973) 754-2010, as listed by Medicare (CMS).
What is the Medicare star rating of St Joseph's University Medical Center Inc?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][5]

Programs and centers[4][5]

  • Level II Trauma Center
  • Pediatric emergency department
  • Geriatric emergency department
  • Stroke center
  • Alternatives to Opiates (ALTO) Program
  • Life Sustaining Management and Alternatives Program (LSMA)
  • Firearm Safety Program
  • St. Joseph's Children's Hospital (state-designated children's hospital)

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

Emergency roomYes
Open 24/7Yes
Trauma designationLevel II (state-designated; also ACS-verified)
Stroke designationStroke center (level not stated)

Visiting and practical information

Patient portalPatient Portal

Recognition[4][5]

  • Magnet Recognition (ANCC), six-time recipient
  • State-designated Level II Trauma Center (NJ)
  • American College of Surgeons verified Trauma Center

Doctors and clinicians (1,192)

1,192 doctors and other clinicians list St Joseph's University Medical Center Inc 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

Doctors with a page on this site (1,192)

And 1,168 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

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

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

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

Clinics and urgent care

Pharmacies

Assisted living nearby

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

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 Joseph's University Medical Center Inc 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 hospital2 of 5 stars
Would recommend the hospital2 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1059%National average: 72%
Would definitely recommend the hospital58%National average: 71%
Nurses “always” communicated well73%National average: 80%
Doctors “always” communicated well74%National average: 80%
Staff “always” explained medicines before giving them54%National average: 62%
Were given information about recovery at home82%National average: 86%
Room and bathroom “always” clean69%National average: 74%
Area around the room “always” quiet at night45%National average: 60%
Completed surveys1,521Response rate: 11%

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)0.154Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.372Better than the national benchmark
Surgical site infections after colon surgery0.697No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.459No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.235Better 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 patients12.4%
Deaths within 30 days: heart failure patients8.9%
Deaths within 30 days: pneumonia patients13.6%
Deaths within 30 days: COPD patients7.7%
Deaths within 30 days: stroke patients10.6%
Deaths within 30 days: coronary bypass surgery (CABG)2.3%
Serious complications (patient safety indicator PSI-90)0.73No different from the national rate
Complications after hip or knee replacement3.8%

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 attack14.9%
Readmitted within 30 days: heart failure22%
Readmitted within 30 days: pneumonia16.4%
Readmitted within 30 days: COPD20.5%
Readmitted within 30 days: coronary bypass surgery11.2%
Readmitted within 30 days: hip or knee replacement6%

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)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)217 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)5%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)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 New JerseyBest hospitals in New Jersey

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as St Joseph's University Medical Center Inc 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 →

$ 12 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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99203 New Pat Low Sev - Telehealth $551 $551 $97.91 – $551
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $182.99
  • Aetna — Managed Care: $275.50
  • Aetna — Medicare Advantage: $130.71
  • Aetna — PPO/Signature Administrators: $275.50
  • Aetna Better Health — Managed Medicaid: $113.34
  • Aetna Whole Health — Commercial: $266.64
  • AmeriHealth — Managed Care/PPO: $350.82
  • AmeriHealth — Medicare Advantage: $130.71
  • Cigna — Out of Network Plans: $551
  • Clover Health — Medicare Advantage: $130.71
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99203 New Patient - Level 3 $551 $551 $97.91 – $551
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $182.99
  • Aetna — Managed Care: $275.50
  • Aetna — Medicare Advantage: $130.71
  • Aetna — PPO/Signature Administrators: $275.50
  • Aetna Better Health — Managed Medicaid: $113.34
  • Aetna Whole Health — Commercial: $266.64
  • AmeriHealth — Managed Care/PPO: $350.82
  • AmeriHealth — Medicare Advantage: $130.71
  • Cigna — Out of Network Plans: $551
  • Clover Health — Medicare Advantage: $130.71
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99203 New Pat Low Sev $551 $551 $97.91 – $551
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $182.99
  • Aetna — Managed Care: $275.50
  • Aetna — Medicare Advantage: $130.71
  • Aetna — PPO/Signature Administrators: $275.50
  • Aetna Better Health — Managed Medicaid: $113.34
  • Aetna Whole Health — Commercial: $266.64
  • AmeriHealth — Managed Care/PPO: $350.82
  • AmeriHealth — Medicare Advantage: $130.71
  • Cigna — Out of Network Plans: $551
  • Clover Health — Medicare Advantage: $130.71
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99204 New Pat Moderate - Telehealth $595 $595 $105.73 – $595
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $275.20
  • Aetna — Managed Care: $297.50
  • Aetna — Medicare Advantage: $196.57
  • Aetna — PPO/Signature Administrators: $297.50
  • Aetna Better Health — Managed Medicaid: $122.39
  • Aetna Whole Health — Commercial: $401.01
  • AmeriHealth — Managed Care/PPO: $378.84
  • AmeriHealth — Medicare Advantage: $196.57
  • Cigna — Out of Network Plans: $595
  • Clover Health — Medicare Advantage: $196.57
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99204 New Patient - Level 4 $595 $595 $105.73 – $595
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $275.20
  • Aetna — Managed Care: $297.50
  • Aetna — Medicare Advantage: $196.57
  • Aetna — PPO/Signature Administrators: $297.50
  • Aetna Better Health — Managed Medicaid: $122.39
  • Aetna Whole Health — Commercial: $401.01
  • AmeriHealth — Managed Care/PPO: $378.84
  • AmeriHealth — Medicare Advantage: $196.57
  • Cigna — Out of Network Plans: $595
  • Clover Health — Medicare Advantage: $196.57
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99204 New Pat Moderate $595 $595 $105.73 – $595
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $275.20
  • Aetna — Managed Care: $297.50
  • Aetna — Medicare Advantage: $196.57
  • Aetna — PPO/Signature Administrators: $297.50
  • Aetna Better Health — Managed Medicaid: $122.39
  • Aetna Whole Health — Commercial: $401.01
  • AmeriHealth — Managed Care/PPO: $378.84
  • AmeriHealth — Medicare Advantage: $196.57
  • Cigna — Out of Network Plans: $595
  • Clover Health — Medicare Advantage: $196.57
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99205 New Pat High Sev - Telehealth $896 $896 $159.22 – $896
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $367.16
  • Aetna — Managed Care: $448
  • Aetna — Medicare Advantage: $262.26
  • Aetna — PPO/Signature Administrators: $448
  • Aetna Better Health — Managed Medicaid: $184.31
  • Aetna Whole Health — Commercial: $535
  • AmeriHealth — Managed Care/PPO: $570.48
  • AmeriHealth — Medicare Advantage: $262.26
  • Cigna — Out of Network Plans: $896
  • Clover Health — Medicare Advantage: $262.26
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99205 New Patient - Level 5 $896 $896 $159.22 – $896
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $367.16
  • Aetna — Managed Care: $448
  • Aetna — Medicare Advantage: $262.26
  • Aetna — PPO/Signature Administrators: $448
  • Aetna Better Health — Managed Medicaid: $184.31
  • Aetna Whole Health — Commercial: $535
  • AmeriHealth — Managed Care/PPO: $570.48
  • AmeriHealth — Medicare Advantage: $262.26
  • Cigna — Out of Network Plans: $896
  • Clover Health — Medicare Advantage: $262.26
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99205 New Pat High Sev $896 $896 $159.22 – $896
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $367.16
  • Aetna — Managed Care: $448
  • Aetna — Medicare Advantage: $262.26
  • Aetna — PPO/Signature Administrators: $448
  • Aetna Better Health — Managed Medicaid: $184.31
  • Aetna Whole Health — Commercial: $535
  • AmeriHealth — Managed Care/PPO: $570.48
  • AmeriHealth — Medicare Advantage: $262.26
  • Cigna — Out of Network Plans: $896
  • Clover Health — Medicare Advantage: $262.26
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99213 Established Patient Level 3 - Telehealth $486 $486 $86.36 – $486
Established patient office visit (about 20–29 minutes): 10 of 34 insurance plan rates
  • Aetna — HTC: $148.31
  • Aetna — Managed Care: $243
  • Aetna — Medicare Advantage: $105.93
  • Aetna — PPO/Signature Administrators: $243
  • Aetna Better Health — Managed Medicaid: $99.97
  • Aetna Whole Health — Commercial: $216.11
  • AmeriHealth — Managed Care/PPO: $309.44
  • AmeriHealth — Medicare Advantage: $105.93
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $116
  • Cigna — Out of Network Plans: $486
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99213 Established Patient Level 3 $486 $486 $86.36 – $486
Established patient office visit (about 20–29 minutes): 10 of 34 insurance plan rates
  • Aetna — HTC: $148.31
  • Aetna — Managed Care: $243
  • Aetna — Medicare Advantage: $105.93
  • Aetna — PPO/Signature Administrators: $243
  • Aetna Better Health — Managed Medicaid: $99.97
  • Aetna Whole Health — Commercial: $216.11
  • AmeriHealth — Managed Care/PPO: $309.44
  • AmeriHealth — Medicare Advantage: $105.93
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $116
  • Cigna — Out of Network Plans: $486
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ov-Estab-Expanded Prob Focused $486 $486 $86.36 – $486
Established patient office visit (about 20–29 minutes): 10 of 34 insurance plan rates
  • Aetna — HTC: $148.31
  • Aetna — Managed Care: $243
  • Aetna — Medicare Advantage: $105.93
  • Aetna — PPO/Signature Administrators: $243
  • Aetna Better Health — Managed Medicaid: $99.97
  • Aetna Whole Health — Commercial: $216.11
  • AmeriHealth — Managed Care/PPO: $309.44
  • AmeriHealth — Medicare Advantage: $105.93
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $116
  • Cigna — Out of Network Plans: $486
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99214 Established Patient Level 4 - Telehealth $570 $570 $101.29 – $570
Established patient office visit (about 30–39 minutes): 10 of 34 insurance plan rates
  • Aetna — HTC: $210.92
  • Aetna — Managed Care: $285
  • Aetna — Medicare Advantage: $150.65
  • Aetna — PPO/Signature Administrators: $285
  • Aetna Better Health — Managed Medicaid: $117.25
  • Aetna Whole Health — Commercial: $307.33
  • AmeriHealth — Managed Care/PPO: $362.92
  • AmeriHealth — Medicare Advantage: $150.65
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $170
  • Cigna — Out of Network Plans: $570
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99214 Established Patient Level 4 $570 $570 $101.29 – $570
Established patient office visit (about 30–39 minutes): 10 of 34 insurance plan rates
  • Aetna — HTC: $210.92
  • Aetna — Managed Care: $285
  • Aetna — Medicare Advantage: $150.65
  • Aetna — PPO/Signature Administrators: $285
  • Aetna Better Health — Managed Medicaid: $117.25
  • Aetna Whole Health — Commercial: $307.33
  • AmeriHealth — Managed Care/PPO: $362.92
  • AmeriHealth — Medicare Advantage: $150.65
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $170
  • Cigna — Out of Network Plans: $570
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OV-ESTABLISHED DETAILED $570 $570 $101.29 – $570
Established patient office visit (about 30–39 minutes): 10 of 34 insurance plan rates
  • Aetna — HTC: $210.92
  • Aetna — Managed Care: $285
  • Aetna — Medicare Advantage: $150.65
  • Aetna — PPO/Signature Administrators: $285
  • Aetna Better Health — Managed Medicaid: $117.25
  • Aetna Whole Health — Commercial: $307.33
  • AmeriHealth — Managed Care/PPO: $362.92
  • AmeriHealth — Medicare Advantage: $150.65
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $170
  • Cigna — Out of Network Plans: $570
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office Consult-Moderate $868 $868 $124.40 – $868
Office consultation with a specialist (moderate): 10 of 33 insurance plan rates
  • Aetna — HTC: $174.16
  • Aetna — Managed Care: $434
  • Aetna — Medicare Advantage: $124.40
  • Aetna — PPO/Signature Administrators: $434
  • Aetna Better Health — Managed Medicaid: $178.55
  • Aetna Whole Health — Commercial: $253.78
  • AmeriHealth — Managed Care/PPO: $552.66
  • AmeriHealth — Medicare Advantage: $124.40
  • Cigna — Out of Network Plans: $868
  • Clover Health — Medicare Advantage: $124.40
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99243 Office Consult Level 3 $868 $868 $124.40 – $868
Office consultation with a specialist (moderate): 10 of 33 insurance plan rates
  • Aetna — HTC: $174.16
  • Aetna — Managed Care: $434
  • Aetna — Medicare Advantage: $124.40
  • Aetna — PPO/Signature Administrators: $434
  • Aetna Better Health — Managed Medicaid: $178.55
  • Aetna Whole Health — Commercial: $253.78
  • AmeriHealth — Managed Care/PPO: $552.66
  • AmeriHealth — Medicare Advantage: $124.40
  • Cigna — Out of Network Plans: $868
  • Clover Health — Medicare Advantage: $124.40
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal-Off.Consult Moderate $868 $868 $124.40 – $868
Office consultation with a specialist (moderate): 10 of 33 insurance plan rates
  • Aetna — HTC: $174.16
  • Aetna — Managed Care: $434
  • Aetna — Medicare Advantage: $124.40
  • Aetna — PPO/Signature Administrators: $434
  • Aetna Better Health — Managed Medicaid: $178.55
  • Aetna Whole Health — Commercial: $253.78
  • AmeriHealth — Managed Care/PPO: $552.66
  • AmeriHealth — Medicare Advantage: $124.40
  • Cigna — Out of Network Plans: $868
  • Clover Health — Medicare Advantage: $124.40
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office Consult-Extensive $972 $972 $172.72 – $972
Office consultation with a specialist (moderate to high): 10 of 33 insurance plan rates
  • Aetna — HTC: $248.52
  • Aetna — Managed Care: $486
  • Aetna — Medicare Advantage: $177.51
  • Aetna — PPO/Signature Administrators: $486
  • Aetna Better Health — Managed Medicaid: $199.94
  • Aetna Whole Health — Commercial: $362.13
  • AmeriHealth — Managed Care/PPO: $618.87
  • AmeriHealth — Medicare Advantage: $177.51
  • Cigna — Out of Network Plans: $972
  • Clover Health — Medicare Advantage: $177.51
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99244 Office Consult Level 4 $972 $972 $172.72 – $972
Office consultation with a specialist (moderate to high): 10 of 33 insurance plan rates
  • Aetna — HTC: $248.52
  • Aetna — Managed Care: $486
  • Aetna — Medicare Advantage: $177.51
  • Aetna — PPO/Signature Administrators: $486
  • Aetna Better Health — Managed Medicaid: $199.94
  • Aetna Whole Health — Commercial: $362.13
  • AmeriHealth — Managed Care/PPO: $618.87
  • AmeriHealth — Medicare Advantage: $177.51
  • Cigna — Out of Network Plans: $972
  • Clover Health — Medicare Advantage: $177.51
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Consultation Level 4 $972 $972 $172.72 – $972
Office consultation with a specialist (moderate to high): 10 of 33 insurance plan rates
  • Aetna — HTC: $248.52
  • Aetna — Managed Care: $486
  • Aetna — Medicare Advantage: $177.51
  • Aetna — PPO/Signature Administrators: $486
  • Aetna Better Health — Managed Medicaid: $199.94
  • Aetna Whole Health — Commercial: $362.13
  • AmeriHealth — Managed Care/PPO: $618.87
  • AmeriHealth — Medicare Advantage: $177.51
  • Cigna — Out of Network Plans: $972
  • Clover Health — Medicare Advantage: $177.51
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Preventive-Age 18-39 $445 $445 $79.08 – $445
Preventive checkup, new patient, age 18–39: 10 of 33 insurance plan rates
  • Aetna — HTC: $209.37
  • Aetna — Managed Care: $222.50
  • Aetna — Medicare Advantage: $149.55
  • Aetna — PPO/Signature Administrators: $222.50
  • Aetna Better Health — Managed Medicaid: $91.54
  • Aetna Whole Health — Commercial: $305.09
  • AmeriHealth — Managed Care/PPO: $283.33
  • AmeriHealth — Medicare Advantage: $149.55
  • Cigna — Out of Network Plans: $445
  • Clover Health — Medicare Advantage: $149.55
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99385 New Prevent 18-39 Yrs. $445 $445 $79.08 – $445
Preventive checkup, new patient, age 18–39: 10 of 33 insurance plan rates
  • Aetna — HTC: $209.37
  • Aetna — Managed Care: $222.50
  • Aetna — Medicare Advantage: $149.55
  • Aetna — PPO/Signature Administrators: $222.50
  • Aetna Better Health — Managed Medicaid: $91.54
  • Aetna Whole Health — Commercial: $305.09
  • AmeriHealth — Managed Care/PPO: $283.33
  • AmeriHealth — Medicare Advantage: $149.55
  • Cigna — Out of Network Plans: $445
  • Clover Health — Medicare Advantage: $149.55
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: Initial Comp Preventive Med 18 To 39 Years New 993 $401.76 $401.76 $20.27 – $401.76
Preventive checkup, new patient, age 18–39: 10 of 26 insurance plan rates
  • Aetna — HTC: $37.84
  • Aetna — Managed Care: $32.98
  • Aetna — Medicare Advantage: $27.03
  • Aetna — PPO/Signature Administrators: $32.98
  • Aetna Better Health — Managed Medicaid: $55
  • Aetna Whole Health — Commercial: $31.08
  • AmeriHealth — Managed Care/PPO: $31.08
  • AmeriHealth — Medicare Advantage: $27.03
  • Cigna — Out of Network Plans: $401.76
  • Clover Health — Medicare Advantage: $27.03
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Preventive-New-Age 40-64 $520 $520 $92.40 – $520
Preventive checkup, new patient, age 40–64: 10 of 33 insurance plan rates
  • Aetna — HTC: $241.56
  • Aetna — Managed Care: $260
  • Aetna — Medicare Advantage: $172.54
  • Aetna — PPO/Signature Administrators: $260
  • Aetna Better Health — Managed Medicaid: $106.96
  • Aetna Whole Health — Commercial: $351.99
  • AmeriHealth — Managed Care/PPO: $331.08
  • AmeriHealth — Medicare Advantage: $172.54
  • Cigna — Out of Network Plans: $520
  • Clover Health — Medicare Advantage: $172.54
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: Initial Comp Preventive Med 40 To 64 Years New 993 $466.56 $466.56 $20.27 – $466.56
Preventive checkup, new patient, age 40–64: 10 of 26 insurance plan rates
  • Aetna — HTC: $37.84
  • Aetna — Managed Care: $32.98
  • Aetna — Medicare Advantage: $27.03
  • Aetna — PPO/Signature Administrators: $32.98
  • Aetna Better Health — Managed Medicaid: $50
  • Aetna Whole Health — Commercial: $31.08
  • AmeriHealth — Managed Care/PPO: $31.08
  • AmeriHealth — Medicare Advantage: $27.03
  • Cigna — Out of Network Plans: $466.56
  • Clover Health — Medicare Advantage: $27.03
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Preventive-New-Age 40-64 $520 $520 $338 – $520
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $520
  • Consumer Health Network — Commercial: $468
  • Multiplan — All Products: $390
  • Private Healthcare Systems — All Products: $338
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99283 Er Moderate Severity $1,827 $1,827 $324.30 – $1,891
Emergency room visit (moderate): 10 of 33 insurance plan rates
  • Aetna — HTC: $454.03
  • Aetna — Managed Care: $1,380
  • Aetna — Medicare Advantage: $324.30
  • Aetna — PPO/Signature Administrators: $1,380
  • Aetna Better Health — Managed Medicaid: $375.81
  • Aetna Whole Health — Commercial: $661.58
  • AmeriHealth — Managed Care/PPO: $1,274
  • AmeriHealth — Medicare Advantage: $324.30
  • Cigna — Out of Network Plans: $1,827
  • Clover Health — Medicare Advantage: $324.30
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: 99283 - Level 3 PROFEE $199.77 $199.77 $56.09 – $199.77
Emergency room visit (moderate): 10 of 29 insurance plan rates
  • Aetna — HTC: $104.71
  • Aetna — Managed Care: $91.24
  • Aetna — Medicare Advantage: $74.79
  • Aetna — PPO/Signature Administrators: $91.24
  • Aetna Better Health — Managed Medicaid: $74.66
  • Aetna Whole Health — Commercial: $86.01
  • AmeriHealth — Managed Care/PPO: $86.01
  • AmeriHealth — Medicare Advantage: $74.79
  • Cigna — Out of Network Plans: $199.77
  • Clover Health — Medicare Advantage: $74.79
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency Department Visit, Level 3 99283 $199.77 $199.77 $56.09 – $199.77
Emergency room visit (moderate): 10 of 29 insurance plan rates
  • Aetna — HTC: $104.71
  • Aetna — Managed Care: $91.24
  • Aetna — Medicare Advantage: $74.79
  • Aetna — PPO/Signature Administrators: $91.24
  • Aetna Better Health — Managed Medicaid: $74.66
  • Aetna Whole Health — Commercial: $86.01
  • AmeriHealth — Managed Care/PPO: $86.01
  • AmeriHealth — Medicare Advantage: $74.79
  • Cigna — Out of Network Plans: $199.77
  • Clover Health — Medicare Advantage: $74.79
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99284 Er High Severity Urgent $2,608 $2,608 $463.44 – $2,608
Emergency room visit (moderately high): 10 of 33 insurance plan rates
  • Aetna — HTC: $694.01
  • Aetna — Managed Care: $1,380
  • Aetna — Medicare Advantage: $495.72
  • Aetna — PPO/Signature Administrators: $1,380
  • Aetna Better Health — Managed Medicaid: $536.47
  • Aetna Whole Health — Commercial: $1,011.27
  • AmeriHealth — Managed Care/PPO: $1,274
  • AmeriHealth — Medicare Advantage: $495.72
  • Cigna — Out of Network Plans: $2,608
  • Clover Health — Medicare Advantage: $495.72
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: 99284 - Level 4 PROFEE $378.66 $378.66 $95.40 – $378.66
Emergency room visit (moderately high): 10 of 29 insurance plan rates
  • Aetna — HTC: $178.08
  • Aetna — Managed Care: $155.18
  • Aetna — Medicare Advantage: $127.20
  • Aetna — PPO/Signature Administrators: $155.18
  • Aetna Better Health — Managed Medicaid: $138.94
  • Aetna Whole Health — Commercial: $146.28
  • AmeriHealth — Managed Care/PPO: $146.28
  • AmeriHealth — Medicare Advantage: $127.20
  • Cigna — Out of Network Plans: $378.66
  • Clover Health — Medicare Advantage: $127.20
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: Emergency Department Visit, Level 4 99284 $557.25 $557.25 $95.40 – $557.25
Emergency room visit (moderately high): 10 of 29 insurance plan rates
  • Aetna — HTC: $178.08
  • Aetna — Managed Care: $155.18
  • Aetna — Medicare Advantage: $127.20
  • Aetna — PPO/Signature Administrators: $155.18
  • Aetna Better Health — Managed Medicaid: $138.94
  • Aetna Whole Health — Commercial: $146.28
  • AmeriHealth — Managed Care/PPO: $146.28
  • AmeriHealth — Medicare Advantage: $127.20
  • Cigna — Out of Network Plans: $557.25
  • Clover Health — Medicare Advantage: $127.20
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 99285 Er High Severity Immediate $4,652 $4,652 $543 – $4,652
Emergency room visit (high): 10 of 33 insurance plan rates
  • Aetna — HTC: $990.51
  • Aetna — Managed Care: $1,380
  • Aetna — Medicare Advantage: $707.51
  • Aetna — PPO/Signature Administrators: $1,380
  • Aetna Better Health — Managed Medicaid: $956.92
  • Aetna Whole Health — Commercial: $1,443.31
  • AmeriHealth — Managed Care/PPO: $1,274
  • AmeriHealth — Medicare Advantage: $707.51
  • Cigna — Out of Network Plans: $4,652
  • Clover Health — Medicare Advantage: $707.51
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Trauma Response W/O Pre-notification 99285 $12,176 $12,176 $543 – $12,176
Emergency room visit (high): 10 of 33 insurance plan rates
  • Aetna — HTC: $990.51
  • Aetna — Managed Care: $1,380
  • Aetna — Medicare Advantage: $707.51
  • Aetna — PPO/Signature Administrators: $1,380
  • Aetna Better Health — Managed Medicaid: $2,504.60
  • Aetna Whole Health — Commercial: $1,443.31
  • AmeriHealth — Managed Care/PPO: $1,274
  • AmeriHealth — Medicare Advantage: $707.51
  • Cigna — Out of Network Plans: $12,176
  • Clover Health — Medicare Advantage: $707.51
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: 99285 - Level 5 PROFEE $562.51 $562.51 $138.25 – $562.51
Emergency room visit (high): 10 of 29 insurance plan rates
  • Aetna — HTC: $258.06
  • Aetna — Managed Care: $224.88
  • Aetna — Medicare Advantage: $184.33
  • Aetna — PPO/Signature Administrators: $224.88
  • Aetna Better Health — Managed Medicaid: $206.85
  • Aetna Whole Health — Commercial: $211.98
  • AmeriHealth — Managed Care/PPO: $211.98
  • AmeriHealth — Medicare Advantage: $184.33
  • Cigna — Out of Network Plans: $562.51
  • Clover Health — Medicare Advantage: $184.33

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Basic Metabolic Panel (8) $256 $256 $8.46 – $256
Basic metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — HTC: $11.84
  • Aetna — Managed Care: $15.43
  • Aetna — Medicare Advantage: $8.46
  • Aetna — PPO/Signature Administrators: $15.43
  • Aetna Better Health — Managed Medicaid: $52.66
  • Aetna Whole Health — Commercial: $17.26
  • AmeriHealth — Managed Care/PPO: $163
  • AmeriHealth — Medicare Advantage: $8.46
  • Cigna — Out of Network Plans: $256
  • Clover Health — Medicare Advantage: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SMA7 STROKE $256 $256 $8.46 – $256
Basic metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — HTC: $11.84
  • Aetna — Managed Care: $15.43
  • Aetna — Medicare Advantage: $8.46
  • Aetna — PPO/Signature Administrators: $15.43
  • Aetna Better Health — Managed Medicaid: $52.66
  • Aetna Whole Health — Commercial: $17.26
  • AmeriHealth — Managed Care/PPO: $163
  • AmeriHealth — Medicare Advantage: $8.46
  • Cigna — Out of Network Plans: $256
  • Clover Health — Medicare Advantage: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Basic Metabolic Panel (8) $256 $256 $166.40 – $256
Basic metabolic panel (blood test): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $256
  • Consumer Health Network — Commercial: $230.40
  • Multiplan — All Products: $192
  • Private Healthcare Systems — All Products: $166.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel $405 $405 $9.98 – $405
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — HTC: $14.78
  • Aetna — Managed Care: $17.43
  • Aetna — Medicare Advantage: $10.56
  • Aetna — PPO/Signature Administrators: $17.43
  • Aetna Better Health — Managed Medicaid: $83.31
  • Aetna Whole Health — Commercial: $21.54
  • AmeriHealth — Managed Care/PPO: $257.86
  • AmeriHealth — Medicare Advantage: $10.56
  • Cigna — Out of Network Plans: $405
  • Clover Health — Medicare Advantage: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Comprehensive Metabolic Panel $405 $405 $263.25 – $405
Comprehensive metabolic panel (blood test): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $405
  • Consumer Health Network — Commercial: $364.50
  • Multiplan — All Products: $303.75
  • Private Healthcare Systems — All Products: $263.25
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHEN METABOLIC PANEL Not listed in the file Not listed in the file $13.45 – $20.98
Comprehensive metabolic panel (blood test): rates for 6 insurance plans
  • Horizon Blue Cross Blue Shield — Indemnity: $20.57
  • Horizon Blue Cross Blue Shield — Managed Care: $20.98
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $13.45
  • Horizon Blue Cross Blue Shield — Omnia: $20.57
  • Horizon Blue Cross Blue Shield — PPO: $20.57
  • Horizon Blue Cross Blue Shield — SHBP: $20.57
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL Not listed in the file Not listed in the file $14.25 – $136.13
Obstetric blood test panel: 10 of 24 insurance plan rates
  • Aetna — HTC: $66.93
  • Aetna — Managed Care: $90.11
  • Aetna — Medicare Advantage: $47.81
  • Aetna — PPO/Signature Administrators: $90.11
  • Aetna Whole Health — Commercial: $97.53
  • AmeriHealth — Medicare Advantage: $47.81
  • Clover Health — Medicare Advantage: $47.81
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $50.20
  • Horizon Blue Cross Blue Shield — Indemnity: $136.13
  • Horizon Blue Cross Blue Shield — Managed Care: $136.13
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Doctor (professional) fee In the file: OBSTETRIC PANEL Not listed in the file Not listed in the file $15.50 – $53.56
Obstetric blood test panel: 10 of 11 insurance plan rates
  • Aetna — Managed Care: $53.56
  • Aetna — Medicare Advantage: $53.56
  • Aetna — PPO/Signature Administrators: $53.56
  • Aetna Better Health — Managed Medicaid: $53.56
  • Aetna Whole Health — Commercial: $53.56
  • Consumer Health Network — Commercial: $15.50
  • Horizon Blue Cross Blue Shield — Indemnity: $33.47
  • Horizon Blue Cross Blue Shield — Managed Care: $33.47
  • Horizon Blue Cross Blue Shield — Omnia: $33.47
  • Horizon Blue Cross Blue Shield — PPO: $33.47
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Panel $267 $267 $13.39 – $267
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates
  • Aetna — HTC: $18.75
  • Aetna — Managed Care: $24.42
  • Aetna — Medicare Advantage: $13.39
  • Aetna — PPO/Signature Administrators: $24.42
  • Aetna Better Health — Managed Medicaid: $54.92
  • Aetna Whole Health — Commercial: $27.32
  • AmeriHealth — Managed Care/PPO: $170
  • AmeriHealth — Medicare Advantage: $13.39
  • Cigna — Out of Network Plans: $267
  • Clover Health — Medicare Advantage: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Profile 4 $267 $267 $13.39 – $267
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates
  • Aetna — HTC: $18.75
  • Aetna — Managed Care: $24.42
  • Aetna — Medicare Advantage: $13.39
  • Aetna — PPO/Signature Administrators: $24.42
  • Aetna Better Health — Managed Medicaid: $54.92
  • Aetna Whole Health — Commercial: $27.32
  • AmeriHealth — Managed Care/PPO: $170
  • AmeriHealth — Medicare Advantage: $13.39
  • Cigna — Out of Network Plans: $267
  • Clover Health — Medicare Advantage: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Lipid Panel $267 $267 $173.55 – $267
Cholesterol panel (lipid panel): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $267
  • Consumer Health Network — Commercial: $240.30
  • Multiplan — All Products: $200.25
  • Private Healthcare Systems — All Products: $173.55
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Function Panel $208 $208 $7.91 – $208
Kidney function panel: 10 of 33 insurance plan rates
  • Aetna — HTC: $12.15
  • Aetna — Managed Care: $15.83
  • Aetna — Medicare Advantage: $8.68
  • Aetna — PPO/Signature Administrators: $15.83
  • Aetna Better Health — Managed Medicaid: $42.79
  • Aetna Whole Health — Commercial: $17.71
  • AmeriHealth — Managed Care/PPO: $132.43
  • AmeriHealth — Medicare Advantage: $8.68
  • Cigna — Out of Network Plans: $208
  • Clover Health — Medicare Advantage: $8.68
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Kidney Stone Analysis $208 $208 $7.91 – $208
Kidney function panel: 10 of 33 insurance plan rates
  • Aetna — HTC: $12.15
  • Aetna — Managed Care: $15.83
  • Aetna — Medicare Advantage: $8.68
  • Aetna — PPO/Signature Administrators: $15.83
  • Aetna Better Health — Managed Medicaid: $42.79
  • Aetna Whole Health — Commercial: $17.71
  • AmeriHealth — Managed Care/PPO: $132.43
  • AmeriHealth — Medicare Advantage: $8.68
  • Cigna — Out of Network Plans: $208
  • Clover Health — Medicare Advantage: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Renal Function Panel $208 $208 $135.20 – $208
Kidney function panel: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $208
  • Consumer Health Network — Commercial: $187.20
  • Multiplan — All Products: $156
  • Private Healthcare Systems — All Products: $135.20
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Liver Function Panel (7) $174 $174 $6.65 – $174
Liver function panel: 10 of 33 insurance plan rates
  • Aetna — HTC: $11.44
  • Aetna — Managed Care: $14.89
  • Aetna — Medicare Advantage: $8.17
  • Aetna — PPO/Signature Administrators: $14.89
  • Aetna Better Health — Managed Medicaid: $35.79
  • Aetna Whole Health — Commercial: $16.67
  • AmeriHealth — Managed Care/PPO: $110.79
  • AmeriHealth — Medicare Advantage: $8.17
  • Cigna — Out of Network Plans: $174
  • Clover Health — Medicare Advantage: $8.17
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Liver Function Panel (7) $174 $174 $113.10 – $174
Liver function panel: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $174
  • Consumer Health Network — Commercial: $156.60
  • Multiplan — All Products: $130.50
  • Private Healthcare Systems — All Products: $113.10
Liver function panel CPT 80076 · Inpatient or outpatient · Doctor (professional) fee In the file: HEPATIC FUNCTION PANEL Not listed in the file Not listed in the file $8.85 – $17.92
Liver function panel: 10 of 11 insurance plan rates
  • Aetna — Managed Care: $8.85
  • Aetna — Medicare Advantage: $8.85
  • Aetna — PPO/Signature Administrators: $8.85
  • Aetna Better Health — Managed Medicaid: $8.85
  • Aetna Whole Health — Commercial: $8.85
  • Horizon Blue Cross Blue Shield — Indemnity: $17.57
  • Horizon Blue Cross Blue Shield — Managed Care: $17.92
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $11.49
  • Horizon Blue Cross Blue Shield — Omnia: $17.57
  • Horizon Blue Cross Blue Shield — PPO: $17.57
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Auto With Micro $70 $70 $1.14 – $70
Urine test (automated, with microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $4.44
  • Aetna — Managed Care: $5.77
  • Aetna — Medicare Advantage: $3.17
  • Aetna — PPO/Signature Administrators: $5.77
  • Aetna Better Health — Managed Medicaid: $14.40
  • Aetna Whole Health — Commercial: $6.47
  • AmeriHealth — Managed Care/PPO: $44.57
  • AmeriHealth — Medicare Advantage: $3.17
  • Cigna — Out of Network Plans: $70
  • Clover Health — Medicare Advantage: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Automated Dipstick (Lab Only) $70 $70 $1.14 – $70
Urine test (automated, with microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $4.44
  • Aetna — Managed Care: $5.77
  • Aetna — Medicare Advantage: $3.17
  • Aetna — PPO/Signature Administrators: $5.77
  • Aetna Better Health — Managed Medicaid: $14.40
  • Aetna Whole Health — Commercial: $6.47
  • AmeriHealth — Managed Care/PPO: $44.57
  • AmeriHealth — Medicare Advantage: $3.17
  • Cigna — Out of Network Plans: $70
  • Clover Health — Medicare Advantage: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Automated Dipstick with Microscopy (Lab Only) $70 $70 $1.14 – $70
Urine test (automated, with microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $4.44
  • Aetna — Managed Care: $5.77
  • Aetna — Medicare Advantage: $3.17
  • Aetna — PPO/Signature Administrators: $5.77
  • Aetna Better Health — Managed Medicaid: $14.40
  • Aetna Whole Health — Commercial: $6.47
  • AmeriHealth — Managed Care/PPO: $44.57
  • AmeriHealth — Medicare Advantage: $3.17
  • Cigna — Out of Network Plans: $70
  • Clover Health — Medicare Advantage: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Er Urine,Blood $137 $137 $0.95 – $137
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $4.87
  • Aetna — Managed Care: $4.66
  • Aetna — Medicare Advantage: $3.48
  • Aetna — PPO/Signature Administrators: $4.66
  • Aetna Better Health — Managed Medicaid: $28.18
  • Aetna Whole Health — Commercial: $7.10
  • AmeriHealth — Managed Care/PPO: $87.23
  • AmeriHealth — Medicare Advantage: $3.48
  • Cigna — Out of Network Plans: $137
  • Clover Health — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Non-Automated $137 $137 $0.95 – $137
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $4.87
  • Aetna — Managed Care: $4.66
  • Aetna — Medicare Advantage: $3.48
  • Aetna — PPO/Signature Administrators: $4.66
  • Aetna Better Health — Managed Medicaid: $28.18
  • Aetna Whole Health — Commercial: $7.10
  • AmeriHealth — Managed Care/PPO: $87.23
  • AmeriHealth — Medicare Advantage: $3.48
  • Cigna — Out of Network Plans: $137
  • Clover Health — Medicare Advantage: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 81002 Urinalysis No-Auto $137 $137 $0.95 – $137
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $4.87
  • Aetna — Managed Care: $4.66
  • Aetna — Medicare Advantage: $3.48
  • Aetna — PPO/Signature Administrators: $4.66
  • Aetna Better Health — Managed Medicaid: $28.18
  • Aetna Whole Health — Commercial: $7.10
  • AmeriHealth — Managed Care/PPO: $87.23
  • AmeriHealth — Medicare Advantage: $3.48
  • Cigna — Out of Network Plans: $137
  • Clover Health — Medicare Advantage: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hgb Free,Urine $53 $53 $1.43 – $53
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $3.15
  • Aetna — Managed Care: $4.10
  • Aetna — Medicare Advantage: $2.25
  • Aetna — PPO/Signature Administrators: $4.10
  • Aetna Better Health — Managed Medicaid: $10.90
  • Aetna Whole Health — Commercial: $4.59
  • AmeriHealth — Managed Care/PPO: $33.75
  • AmeriHealth — Medicare Advantage: $2.25
  • Cigna — Out of Network Plans: $53
  • Clover Health — Medicare Advantage: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis Auto W/O Microscopy $53 $53 $1.43 – $53
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $3.15
  • Aetna — Managed Care: $4.10
  • Aetna — Medicare Advantage: $2.25
  • Aetna — PPO/Signature Administrators: $4.10
  • Aetna Better Health — Managed Medicaid: $10.90
  • Aetna Whole Health — Commercial: $4.59
  • AmeriHealth — Managed Care/PPO: $33.75
  • AmeriHealth — Medicare Advantage: $2.25
  • Cigna — Out of Network Plans: $53
  • Clover Health — Medicare Advantage: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis,Dipstick-Automated $53 $53 $1.43 – $53
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — HTC: $3.15
  • Aetna — Managed Care: $4.10
  • Aetna — Medicare Advantage: $2.25
  • Aetna — PPO/Signature Administrators: $4.10
  • Aetna Better Health — Managed Medicaid: $10.90
  • Aetna Whole Health — Commercial: $4.59
  • AmeriHealth — Managed Care/PPO: $33.75
  • AmeriHealth — Medicare Advantage: $2.25
  • Cigna — Out of Network Plans: $53
  • Clover Health — Medicare Advantage: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total $233 $233 $18.39 – $233
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — HTC: $25.75
  • Aetna — Managed Care: $33.52
  • Aetna — Medicare Advantage: $18.39
  • Aetna — PPO/Signature Administrators: $33.52
  • Aetna Better Health — Managed Medicaid: $47.93
  • Aetna Whole Health — Commercial: $37.52
  • AmeriHealth — Managed Care/PPO: $148.35
  • AmeriHealth — Medicare Advantage: $18.39
  • Cigna — Out of Network Plans: $233
  • Clover Health — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total Diag Mcare Only $233 $233 $18.39 – $233
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — HTC: $25.75
  • Aetna — Managed Care: $33.52
  • Aetna — Medicare Advantage: $18.39
  • Aetna — PPO/Signature Administrators: $33.52
  • Aetna Better Health — Managed Medicaid: $47.93
  • Aetna Whole Health — Commercial: $37.52
  • AmeriHealth — Managed Care/PPO: $148.35
  • AmeriHealth — Medicare Advantage: $18.39
  • Cigna — Out of Network Plans: $233
  • Clover Health — Medicare Advantage: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Total Non Medicare $233 $233 $18.39 – $233
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — HTC: $25.75
  • Aetna — Managed Care: $33.52
  • Aetna — Medicare Advantage: $18.39
  • Aetna — PPO/Signature Administrators: $33.52
  • Aetna Better Health — Managed Medicaid: $47.93
  • Aetna Whole Health — Commercial: $37.52
  • AmeriHealth — Managed Care/PPO: $148.35
  • AmeriHealth — Medicare Advantage: $18.39
  • Cigna — Out of Network Plans: $233
  • Clover Health — Medicare Advantage: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thyrotropin Releasing Hormone $221 $221 $16.80 – $221
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — HTC: $23.52
  • Aetna — Managed Care: $30.62
  • Aetna — Medicare Advantage: $16.80
  • Aetna — PPO/Signature Administrators: $30.62
  • Aetna Better Health — Managed Medicaid: $45.46
  • Aetna Whole Health — Commercial: $34.27
  • AmeriHealth — Managed Care/PPO: $140.71
  • AmeriHealth — Medicare Advantage: $16.80
  • Cigna — Out of Network Plans: $221
  • Clover Health — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh (15 Minutes) $221 $221 $16.80 – $221
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — HTC: $23.52
  • Aetna — Managed Care: $30.62
  • Aetna — Medicare Advantage: $16.80
  • Aetna — PPO/Signature Administrators: $30.62
  • Aetna Better Health — Managed Medicaid: $45.46
  • Aetna Whole Health — Commercial: $34.27
  • AmeriHealth — Managed Care/PPO: $140.71
  • AmeriHealth — Medicare Advantage: $16.80
  • Cigna — Out of Network Plans: $221
  • Clover Health — Medicare Advantage: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh (2 Hours) $221 $221 $16.80 – $221
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — HTC: $23.52
  • Aetna — Managed Care: $30.62
  • Aetna — Medicare Advantage: $16.80
  • Aetna — PPO/Signature Administrators: $30.62
  • Aetna Better Health — Managed Medicaid: $45.46
  • Aetna Whole Health — Commercial: $34.27
  • AmeriHealth — Managed Care/PPO: $140.71
  • AmeriHealth — Medicare Advantage: $16.80
  • Cigna — Out of Network Plans: $221
  • Clover Health — Medicare Advantage: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc Auto Diff $151 $151 $4.75 – $151
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — HTC: $10.88
  • Aetna — Managed Care: $14.18
  • Aetna — Medicare Advantage: $7.77
  • Aetna — PPO/Signature Administrators: $14.18
  • Aetna Better Health — Managed Medicaid: $31.06
  • Aetna Whole Health — Commercial: $15.85
  • AmeriHealth — Managed Care/PPO: $96.14
  • AmeriHealth — Medicare Advantage: $7.77
  • Cigna — Out of Network Plans: $151
  • Clover Health — Medicare Advantage: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc With Diff $151 $151 $4.75 – $151
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — HTC: $10.88
  • Aetna — Managed Care: $14.18
  • Aetna — Medicare Advantage: $7.77
  • Aetna — PPO/Signature Administrators: $14.18
  • Aetna Better Health — Managed Medicaid: $31.06
  • Aetna Whole Health — Commercial: $15.85
  • AmeriHealth — Managed Care/PPO: $96.14
  • AmeriHealth — Medicare Advantage: $7.77
  • Cigna — Out of Network Plans: $151
  • Clover Health — Medicare Advantage: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc W/Plats, Auto Diff $151 $151 $4.75 – $151
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — HTC: $10.88
  • Aetna — Managed Care: $14.18
  • Aetna — Medicare Advantage: $7.77
  • Aetna — PPO/Signature Administrators: $14.18
  • Aetna Better Health — Managed Medicaid: $31.06
  • Aetna Whole Health — Commercial: $15.85
  • AmeriHealth — Managed Care/PPO: $96.14
  • AmeriHealth — Medicare Advantage: $7.77
  • Cigna — Out of Network Plans: $151
  • Clover Health — Medicare Advantage: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC STROKE $151 $151 $4.56 – $151
Complete blood count (CBC), automated: 10 of 33 insurance plan rates
  • Aetna — HTC: $9.06
  • Aetna — Managed Care: $11.80
  • Aetna — Medicare Advantage: $6.47
  • Aetna — PPO/Signature Administrators: $11.80
  • Aetna Better Health — Managed Medicaid: $31.06
  • Aetna Whole Health — Commercial: $13.20
  • AmeriHealth — Managed Care/PPO: $96.14
  • AmeriHealth — Medicare Advantage: $6.47
  • Cigna — Out of Network Plans: $151
  • Clover Health — Medicare Advantage: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc No Diff $151 $151 $4.56 – $151
Complete blood count (CBC), automated: 10 of 33 insurance plan rates
  • Aetna — HTC: $9.06
  • Aetna — Managed Care: $11.80
  • Aetna — Medicare Advantage: $6.47
  • Aetna — PPO/Signature Administrators: $11.80
  • Aetna Better Health — Managed Medicaid: $31.06
  • Aetna Whole Health — Commercial: $13.20
  • AmeriHealth — Managed Care/PPO: $96.14
  • AmeriHealth — Medicare Advantage: $6.47
  • Cigna — Out of Network Plans: $151
  • Clover Health — Medicare Advantage: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC STROKE $151 $151 $98.15 – $151
Complete blood count (CBC), automated: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $151
  • Consumer Health Network — Commercial: $135.90
  • Multiplan — All Products: $113.25
  • Private Healthcare Systems — All Products: $98.15
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC Prothrombin Time $68 $68 $2.85 – $68
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — HTC: $6.01
  • Aetna — Managed Care: $7.16
  • Aetna — Medicare Advantage: $4.29
  • Aetna — PPO/Signature Administrators: $7.16
  • Aetna Better Health — Managed Medicaid: $13.99
  • Aetna Whole Health — Commercial: $8.75
  • AmeriHealth — Managed Care/PPO: $43.30
  • AmeriHealth — Medicare Advantage: $4.29
  • Cigna — Out of Network Plans: $68
  • Clover Health — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time (Pt) $68 $68 $2.85 – $68
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — HTC: $6.01
  • Aetna — Managed Care: $7.16
  • Aetna — Medicare Advantage: $4.29
  • Aetna — PPO/Signature Administrators: $7.16
  • Aetna Better Health — Managed Medicaid: $13.99
  • Aetna Whole Health — Commercial: $8.75
  • AmeriHealth — Managed Care/PPO: $43.30
  • AmeriHealth — Medicare Advantage: $4.29
  • Cigna — Out of Network Plans: $68
  • Clover Health — Medicare Advantage: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin Time (Pt) B709 $68 $68 $2.85 – $68
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — HTC: $6.01
  • Aetna — Managed Care: $7.16
  • Aetna — Medicare Advantage: $4.29
  • Aetna — PPO/Signature Administrators: $7.16
  • Aetna Better Health — Managed Medicaid: $13.99
  • Aetna Whole Health — Commercial: $8.75
  • AmeriHealth — Managed Care/PPO: $43.30
  • AmeriHealth — Medicare Advantage: $4.29
  • Cigna — Out of Network Plans: $68
  • Clover Health — Medicare Advantage: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ptt B750 $135 $135 $2.85 – $135
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — HTC: $8.41
  • Aetna — Managed Care: $10.93
  • Aetna — Medicare Advantage: $6.01
  • Aetna — PPO/Signature Administrators: $10.93
  • Aetna Better Health — Managed Medicaid: $27.77
  • Aetna Whole Health — Commercial: $12.26
  • AmeriHealth — Managed Care/PPO: $85.95
  • AmeriHealth — Medicare Advantage: $6.01
  • Cigna — Out of Network Plans: $135
  • Clover Health — Medicare Advantage: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pttpo $135 $135 $2.85 – $135
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — HTC: $8.41
  • Aetna — Managed Care: $10.93
  • Aetna — Medicare Advantage: $6.01
  • Aetna — PPO/Signature Administrators: $10.93
  • Aetna Better Health — Managed Medicaid: $27.77
  • Aetna Whole Health — Commercial: $12.26
  • AmeriHealth — Managed Care/PPO: $85.95
  • AmeriHealth — Medicare Advantage: $6.01
  • Cigna — Out of Network Plans: $135
  • Clover Health — Medicare Advantage: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pttpr $135 $135 $2.85 – $135
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — HTC: $8.41
  • Aetna — Managed Care: $10.93
  • Aetna — Medicare Advantage: $6.01
  • Aetna — PPO/Signature Administrators: $10.93
  • Aetna Better Health — Managed Medicaid: $27.77
  • Aetna Whole Health — Commercial: $12.26
  • AmeriHealth — Managed Care/PPO: $85.95
  • AmeriHealth — Medicare Advantage: $6.01
  • Cigna — Out of Network Plans: $135
  • Clover Health — Medicare Advantage: $6.01

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Brain/Head W/O C 70450 $2,872 $2,872 $124.20 – $2,872
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $362.55
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $362.55
  • Aetna Better Health — Managed Medicaid: $590.77
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $1,828.60
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $2,872
  • Clover Health — Medicare Advantage: $124.20
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Brain/Stroke Code W/O 70450 $2,872 $2,872 $124.20 – $2,872
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $362.55
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $362.55
  • Aetna Better Health — Managed Medicaid: $590.77
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $1,828.60
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $2,872
  • Clover Health — Medicare Advantage: $124.20
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pituitary W/O Cont $2,872 $2,872 $124.20 – $2,872
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $362.55
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $362.55
  • Aetna Better Health — Managed Medicaid: $590.77
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $1,828.60
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $2,872
  • Clover Health — Medicare Advantage: $124.20
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain/Head W/Wo C 70553 $5,662 $5,662 $414.47 – $5,662
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $580.26
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $414.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $1,164.67
  • Aetna Whole Health — Commercial: $845.52
  • AmeriHealth — Managed Care/PPO: $3,605
  • AmeriHealth — Medicare Advantage: $414.47
  • Cigna — Out of Network Plans: $5,662
  • Clover Health — Medicare Advantage: $414.47
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Iac'S W/Wo C 70553 $5,662 $5,662 $414.47 – $5,662
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $580.26
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $414.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $1,164.67
  • Aetna Whole Health — Commercial: $845.52
  • AmeriHealth — Managed Care/PPO: $3,605
  • AmeriHealth — Medicare Advantage: $414.47
  • Cigna — Out of Network Plans: $5,662
  • Clover Health — Medicare Advantage: $414.47
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Pituitary W/Wo C 70553 $5,662 $5,662 $414.47 – $5,662
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $580.26
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $414.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $1,164.67
  • Aetna Whole Health — Commercial: $845.52
  • AmeriHealth — Managed Care/PPO: $3,605
  • AmeriHealth — Medicare Advantage: $414.47
  • Cigna — Out of Network Plans: $5,662
  • Clover Health — Medicare Advantage: $414.47
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest 2 Views $340 $340 $30.66 – $340
Chest X-ray, 2 views: 10 of 33 insurance plan rates
  • Aetna — HTC: $144.74
  • Aetna — Managed Care: $39.31
  • Aetna — Medicare Advantage: $103.39
  • Aetna — PPO/Signature Administrators: $39.31
  • Aetna Better Health — Managed Medicaid: $69.94
  • Aetna Whole Health — Commercial: $210.91
  • AmeriHealth — Managed Care/PPO: $216.48
  • AmeriHealth — Medicare Advantage: $103.39
  • Cigna — Out of Network Plans: $340
  • Clover Health — Medicare Advantage: $103.39
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest Lat Decub Bil $340 $340 $30.66 – $340
Chest X-ray, 2 views: 10 of 33 insurance plan rates
  • Aetna — HTC: $144.74
  • Aetna — Managed Care: $39.31
  • Aetna — Medicare Advantage: $103.39
  • Aetna — PPO/Signature Administrators: $39.31
  • Aetna Better Health — Managed Medicaid: $69.94
  • Aetna Whole Health — Commercial: $210.91
  • AmeriHealth — Managed Care/PPO: $216.48
  • AmeriHealth — Medicare Advantage: $103.39
  • Cigna — Out of Network Plans: $340
  • Clover Health — Medicare Advantage: $103.39
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Chest Inspir/Expir $340 $340 $30.66 – $340
Chest X-ray, 2 views: 10 of 33 insurance plan rates
  • Aetna — HTC: $144.74
  • Aetna — Managed Care: $39.31
  • Aetna — Medicare Advantage: $103.39
  • Aetna — PPO/Signature Administrators: $39.31
  • Aetna Better Health — Managed Medicaid: $69.94
  • Aetna Whole Health — Commercial: $210.91
  • AmeriHealth — Managed Care/PPO: $216.48
  • AmeriHealth — Medicare Advantage: $103.39
  • Cigna — Out of Network Plans: $340
  • Clover Health — Medicare Advantage: $103.39
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR Lumbosacral Min 4V 72110 $759 $759 $44.82 – $759
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $78.13
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $78.13
  • Aetna Better Health — Managed Medicaid: $156.13
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $483.26
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $759
  • Clover Health — Medicare Advantage: $124.20
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: Lumbar Spine min 4 views 72110 $52.23 $52.23 $33.95 – $102.65
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates
  • Aetna — HTC: $85.53
  • Aetna — Managed Care: $74.53
  • Aetna — Medicare Advantage: $61.09
  • Aetna — PPO/Signature Administrators: $74.53
  • Aetna Better Health — Managed Medicaid: $63.59
  • Aetna Whole Health — Commercial: $70.25
  • AmeriHealth — Managed Care/PPO: $70.25
  • AmeriHealth — Medicare Advantage: $61.09
  • Cigna — Out of Network Plans: $52.23
  • Clover Health — Medicare Advantage: $61.09
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee In the file: XR Spine Lumbosacral 4+ Views $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $102.65
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates
  • Aetna — HTC: $85.53
  • Aetna — Managed Care: $74.53
  • Aetna — Medicare Advantage: $61.09
  • Aetna — PPO/Signature Administrators: $74.53
  • Aetna Better Health — Managed Medicaid: $63.59
  • Aetna Whole Health — Commercial: $70.25
  • AmeriHealth — Managed Care/PPO: $70.25
  • AmeriHealth — Medicare Advantage: $61.09
  • Cigna — Out of Network Plans: $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Clover Health — Medicare Advantage: $61.09
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Lumbar Spine W/O C 72148 $4,687 $4,687 $283.47 – $4,687
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $396.85
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $283.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $964.12
  • Aetna Whole Health — Commercial: $578.27
  • AmeriHealth — Managed Care/PPO: $2,984.21
  • AmeriHealth — Medicare Advantage: $283.47
  • Cigna — Out of Network Plans: $4,687
  • Clover Health — Medicare Advantage: $283.47
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI Lumbar Spine W/O C 72148 $4,687 $4,687 $3,046.55 – $4,687
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $4,687
  • Consumer Health Network — Commercial: $4,218.30
  • Multiplan — All Products: $3,515.25
  • Private Healthcare Systems — All Products: $3,046.55
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI LUMBAR SPINE W/O DYE Not listed in the file Not listed in the file $163.07 – $869.22
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates
  • Aetna — HTC: $304.39
  • Aetna — Managed Care: $265.25
  • Aetna — Medicare Advantage: $217.42
  • Aetna — PPO/Signature Administrators: $265.25
  • Aetna Better Health — Managed Medicaid: $562.91
  • Aetna Whole Health — Commercial: $250.03
  • AmeriHealth — Managed Care/PPO: $250.03
  • AmeriHealth — Medicare Advantage: $217.42
  • Clover Health — Medicare Advantage: $217.42
  • Consumer Health Network — Commercial: $463.50
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W/C 72193 $3,334 $3,334 $208.38 – $3,334
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $291.73
  • Aetna — Managed Care: $550.32
  • Aetna — Medicare Advantage: $208.38
  • Aetna — PPO/Signature Administrators: $550.32
  • Aetna Better Health — Managed Medicaid: $685.80
  • Aetna Whole Health — Commercial: $425.10
  • AmeriHealth — Managed Care/PPO: $2,122.76
  • AmeriHealth — Medicare Advantage: $208.38
  • Cigna — Out of Network Plans: $3,334
  • Clover Health — Medicare Advantage: $208.38
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Si Joints W/C 72193 $3,334 $3,334 $208.38 – $3,334
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $291.73
  • Aetna — Managed Care: $550.32
  • Aetna — Medicare Advantage: $208.38
  • Aetna — PPO/Signature Administrators: $550.32
  • Aetna Better Health — Managed Medicaid: $685.80
  • Aetna Whole Health — Commercial: $425.10
  • AmeriHealth — Managed Care/PPO: $2,122.76
  • AmeriHealth — Medicare Advantage: $208.38
  • Cigna — Out of Network Plans: $3,334
  • Clover Health — Medicare Advantage: $208.38
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Pelvis W/C 72193 $3,334 $3,334 $2,167.10 – $3,334
CT scan of the pelvis, with contrast: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $3,334
  • Consumer Health Network — Commercial: $3,000.60
  • Multiplan — All Products: $2,500.50
  • Private Healthcare Systems — All Products: $2,167.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri Lower Ext Jt Bil W/O 73721 $6,443 $6,443 $283.47 – $6,443
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $396.85
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $283.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $1,325.33
  • Aetna Whole Health — Commercial: $578.27
  • AmeriHealth — Managed Care/PPO: $4,102.26
  • AmeriHealth — Medicare Advantage: $283.47
  • Cigna — Out of Network Plans: $6,443
  • Clover Health — Medicare Advantage: $283.47
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri Lower Ext Jt W/O 73721 $3,704 $3,704 $283.47 – $3,704
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $396.85
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $283.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $761.91
  • Aetna Whole Health — Commercial: $578.27
  • AmeriHealth — Managed Care/PPO: $2,358.34
  • AmeriHealth — Medicare Advantage: $283.47
  • Cigna — Out of Network Plans: $3,704
  • Clover Health — Medicare Advantage: $283.47
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Ankle Bil W/O C 73721 $6,443 $6,443 $283.47 – $6,443
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $396.85
  • Aetna — Managed Care: $1,891
  • Aetna — Medicare Advantage: $283.47
  • Aetna — PPO/Signature Administrators: $2,112
  • Aetna Better Health — Managed Medicaid: $1,325.33
  • Aetna Whole Health — Commercial: $578.27
  • AmeriHealth — Managed Care/PPO: $4,102.26
  • AmeriHealth — Medicare Advantage: $283.47
  • Cigna — Out of Network Plans: $6,443
  • Clover Health — Medicare Advantage: $283.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abd-Pel W/C 74177 $3,716 $3,716 $245.53 – $3,716
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $580.26
  • Aetna — Managed Care: $514.14
  • Aetna — Medicare Advantage: $414.47
  • Aetna — PPO/Signature Administrators: $514.14
  • Aetna Better Health — Managed Medicaid: $764.38
  • Aetna Whole Health — Commercial: $845.52
  • AmeriHealth — Managed Care/PPO: $2,365.98
  • AmeriHealth — Medicare Advantage: $414.47
  • Cigna — Out of Network Plans: $3,716
  • Clover Health — Medicare Advantage: $414.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT FAST ABD/PEL W/CON 74177 $3,716 $3,716 $245.53 – $3,716
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates
  • Aetna — HTC: $580.26
  • Aetna — Managed Care: $514.14
  • Aetna — Medicare Advantage: $414.47
  • Aetna — PPO/Signature Administrators: $514.14
  • Aetna Better Health — Managed Medicaid: $764.38
  • Aetna Whole Health — Commercial: $845.52
  • AmeriHealth — Managed Care/PPO: $2,365.98
  • AmeriHealth — Medicare Advantage: $414.47
  • Cigna — Out of Network Plans: $3,716
  • Clover Health — Medicare Advantage: $414.47
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT Abd-Pel W/C 74177 $3,716 $3,716 $2,415.40 – $3,716
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $3,716
  • Consumer Health Network — Commercial: $3,344.40
  • Multiplan — All Products: $2,787
  • Private Healthcare Systems — All Products: $2,415.40
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Comp 76700 $1,514 $1,514 $107.57 – $1,514
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $757
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $757
  • Aetna Better Health — Managed Medicaid: $311.43
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $963.96
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $1,514
  • Clover Health — Medicare Advantage: $124.20
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 76700 US Abdomen Complete $1,514 $1,514 $124.20 – $1,514
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $757
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $757
  • Aetna Better Health — Managed Medicaid: $311.43
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $963.96
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $1,514
  • Clover Health — Medicare Advantage: $124.20
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Doctor (professional) fee In the file: US Abdomen Complete 76700 $398.88 $398.88 $97.32 – $398.88
Ultrasound of the abdomen, complete: 10 of 26 insurance plan rates
  • Aetna — HTC: $181.66
  • Aetna — Managed Care: $158.31
  • Aetna — Medicare Advantage: $129.76
  • Aetna — PPO/Signature Administrators: $158.31
  • Aetna Better Health — Managed Medicaid: $161.98
  • Aetna Whole Health — Commercial: $149.22
  • AmeriHealth — Managed Care/PPO: $149.22
  • AmeriHealth — Medicare Advantage: $129.76
  • Cigna — Out of Network Plans: $398.88
  • Clover Health — Medicare Advantage: $129.76
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 76805 OB US >= 14 Wks, Sgl Fet $1,014 $1,014 $105.29 – $1,014
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $767.03
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $881.63
  • Aetna Better Health — Managed Medicaid: $208.58
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $645.61
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $1,014
  • Clover Health — Medicare Advantage: $124.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Ob > 14 Wks T/A 76805 $1,014 $1,014 $105.29 – $1,014
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $767.03
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $881.63
  • Aetna Better Health — Managed Medicaid: $208.58
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $645.61
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $1,014
  • Clover Health — Medicare Advantage: $124.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: Tech;Echography, Pregnant Uterus, B-Scan And/Or Re $165.73 $165.73 $107.72 – $273.48
Pregnancy ultrasound (after the first trimester): 10 of 26 insurance plan rates
  • Aetna — HTC: $216.06
  • Aetna — Managed Care: $188.28
  • Aetna — Medicare Advantage: $154.33
  • Aetna — PPO/Signature Administrators: $188.28
  • Aetna Better Health — Managed Medicaid: $172.38
  • Aetna Whole Health — Commercial: $177.48
  • AmeriHealth — Managed Care/PPO: $177.48
  • AmeriHealth — Medicare Advantage: $154.33
  • Cigna — Out of Network Plans: $165.73
  • Clover Health — Medicare Advantage: $154.33
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Non Ob Transvaginal 76830 $1,495 $1,495 $120.12 – $1,495
Transvaginal ultrasound: 10 of 33 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $747.50
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $747.50
  • Aetna Better Health — Managed Medicaid: $307.52
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Managed Care/PPO: $951.87
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $1,495
  • Clover Health — Medicare Advantage: $124.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 76830 Transvaginal Us, Non-Ob $1,495 $1,495 $124.20 – $1,891
Transvaginal ultrasound: 10 of 29 insurance plan rates
  • Aetna — HTC: $173.88
  • Aetna — Managed Care: $1,380
  • Aetna — Medicare Advantage: $124.20
  • Aetna — PPO/Signature Administrators: $1,380
  • Aetna Better Health — Managed Medicaid: $307.52
  • Aetna Whole Health — Commercial: $253.37
  • AmeriHealth — Medicare Advantage: $124.20
  • Cigna — Out of Network Plans: $1,495
  • Clover Health — Medicare Advantage: $124.20
  • Consumer Health Network — Commercial: $1,345.50
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: US Non OB TV and Transabdominal Pelvic 76830 $410.85 $410.85 $100.52 – $410.85
Transvaginal ultrasound: 10 of 26 insurance plan rates
  • Aetna — HTC: $187.64
  • Aetna — Managed Care: $163.52
  • Aetna — Medicare Advantage: $134.03
  • Aetna — PPO/Signature Administrators: $163.52
  • Aetna Better Health — Managed Medicaid: $142.35
  • Aetna Whole Health — Commercial: $154.13
  • AmeriHealth — Managed Care/PPO: $154.13
  • AmeriHealth — Medicare Advantage: $134.03
  • Cigna — Out of Network Plans: $410.85
  • Clover Health — Medicare Advantage: $134.03
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAM DIAGNOSTIC UNI $853 $853 $105.06 – $853
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates
  • Aetna — HTC: $197.40
  • Aetna — Managed Care: $230.04
  • Aetna — Medicare Advantage: $141
  • Aetna — PPO/Signature Administrators: $230.04
  • Aetna Better Health — Managed Medicaid: $175.46
  • Aetna Whole Health — Commercial: $287.64
  • AmeriHealth — Managed Care/PPO: $543.11
  • AmeriHealth — Medicare Advantage: $141
  • Cigna — Out of Network Plans: $853
  • Clover Health — Medicare Advantage: $141
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAM DIGITAL ADDTL V UNI 77065 $853 $853 $105.06 – $853
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates
  • Aetna — HTC: $197.40
  • Aetna — Managed Care: $230.04
  • Aetna — Medicare Advantage: $141
  • Aetna — PPO/Signature Administrators: $230.04
  • Aetna Better Health — Managed Medicaid: $175.46
  • Aetna Whole Health — Commercial: $287.64
  • AmeriHealth — Managed Care/PPO: $543.11
  • AmeriHealth — Medicare Advantage: $141
  • Cigna — Out of Network Plans: $853
  • Clover Health — Medicare Advantage: $141
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAM DIAGNOSTIC UNI $853 $853 $554.45 – $853
Diagnostic mammogram, one breast: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $853
  • Consumer Health Network — Commercial: $767.70
  • Multiplan — All Products: $639.75
  • Private Healthcare Systems — All Products: $554.45
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAM DIAGNOSTIC BIL $1,206 $1,206 $133.27 – $1,206
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates
  • Aetna — HTC: $250.15
  • Aetna — Managed Care: $294.29
  • Aetna — Medicare Advantage: $178.68
  • Aetna — PPO/Signature Administrators: $294.29
  • Aetna Better Health — Managed Medicaid: $248.07
  • Aetna Whole Health — Commercial: $364.51
  • AmeriHealth — Managed Care/PPO: $767.86
  • AmeriHealth — Medicare Advantage: $178.68
  • Cigna — Out of Network Plans: $1,206
  • Clover Health — Medicare Advantage: $178.68
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAM DIGITAL ADDTL V BIL 77066 $1,206 $1,206 $133.27 – $1,206
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates
  • Aetna — HTC: $250.15
  • Aetna — Managed Care: $294.29
  • Aetna — Medicare Advantage: $178.68
  • Aetna — PPO/Signature Administrators: $294.29
  • Aetna Better Health — Managed Medicaid: $248.07
  • Aetna Whole Health — Commercial: $364.51
  • AmeriHealth — Managed Care/PPO: $767.86
  • AmeriHealth — Medicare Advantage: $178.68
  • Cigna — Out of Network Plans: $1,206
  • Clover Health — Medicare Advantage: $178.68
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Doctor (professional) fee In the file: Diagnostic mammography, inc/CAD,bilateral (MOD 26) $165.95 $165.95 $107.87 – $268.02
Diagnostic mammogram, both breasts: 10 of 25 insurance plan rates
  • Aetna — HTC: $250.15
  • Aetna — Managed Care: $217.99
  • Aetna — Medicare Advantage: $178.68
  • Aetna — PPO/Signature Administrators: $217.99
  • Aetna Better Health — Managed Medicaid: $239.62
  • Aetna Whole Health — Commercial: $205.48
  • AmeriHealth — Managed Care/PPO: $205.48
  • AmeriHealth — Medicare Advantage: $178.68
  • Cigna — Out of Network Plans: $165.95
  • Clover Health — Medicare Advantage: $178.68
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAM SCREENING BIL $1,025 $1,025 $107.57 – $1,025
Screening mammogram, both breasts: 10 of 33 insurance plan rates
  • Aetna — HTC: $201.47
  • Aetna — Managed Care: $243.07
  • Aetna — Medicare Advantage: $143.91
  • Aetna — PPO/Signature Administrators: $243.07
  • Aetna Better Health — Managed Medicaid: $210.84
  • Aetna Whole Health — Commercial: $293.57
  • AmeriHealth — Managed Care/PPO: $652.62
  • AmeriHealth — Medicare Advantage: $143.91
  • Cigna — Out of Network Plans: $1,025
  • Clover Health — Medicare Advantage: $143.91
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAM SCREENING BIL $1,025 $1,025 $666.25 – $1,025
Screening mammogram, both breasts: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $1,025
  • Consumer Health Network — Commercial: $922.50
  • Multiplan — All Products: $768.75
  • Private Healthcare Systems — All Products: $666.25
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Doctor (professional) fee In the file: SCR MAMMO BI INCL CAD Not listed in the file Not listed in the file $107.93 – $215.87
Screening mammogram, both breasts: 10 of 21 insurance plan rates
  • Aetna — HTC: $201.47
  • Aetna — Managed Care: $175.57
  • Aetna — Medicare Advantage: $143.91
  • Aetna — PPO/Signature Administrators: $175.57
  • Aetna Better Health — Managed Medicaid: $193.73
  • Aetna Whole Health — Commercial: $165.50
  • AmeriHealth — Managed Care/PPO: $165.50
  • AmeriHealth — Medicare Advantage: $143.91
  • Clover Health — Medicare Advantage: $143.91
  • Fidelis Care of New Jersey — Managed Medicaid: $107.93

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: 12 lead ecg w interp report 93000 $58.11 $58.11 $12.91 – $58.11
Electrocardiogram (ECG/EKG) with reading: 10 of 26 insurance plan rates
  • Aetna — HTC: $24.09
  • Aetna — Managed Care: $21
  • Aetna — Medicare Advantage: $17.21
  • Aetna — PPO/Signature Administrators: $21
  • Aetna Better Health — Managed Medicaid: $31.92
  • Aetna Whole Health — Commercial: $19.79
  • AmeriHealth — Managed Care/PPO: $19.79
  • AmeriHealth — Medicare Advantage: $17.21
  • Cigna — Out of Network Plans: $58.11
  • Clover Health — Medicare Advantage: $17.21
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · Doctor (professional) fee In the file: CV ECG Report $58.11 $58.11 $12.91 – $58.11
Electrocardiogram (ECG/EKG) with reading: 10 of 26 insurance plan rates
  • Aetna — HTC: $24.09
  • Aetna — Managed Care: $21
  • Aetna — Medicare Advantage: $17.21
  • Aetna — PPO/Signature Administrators: $21
  • Aetna Better Health — Managed Medicaid: $31.92
  • Aetna Whole Health — Commercial: $19.79
  • AmeriHealth — Managed Care/PPO: $19.79
  • AmeriHealth — Medicare Advantage: $17.21
  • Cigna — Out of Network Plans: $58.11
  • Clover Health — Medicare Advantage: $17.21
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE Not listed in the file Not listed in the file $17.21 – $194.04
Electrocardiogram (ECG/EKG) with reading: 10 of 19 insurance plan rates
  • Aetna — HTC: $24.09
  • Aetna — Managed Care: $169.29
  • Aetna — Medicare Advantage: $17.21
  • Aetna — PPO/Signature Administrators: $194.04
  • Aetna Whole Health — Commercial: $35.11
  • AmeriHealth — Medicare Advantage: $17.21
  • Clover Health — Medicare Advantage: $17.21
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $18.07
  • Horizon Blue Cross Blue Shield — Indemnity: $49.01
  • Horizon Blue Cross Blue Shield — Managed Care: $49.01
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 93452 Left Heart Cath W LV (pressures only) $13,144 $13,144 $2,335.69 – $17,365
Left heart catheterization (diagnostic): 10 of 33 insurance plan rates
  • Aetna — HTC: $5,392.10
  • Aetna — Managed Care: $9,832
  • Aetna — Medicare Advantage: $3,851.50
  • Aetna — PPO/Signature Administrators: $9,832
  • Aetna Better Health — Managed Medicaid: $2,703.72
  • Aetna Whole Health — Commercial: $7,857.06
  • AmeriHealth — Managed Care/PPO: $17,365
  • AmeriHealth — Medicare Advantage: $3,851.50
  • Cigna — Out of Network Plans: $13,144
  • Clover Health — Medicare Advantage: $3,851.50
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: left heart cath (lhc) only 93452 $3,047.78 $3,047.78 $749.47 – $3,047.78
Left heart catheterization (diagnostic): 10 of 26 insurance plan rates
  • Aetna — HTC: $1,399.01
  • Aetna — Managed Care: $1,219.13
  • Aetna — Medicare Advantage: $999.29
  • Aetna — PPO/Signature Administrators: $1,219.13
  • Aetna Better Health — Managed Medicaid: $1,292.30
  • Aetna Whole Health — Commercial: $1,149.18
  • AmeriHealth — Managed Care/PPO: $1,149.18
  • AmeriHealth — Medicare Advantage: $999.29
  • Cigna — Out of Network Plans: $3,047.78
  • Clover Health — Medicare Advantage: $999.29
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Doctor (professional) fee In the file: Left Heart Cath (LHC) Only 93452 (Interpretation) $791.70 $791.70 $514.61 – $1,548.38
Left heart catheterization (diagnostic): 10 of 26 insurance plan rates
  • Aetna — HTC: $1,399.01
  • Aetna — Managed Care: $1,219.13
  • Aetna — Medicare Advantage: $999.29
  • Aetna — PPO/Signature Administrators: $1,219.13
  • Aetna Better Health — Managed Medicaid: $1,292.30
  • Aetna Whole Health — Commercial: $1,149.18
  • AmeriHealth — Managed Care/PPO: $1,149.18
  • AmeriHealth — Medicare Advantage: $999.29
  • Cigna — Out of Network Plans: $791.70
  • Clover Health — Medicare Advantage: $999.29
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMP EPS WITH OUT INDUCTION OF ARRYTHMIA $17,811 $17,811 $1,051 – $26,384.60
Heart rhythm study (electrophysiology evaluation): 10 of 33 insurance plan rates
  • Aetna — HTC: $12,972.69
  • Aetna — Managed Care: $9,832
  • Aetna — Medicare Advantage: $9,266.21
  • Aetna — PPO/Signature Administrators: $9,832
  • Aetna Better Health — Managed Medicaid: $3,663.72
  • Aetna Whole Health — Commercial: $18,903.06
  • AmeriHealth — Managed Care/PPO: $17,365
  • AmeriHealth — Medicare Advantage: $9,266.21
  • Cigna — Out of Network Plans: $17,811
  • Clover Health — Medicare Advantage: $9,266.21
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Doctor (professional) fee In the file: Comp EP eval w/o ind of arrhythmia 93619 $1,305.63 $1,305.63 $307.13 – $1,409.97
Heart rhythm study (electrophysiology evaluation): 10 of 26 insurance plan rates
  • Aetna — HTC: $573.30
  • Aetna — Managed Care: $499.59
  • Aetna — Medicare Advantage: $409.50
  • Aetna — PPO/Signature Administrators: $499.59
  • Aetna Better Health — Managed Medicaid: $1,106.91
  • Aetna Whole Health — Commercial: $470.93
  • AmeriHealth — Managed Care/PPO: $470.93
  • AmeriHealth — Medicare Advantage: $409.50
  • Cigna — Out of Network Plans: $1,305.63
  • Clover Health — Medicare Advantage: $409.50
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMP EPS WITH OUT INDUCTION OF ARRYTHMIA $17,811 $17,811 $11,577.15 – $17,811
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $17,811
  • Consumer Health Network — Commercial: $16,029.90
  • Multiplan — All Products: $13,358.25
  • Private Healthcare Systems — All Products: $11,577.15
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP + Afib Ablation $62,118 $62,118 $5,247 – $88,418.80
Heart rhythm study with ablation for atrial fibrillation: 10 of 33 insurance plan rates
  • Aetna — HTC: $43,473.45
  • Aetna — Managed Care: $9,832
  • Aetna — Medicare Advantage: $31,052.47
  • Aetna — PPO/Signature Administrators: $9,832
  • Aetna Better Health — Managed Medicaid: $12,777.67
  • Aetna Whole Health — Commercial: $63,347.03
  • AmeriHealth — Managed Care/PPO: $17,365
  • AmeriHealth — Medicare Advantage: $31,052.47
  • Cigna — Out of Network Plans: $62,118
  • Clover Health — Medicare Advantage: $31,052.47
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Doctor (professional) fee In the file: comp ep/ afib ablat/pul vein iso 93656 $3,749.52 $3,749.52 $652.47 – $3,749.52
Heart rhythm study with ablation for atrial fibrillation: 10 of 25 insurance plan rates
  • Aetna — HTC: $1,217.94
  • Aetna — Managed Care: $1,061.35
  • Aetna — Medicare Advantage: $869.96
  • Aetna — PPO/Signature Administrators: $1,061.35
  • Aetna Better Health — Managed Medicaid: $1,625.68
  • Aetna Whole Health — Commercial: $1,000.45
  • AmeriHealth — Managed Care/PPO: $1,000.45
  • AmeriHealth — Medicare Advantage: $869.96
  • Cigna — Out of Network Plans: $3,749.52
  • Clover Health — Medicare Advantage: $869.96
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP + Afib Ablation $62,118 $62,118 $40,376.70 – $62,118
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $62,118
  • Consumer Health Network — Commercial: $55,906.20
  • Multiplan — All Products: $46,588.50
  • Private Healthcare Systems — All Products: $40,376.70
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Attended Sleep Study(Psg)=>4 P $8,569 $8,569 $1,020.21 – $8,569
Sleep study (overnight, in a sleep lab): 10 of 33 insurance plan rates
  • Aetna — HTC: $1,428.29
  • Aetna — Managed Care: $4,041
  • Aetna — Medicare Advantage: $1,020.21
  • Aetna — PPO/Signature Administrators: $4,776
  • Aetna Better Health — Managed Medicaid: $1,762.64
  • Aetna Whole Health — Commercial: $2,081.22
  • AmeriHealth — Managed Care/PPO: $5,455.88
  • AmeriHealth — Medicare Advantage: $1,020.21
  • Cigna — Out of Network Plans: $8,569
  • Clover Health — Medicare Advantage: $1,020.21
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Attended Sleep Study(Psg)=>4 P $8,569 $8,569 $5,569.85 – $8,569
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $8,569
  • Consumer Health Network — Commercial: $7,712.10
  • Multiplan — All Products: $6,426.75
  • Private Healthcare Systems — All Products: $5,569.85
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: POLYSOM 6/> YRS 4/> PARAM Not listed in the file Not listed in the file $579.59 – $1,283.94
Sleep study (overnight, in a sleep lab): 10 of 22 insurance plan rates
  • Aetna — HTC: $1,081.89
  • Aetna — Managed Care: $942.79
  • Aetna — Medicare Advantage: $772.78
  • Aetna — PPO/Signature Administrators: $942.79
  • Aetna Better Health — Managed Medicaid: $1,221.46
  • Aetna Whole Health — Commercial: $888.70
  • AmeriHealth — Managed Care/PPO: $888.70
  • AmeriHealth — Medicare Advantage: $772.78
  • Clover Health — Medicare Advantage: $772.78
  • Fidelis Care of New Jersey — Managed Medicaid: $579.59

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic Exercise X 15 Minutes $373 $373 $30.83 – $373
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $45.11
  • Aetna — Managed Care: $30.83
  • Aetna — Medicare Advantage: $32.22
  • Aetna — PPO/Signature Administrators: $30.83
  • Aetna Better Health — Managed Medicaid: $76.73
  • Aetna Whole Health — Commercial: $65.73
  • AmeriHealth — Managed Care/PPO: $237.49
  • AmeriHealth — Medicare Advantage: $32.22
  • Cigna — Out of Network Plans: $373
  • Clover Health — Medicare Advantage: $32.22
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 97110 Ot Rom/Strength Ea 15 Mn $373 $373 $30.83 – $373
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $45.11
  • Aetna — Managed Care: $30.83
  • Aetna — Medicare Advantage: $32.22
  • Aetna — PPO/Signature Administrators: $30.83
  • Aetna Better Health — Managed Medicaid: $76.73
  • Aetna Whole Health — Commercial: $65.73
  • AmeriHealth — Managed Care/PPO: $237.49
  • AmeriHealth — Medicare Advantage: $32.22
  • Cigna — Out of Network Plans: $373
  • Clover Health — Medicare Advantage: $32.22
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 97110 Ot Ther Exer Ea 15 Min $373 $373 $30.83 – $373
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates
  • Aetna — HTC: $45.11
  • Aetna — Managed Care: $30.83
  • Aetna — Medicare Advantage: $32.22
  • Aetna — PPO/Signature Administrators: $30.83
  • Aetna Better Health — Managed Medicaid: $76.73
  • Aetna Whole Health — Commercial: $65.73
  • AmeriHealth — Managed Care/PPO: $237.49
  • AmeriHealth — Medicare Advantage: $32.22
  • Cigna — Out of Network Plans: $373
  • Clover Health — Medicare Advantage: $32.22
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Eval - low $585 $585 $65 – $585
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates
  • Aetna — HTC: $151.90
  • Aetna — Managed Care: $87.58
  • Aetna — Medicare Advantage: $108.50
  • Aetna — PPO/Signature Administrators: $87.58
  • Aetna Better Health — Managed Medicaid: $120.33
  • Aetna Whole Health — Commercial: $221.35
  • AmeriHealth — Managed Care/PPO: $372.47
  • AmeriHealth — Medicare Advantage: $108.50
  • Cigna — Out of Network Plans: $585
  • Clover Health — Medicare Advantage: $108.50
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT Eval low 97161 $342.72 $342.72 $80.65 – $342.72
Physical therapy evaluation (low complexity): 10 of 25 insurance plan rates
  • Aetna — HTC: $151.90
  • Aetna — Managed Care: $132.37
  • Aetna — Medicare Advantage: $108.50
  • Aetna — PPO/Signature Administrators: $132.37
  • Aetna Better Health — Managed Medicaid: $80.65
  • Aetna Whole Health — Commercial: $124.78
  • AmeriHealth — Managed Care/PPO: $124.78
  • AmeriHealth — Medicare Advantage: $108.50
  • Cigna — Out of Network Plans: $342.72
  • Clover Health — Medicare Advantage: $108.50
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Eval - low $585 $585 $380.25 – $585
Physical therapy evaluation (low complexity): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $585
  • Consumer Health Network — Commercial: $526.50
  • Multiplan — All Products: $438.75
  • Private Healthcare Systems — All Products: $380.25
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Eval - moderate $697 $697 $65 – $697
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates
  • Aetna — HTC: $151.90
  • Aetna — Managed Care: $87.58
  • Aetna — Medicare Advantage: $108.50
  • Aetna — PPO/Signature Administrators: $87.58
  • Aetna Better Health — Managed Medicaid: $143.37
  • Aetna Whole Health — Commercial: $221.35
  • AmeriHealth — Managed Care/PPO: $443.78
  • AmeriHealth — Medicare Advantage: $108.50
  • Cigna — Out of Network Plans: $697
  • Clover Health — Medicare Advantage: $108.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT Eval moderate 97162 $342.72 $342.72 $80.65 – $342.72
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates
  • Aetna — HTC: $151.90
  • Aetna — Managed Care: $132.37
  • Aetna — Medicare Advantage: $108.50
  • Aetna — PPO/Signature Administrators: $132.37
  • Aetna Better Health — Managed Medicaid: $80.65
  • Aetna Whole Health — Commercial: $124.78
  • AmeriHealth — Managed Care/PPO: $124.78
  • AmeriHealth — Medicare Advantage: $108.50
  • Cigna — Out of Network Plans: $342.72
  • Clover Health — Medicare Advantage: $108.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Eval - moderate $697 $697 $453.05 – $697
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $697
  • Consumer Health Network — Commercial: $627.30
  • Multiplan — All Products: $522.75
  • Private Healthcare Systems — All Products: $453.05
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT Eval - high $669 $669 $65 – $669
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates
  • Aetna — HTC: $151.90
  • Aetna — Managed Care: $87.58
  • Aetna — Medicare Advantage: $108.50
  • Aetna — PPO/Signature Administrators: $87.58
  • Aetna Better Health — Managed Medicaid: $137.61
  • Aetna Whole Health — Commercial: $221.35
  • AmeriHealth — Managed Care/PPO: $425.95
  • AmeriHealth — Medicare Advantage: $108.50
  • Cigna — Out of Network Plans: $669
  • Clover Health — Medicare Advantage: $108.50
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT Eval - high $669 $669 $434.85 – $669
Physical therapy evaluation (high complexity): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $669
  • Consumer Health Network — Commercial: $602.10
  • Multiplan — All Products: $501.75
  • Private Healthcare Systems — All Products: $434.85
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL HIGH COMPLEX 45 MIN Not listed in the file Not listed in the file $80.65 – $162.75
Physical therapy evaluation (high complexity): 10 of 21 insurance plan rates
  • Aetna — HTC: $151.90
  • Aetna — Managed Care: $132.37
  • Aetna — Medicare Advantage: $108.50
  • Aetna — PPO/Signature Administrators: $132.37
  • Aetna Better Health — Managed Medicaid: $80.65
  • Aetna Whole Health — Commercial: $124.78
  • AmeriHealth — Managed Care/PPO: $124.78
  • AmeriHealth — Medicare Advantage: $108.50
  • Clover Health — Medicare Advantage: $108.50
  • Fidelis Care of New Jersey — Managed Medicaid: $81.38
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy 30 Min $485 $485 $59.90 – $600.43
Psychotherapy, 30 minutes: 10 of 34 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $242.50
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $242.50
  • Aetna Better Health — Managed Medicaid: $99.76
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $308.80
  • AmeriHealth — Medicare Advantage: $210.87
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $114
  • Cigna — Out of Network Plans: $485
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90832 Psychotherapy 30 Min With Patient And/Or Family Member $485 $485 $59.90 – $600.43
Psychotherapy, 30 minutes: 10 of 34 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $242.50
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $242.50
  • Aetna Better Health — Managed Medicaid: $99.76
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $308.80
  • AmeriHealth — Medicare Advantage: $210.87
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $114
  • Cigna — Out of Network Plans: $485
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy, 30 minutes w/ patient 90832 $218.55 $218.55 $55.70 – $218.55
Psychotherapy, 30 minutes: 10 of 26 insurance plan rates
  • Aetna — HTC: $103.98
  • Aetna — Managed Care: $90.61
  • Aetna — Medicare Advantage: $74.27
  • Aetna — PPO/Signature Administrators: $90.61
  • Aetna Better Health — Managed Medicaid: $106.40
  • Aetna Whole Health — Commercial: $85.41
  • AmeriHealth — Managed Care/PPO: $85.41
  • AmeriHealth — Medicare Advantage: $74.27
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $81.38
  • Cigna — Out of Network Plans: $218.55
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Op Individual Therapy 45-50Min $540 $540 $66.69 – $600.43
Psychotherapy, 45 minutes: 10 of 33 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $270
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $270
  • Aetna Better Health — Managed Medicaid: $111.08
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $343.82
  • AmeriHealth — Medicare Advantage: $210.87
  • Cigna — Out of Network Plans: $540
  • Clover Health — Medicare Advantage: $210.87
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90834 Psychotherapy 45 Min With Patient And/Or Family Member $540 $540 $66.69 – $600.43
Psychotherapy, 45 minutes: 10 of 33 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $270
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $270
  • Aetna Better Health — Managed Medicaid: $111.08
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $343.82
  • AmeriHealth — Medicare Advantage: $210.87
  • Cigna — Out of Network Plans: $540
  • Clover Health — Medicare Advantage: $210.87
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy, 45 minutes w/ patient 90834 $290.89 $290.89 $73.64 – $290.89
Psychotherapy, 45 minutes: 10 of 26 insurance plan rates
  • Aetna — HTC: $137.47
  • Aetna — Managed Care: $119.79
  • Aetna — Medicare Advantage: $98.19
  • Aetna — PPO/Signature Administrators: $119.79
  • Aetna Better Health — Managed Medicaid: $141.18
  • Aetna Whole Health — Commercial: $112.92
  • AmeriHealth — Managed Care/PPO: $112.92
  • AmeriHealth — Medicare Advantage: $98.19
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $134.96
  • Cigna — Out of Network Plans: $290.89
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90837 Psychotherapy,60 Min W/ Pt/Fam $592 $592 $73.11 – $600.43
Psychotherapy, 60 minutes: 10 of 34 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $296
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $296
  • Aetna Better Health — Managed Medicaid: $121.77
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $376.93
  • AmeriHealth — Medicare Advantage: $210.87
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $226
  • Cigna — Out of Network Plans: $592
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: Psychotherapy, 60 minutes with patient 90837 $436.83 $436.83 $108.46 – $436.83
Psychotherapy, 60 minutes: 10 of 26 insurance plan rates
  • Aetna — HTC: $202.45
  • Aetna — Managed Care: $176.42
  • Aetna — Medicare Advantage: $144.61
  • Aetna — PPO/Signature Administrators: $176.42
  • Aetna Better Health — Managed Medicaid: $207.37
  • Aetna Whole Health — Commercial: $166.30
  • AmeriHealth — Managed Care/PPO: $166.30
  • AmeriHealth — Medicare Advantage: $144.61
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $159.66
  • Cigna — Out of Network Plans: $436.83
Psychotherapy, 60 minutes CPT 90837 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 90837 Psychotherapy,60 Min W/ Pt/Fam $592 $592 $384.80 – $592
Psychotherapy, 60 minutes: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $592
  • Consumer Health Network — Commercial: $532.80
  • Multiplan — All Products: $444
  • Private Healthcare Systems — All Products: $384.80
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90846 Fam Therapy Without Patient $731 $731 $129.90 – $731
Family psychotherapy, without the patient: 10 of 33 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $365.50
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $365.50
  • Aetna Better Health — Managed Medicaid: $150.37
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $465.43
  • AmeriHealth — Medicare Advantage: $210.87
  • Cigna — Out of Network Plans: $731
  • Clover Health — Medicare Advantage: $210.87
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90846 Fam Therapy W/O Patient $731 $731 $129.90 – $731
Family psychotherapy, without the patient: 10 of 33 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $365.50
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $365.50
  • Aetna Better Health — Managed Medicaid: $150.37
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $465.43
  • AmeriHealth — Medicare Advantage: $210.87
  • Cigna — Out of Network Plans: $731
  • Clover Health — Medicare Advantage: $210.87
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Doctor (professional) fee In the file: Family psychotherapy w/o patient, 50 mins 90846 $351.97 $351.97 $79.58 – $351.97
Family psychotherapy, without the patient: 10 of 27 insurance plan rates
  • Aetna — HTC: $148.54
  • Aetna — Managed Care: $129.44
  • Aetna — Medicare Advantage: $106.10
  • Aetna — PPO/Signature Administrators: $129.44
  • Aetna Better Health — Managed Medicaid: $152.66
  • Aetna Whole Health — Commercial: $122.02
  • AmeriHealth — Managed Care/PPO: $122.02
  • AmeriHealth — Medicare Advantage: $106.10
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $167.70
  • Cigna — Out of Network Plans: $351.97
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90847 Family Therapy With Patient $731 $731 $129.90 – $731
Family psychotherapy, with the patient: 10 of 34 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $365.50
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $365.50
  • Aetna Better Health — Managed Medicaid: $150.37
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $465.43
  • AmeriHealth — Medicare Advantage: $210.87
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $246
  • Cigna — Out of Network Plans: $731
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90847 Family Therapy With Pt $731 $731 $129.90 – $731
Family psychotherapy, with the patient: 10 of 34 insurance plan rates
  • Aetna — HTC: $295.22
  • Aetna — Managed Care: $365.50
  • Aetna — Medicare Advantage: $210.87
  • Aetna — PPO/Signature Administrators: $365.50
  • Aetna Better Health — Managed Medicaid: $150.37
  • Aetna Whole Health — Commercial: $430.17
  • AmeriHealth — Managed Care/PPO: $465.43
  • AmeriHealth — Medicare Advantage: $210.87
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $246
  • Cigna — Out of Network Plans: $731
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Doctor (professional) fee In the file: Family psychotherapy w/patient, 50 mins 90847 $365.77 $365.77 $82.51 – $365.77
Family psychotherapy, with the patient: 10 of 27 insurance plan rates
  • Aetna — HTC: $154.01
  • Aetna — Managed Care: $134.21
  • Aetna — Medicare Advantage: $110.01
  • Aetna — PPO/Signature Administrators: $134.21
  • Aetna Better Health — Managed Medicaid: $159.22
  • Aetna Whole Health — Commercial: $126.51
  • AmeriHealth — Managed Care/PPO: $126.51
  • AmeriHealth — Medicare Advantage: $110.01
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $173.58
  • Cigna — Out of Network Plans: $365.77
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90853 Group Psychotherapy $436 $436 $53.85 – $436
Group psychotherapy: 10 of 34 insurance plan rates
  • Aetna — HTC: $168.97
  • Aetna — Managed Care: $218
  • Aetna — Medicare Advantage: $120.69
  • Aetna — PPO/Signature Administrators: $218
  • Aetna Better Health — Managed Medicaid: $89.69
  • Aetna Whole Health — Commercial: $246.21
  • AmeriHealth — Managed Care/PPO: $277.60
  • AmeriHealth — Medicare Advantage: $120.69
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $63
  • Cigna — Out of Network Plans: $436
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 90853 Group Therapy $436 $436 $53.85 – $436
Group psychotherapy: 10 of 34 insurance plan rates
  • Aetna — HTC: $168.97
  • Aetna — Managed Care: $218
  • Aetna — Medicare Advantage: $120.69
  • Aetna — PPO/Signature Administrators: $218
  • Aetna Better Health — Managed Medicaid: $89.69
  • Aetna Whole Health — Commercial: $246.21
  • AmeriHealth — Managed Care/PPO: $277.60
  • AmeriHealth — Medicare Advantage: $120.69
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $63
  • Cigna — Out of Network Plans: $436
Group psychotherapy CPT 90853 · Inpatient or outpatient · Doctor (professional) fee In the file: Non-family group psychotherapy 90853 $87.57 $87.57 $19.56 – $87.57
Group psychotherapy: 10 of 27 insurance plan rates
  • Aetna — HTC: $36.51
  • Aetna — Managed Care: $31.82
  • Aetna — Medicare Advantage: $26.08
  • Aetna — PPO/Signature Administrators: $31.82
  • Aetna Better Health — Managed Medicaid: $37.45
  • Aetna Whole Health — Commercial: $29.99
  • AmeriHealth — Managed Care/PPO: $29.99
  • AmeriHealth — Medicare Advantage: $26.08
  • AmeriHealth Behavioral Health — Managed Care/PPO/Medicare Advantage: $44.58
  • Cigna — Out of Network Plans: $87.57

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 19120 Exc Cyst/Fib/Tum Breast $8,960 $8,960 $1,592.19 – $13,245.08
Removal of breast growth (open surgery): 10 of 33 insurance plan rates
  • Aetna — HTC: $6,512.29
  • Aetna — Managed Care: $4,480
  • Aetna — Medicare Advantage: $4,651.64
  • Aetna — PPO/Signature Administrators: $4,480
  • Aetna Better Health — Managed Medicaid: $1,843.07
  • Aetna Whole Health — Commercial: $9,489.34
  • AmeriHealth — Managed Care/PPO: $5,704.83
  • AmeriHealth — Medicare Advantage: $4,651.64
  • Cigna — Out of Network Plans: $8,960
  • Clover Health — Medicare Advantage: $4,651.64
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Doctor (professional) fee In the file: 19120 Exc Cyst/Fib/Tum Breast 19120 $1,779.99 $1,779.99 $337.45 – $1,779.99
Removal of breast growth (open surgery): 10 of 26 insurance plan rates
  • Aetna — HTC: $629.90
  • Aetna — Managed Care: $548.91
  • Aetna — Medicare Advantage: $449.93
  • Aetna — PPO/Signature Administrators: $548.91
  • Aetna Better Health — Managed Medicaid: $420.41
  • Aetna Whole Health — Commercial: $517.42
  • AmeriHealth — Managed Care/PPO: $517.42
  • AmeriHealth — Medicare Advantage: $449.93
  • Cigna — Out of Network Plans: $1,779.99
  • Clover Health — Medicare Advantage: $449.93
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 19120 Exc Cyst/Fib/Tum Breast $8,960 $8,960 $5,824 – $8,960
Removal of breast growth (open surgery): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $8,960
  • Consumer Health Network — Commercial: $8,064
  • Multiplan — All Products: $6,720
  • Private Healthcare Systems — All Products: $5,824
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: Arthroplas/acetab/prox fem replac 27130 $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,769.73
Total hip replacement: 10 of 26 insurance plan rates
  • Aetna — HTC: $1,783.01
  • Aetna — Managed Care: $1,553.77
  • Aetna — Medicare Advantage: $1,273.58
  • Aetna — PPO/Signature Administrators: $1,553.77
  • Aetna Better Health — Managed Medicaid: $2,088.55
  • Aetna Whole Health — Commercial: $1,464.62
  • AmeriHealth — Managed Care/PPO: $1,464.62
  • AmeriHealth — Medicare Advantage: $1,273.58
  • Cigna — Out of Network Plans: $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Clover Health — Medicare Advantage: $1,273.58
Total hip replacement CPT 27130 · Inpatient or outpatient · Doctor (professional) fee In the file: Total Hip Arthroplasty 27130 $4,574.91 $4,574.91 $955.19 – $4,574.91
Total hip replacement: 10 of 26 insurance plan rates
  • Aetna — HTC: $1,783.01
  • Aetna — Managed Care: $1,553.77
  • Aetna — Medicare Advantage: $1,273.58
  • Aetna — PPO/Signature Administrators: $1,553.77
  • Aetna Better Health — Managed Medicaid: $2,088.55
  • Aetna Whole Health — Commercial: $1,464.62
  • AmeriHealth — Managed Care/PPO: $1,464.62
  • AmeriHealth — Medicare Advantage: $1,273.58
  • Cigna — Out of Network Plans: $4,574.91
  • Clover Health — Medicare Advantage: $1,273.58
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $15,050 – $43,430.52
Total hip replacement: 10 of 20 insurance plan rates
  • Aetna — HTC: $21,353.77
  • Aetna — Medicare Advantage: $15,252.69
  • Aetna Whole Health — Commercial: $31,115.49
  • AmeriHealth — Managed Care/PPO: $15,050
  • AmeriHealth — Medicare Advantage: $15,252.69
  • Clover Health — Medicare Advantage: $15,252.69
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $16,015.33
  • Horizon Blue Cross Blue Shield — Indemnity: $43,430.52
  • Horizon Blue Cross Blue Shield — Managed Care: $43,430.52
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $15,252.69
Total knee replacement CPT 27447 · Inpatient or outpatient · Doctor (professional) fee In the file: Total Knee Arthroplasty 27447 $4,570.08 $4,570.08 $952.93 – $4,570.08
Total knee replacement: 10 of 26 insurance plan rates
  • Aetna — HTC: $1,778.80
  • Aetna — Managed Care: $1,550.10
  • Aetna — Medicare Advantage: $1,270.57
  • Aetna — PPO/Signature Administrators: $1,550.10
  • Aetna Better Health — Managed Medicaid: $2,237.70
  • Aetna Whole Health — Commercial: $1,461.16
  • AmeriHealth — Managed Care/PPO: $1,461.16
  • AmeriHealth — Medicare Advantage: $1,270.57
  • Cigna — Out of Network Plans: $4,570.08
  • Clover Health — Medicare Advantage: $1,270.57
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $15,050 – $43,430.52
Total knee replacement: 10 of 20 insurance plan rates
  • Aetna — HTC: $21,353.77
  • Aetna — Medicare Advantage: $15,252.69
  • Aetna Whole Health — Commercial: $31,115.49
  • AmeriHealth — Managed Care/PPO: $15,050
  • AmeriHealth — Medicare Advantage: $15,252.69
  • Clover Health — Medicare Advantage: $15,252.69
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $16,015.33
  • Horizon Blue Cross Blue Shield — Indemnity: $43,430.52
  • Horizon Blue Cross Blue Shield — Managed Care: $43,430.52
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $15,252.69
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · Doctor (professional) fee In the file: Shoulder Arthroscopy/Surgery 29826 $588.48 $588.48 $119.99 – $1,564.89
Shoulder arthroscopy: shaving of shoulder bone: 10 of 26 insurance plan rates
  • Aetna — HTC: $223.97
  • Aetna — Managed Care: $195.18
  • Aetna — Medicare Advantage: $159.98
  • Aetna — PPO/Signature Administrators: $195.18
  • Aetna Better Health — Managed Medicaid: $964.25
  • Aetna Whole Health — Commercial: $183.98
  • AmeriHealth — Managed Care/PPO: $183.98
  • AmeriHealth — Medicare Advantage: $159.98
  • Cigna — Out of Network Plans: $588.48
  • Clover Health — Medicare Advantage: $159.98
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION Not listed in the file Not listed in the file $159.98 – $455.52
Shoulder arthroscopy: shaving of shoulder bone: 10 of 20 insurance plan rates
  • Aetna — HTC: $223.97
  • Aetna — Medicare Advantage: $159.98
  • Aetna Whole Health — Commercial: $326.36
  • AmeriHealth — Medicare Advantage: $159.98
  • Clover Health — Medicare Advantage: $159.98
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $167.98
  • Horizon Blue Cross Blue Shield — Indemnity: $455.52
  • Horizon Blue Cross Blue Shield — Managed Care: $455.52
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $159.98
  • Horizon Blue Cross Blue Shield — Omnia: $339.59
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · Doctor (professional) fee In the file: Knee Arthroscopy/Surgery 29881 $1,846.71 $1,846.71 $428.80 – $1,846.71
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 26 insurance plan rates
  • Aetna — HTC: $800.42
  • Aetna — Managed Care: $697.51
  • Aetna — Medicare Advantage: $571.73
  • Aetna — PPO/Signature Administrators: $697.51
  • Aetna Better Health — Managed Medicaid: $915.49
  • Aetna Whole Health — Commercial: $657.49
  • AmeriHealth — Managed Care/PPO: $657.49
  • AmeriHealth — Medicare Advantage: $571.73
  • Cigna — Out of Network Plans: $1,846.71
  • Clover Health — Medicare Advantage: $571.73
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L Not listed in the file Not listed in the file $3,887.22 – $11,068.48
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates
  • Aetna — HTC: $5,442.11
  • Aetna — Medicare Advantage: $3,887.22
  • Aetna Whole Health — Commercial: $7,929.93
  • AmeriHealth — Medicare Advantage: $3,887.22
  • Clover Health — Medicare Advantage: $3,887.22
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $4,081.58
  • Horizon Blue Cross Blue Shield — Indemnity: $11,068.48
  • Horizon Blue Cross Blue Shield — Managed Care: $11,068.48
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $3,887.22
  • Horizon Blue Cross Blue Shield — Omnia: $8,251.41
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient or outpatient · Doctor (professional) fee In the file: Remove Tonsils And Adenoids 42820 $972.33 $972.33 $215.60 – $972.33
Removal of tonsils and adenoids (under age 12): 10 of 26 insurance plan rates
  • Aetna — HTC: $402.46
  • Aetna — Managed Care: $350.71
  • Aetna — Medicare Advantage: $287.47
  • Aetna — PPO/Signature Administrators: $350.71
  • Aetna Better Health — Managed Medicaid: $375.47
  • Aetna Whole Health — Commercial: $330.59
  • AmeriHealth — Managed Care/PPO: $330.59
  • AmeriHealth — Medicare Advantage: $287.47
  • Cigna — Out of Network Plans: $972.33
  • Clover Health — Medicare Advantage: $287.47
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file Not listed in the file $7,032.91 – $20,025.52
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates
  • Aetna — HTC: $9,846.08
  • Aetna — Medicare Advantage: $7,032.91
  • Aetna Whole Health — Commercial: $14,347.15
  • AmeriHealth — Medicare Advantage: $7,032.91
  • Clover Health — Medicare Advantage: $7,032.91
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $7,384.56
  • Horizon Blue Cross Blue Shield — Indemnity: $20,025.52
  • Horizon Blue Cross Blue Shield — Managed Care: $20,025.52
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $7,032.91
  • Horizon Blue Cross Blue Shield — Omnia: $14,928.77
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 43235 Egd W/Wo Spec Brush/Wash $3,615 $3,615 $642.39 – $6,397
Upper GI endoscopy (diagnostic): 10 of 33 insurance plan rates
  • Aetna — HTC: $1,508.53
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,077.52
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $743.61
  • Aetna Whole Health — Commercial: $2,198.15
  • AmeriHealth — Managed Care/PPO: $2,301.67
  • AmeriHealth — Medicare Advantage: $1,077.52
  • Cigna — Out of Network Plans: $3,615
  • Clover Health — Medicare Advantage: $1,077.52
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Doctor (professional) fee In the file: EGD/flex/transoral/diag 43235 $892.62 $892.62 $90.68 – $892.62
Upper GI endoscopy (diagnostic): 10 of 26 insurance plan rates
  • Aetna — HTC: $169.26
  • Aetna — Managed Care: $147.50
  • Aetna — Medicare Advantage: $120.90
  • Aetna — PPO/Signature Administrators: $147.50
  • Aetna Better Health — Managed Medicaid: $192.61
  • Aetna Whole Health — Commercial: $139.04
  • AmeriHealth — Managed Care/PPO: $139.04
  • AmeriHealth — Medicare Advantage: $120.90
  • Cigna — Out of Network Plans: $892.62
  • Clover Health — Medicare Advantage: $120.90
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 43235 Egd W/Wo Spec Brush/Wash $3,615 $3,615 $2,349.75 – $3,615
Upper GI endoscopy (diagnostic): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $3,615
  • Consumer Health Network — Commercial: $3,253.50
  • Multiplan — All Products: $2,711.25
  • Private Healthcare Systems — All Products: $2,349.75
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 43239 Egd W Bx 1 Or More $3,615 $3,615 $642.39 – $6,397
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates
  • Aetna — HTC: $1,508.53
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,077.52
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $743.61
  • Aetna Whole Health — Commercial: $2,198.15
  • AmeriHealth — Managed Care/PPO: $2,301.67
  • AmeriHealth — Medicare Advantage: $1,077.52
  • Cigna — Out of Network Plans: $3,615
  • Clover Health — Medicare Advantage: $1,077.52
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Doctor (professional) fee In the file: Pro Fee: 43239 Upper Gi Endoscopy, Biopsy $1,202.37 $1,202.37 $101.24 – $1,202.37
Upper GI endoscopy with biopsy: 10 of 26 insurance plan rates
  • Aetna — HTC: $188.97
  • Aetna — Managed Care: $164.68
  • Aetna — Medicare Advantage: $134.98
  • Aetna — PPO/Signature Administrators: $164.68
  • Aetna Better Health — Managed Medicaid: $227.56
  • Aetna Whole Health — Commercial: $155.23
  • AmeriHealth — Managed Care/PPO: $155.23
  • AmeriHealth — Medicare Advantage: $134.98
  • Cigna — Out of Network Plans: $1,202.37
  • Clover Health — Medicare Advantage: $134.98
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 43239 Egd W Bx 1 Or More $3,615 $3,615 $2,349.75 – $3,615
Upper GI endoscopy with biopsy: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $3,615
  • Consumer Health Network — Commercial: $3,253.50
  • Multiplan — All Products: $2,711.25
  • Private Healthcare Systems — All Products: $2,349.75
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45378 Colo Flx W/Wo Spec Br\Ws $4,281 $4,281 $760.73 – $6,397
Colonoscopy (diagnostic): 10 of 33 insurance plan rates
  • Aetna — HTC: $1,546.74
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,104.81
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $880.60
  • Aetna Whole Health — Commercial: $2,253.82
  • AmeriHealth — Managed Care/PPO: $2,725.71
  • AmeriHealth — Medicare Advantage: $1,104.81
  • Cigna — Out of Network Plans: $4,281
  • Clover Health — Medicare Advantage: $1,104.81
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Doctor (professional) fee In the file: colonoscopy, fiberoptic, beyond splenic flexure; d $1,088.28 $1,088.28 $134.59 – $1,088.28
Colonoscopy (diagnostic): 10 of 26 insurance plan rates
  • Aetna — HTC: $251.23
  • Aetna — Managed Care: $218.93
  • Aetna — Medicare Advantage: $179.45
  • Aetna — PPO/Signature Administrators: $218.93
  • Aetna Better Health — Managed Medicaid: $285.31
  • Aetna Whole Health — Commercial: $206.37
  • AmeriHealth — Managed Care/PPO: $206.37
  • AmeriHealth — Medicare Advantage: $179.45
  • Cigna — Out of Network Plans: $1,088.28
  • Clover Health — Medicare Advantage: $179.45
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45378 Colo Flx W/Wo Spec Br\Ws $4,281 $4,281 $2,782.65 – $4,281
Colonoscopy (diagnostic): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $4,281
  • Consumer Health Network — Commercial: $3,852.90
  • Multiplan — All Products: $3,210.75
  • Private Healthcare Systems — All Products: $2,782.65
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45380 Colon W Bx(S)1 Or > $4,547 $4,547 $808 – $6,397
Colonoscopy with biopsy: 10 of 33 insurance plan rates
  • Aetna — HTC: $1,990.30
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,421.64
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $935.32
  • Aetna Whole Health — Commercial: $2,900.15
  • AmeriHealth — Managed Care/PPO: $2,895.07
  • AmeriHealth — Medicare Advantage: $1,421.64
  • Cigna — Out of Network Plans: $4,547
  • Clover Health — Medicare Advantage: $1,421.64
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Doctor (professional) fee In the file: COLONOSCOPY, FIBEROPTIC, BEYOND SPLENIC FLEXURE; W $1,405.92 $1,405.92 $145.19 – $1,405.92
Colonoscopy with biopsy: 10 of 26 insurance plan rates
  • Aetna — HTC: $271.03
  • Aetna — Managed Care: $236.18
  • Aetna — Medicare Advantage: $193.59
  • Aetna — PPO/Signature Administrators: $236.18
  • Aetna Better Health — Managed Medicaid: $343.83
  • Aetna Whole Health — Commercial: $222.63
  • AmeriHealth — Managed Care/PPO: $222.63
  • AmeriHealth — Medicare Advantage: $193.59
  • Cigna — Out of Network Plans: $1,405.92
  • Clover Health — Medicare Advantage: $193.59
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45380 Colon W Bx(S)1 Or > $4,547 $4,547 $2,955.55 – $4,547
Colonoscopy with biopsy: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $4,547
  • Consumer Health Network — Commercial: $4,092.30
  • Multiplan — All Products: $3,410.25
  • Private Healthcare Systems — All Products: $2,955.55
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45385 Colon Tumor(S) Rem Snare $4,547 $4,547 $808 – $6,397
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates
  • Aetna — HTC: $1,990.30
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,421.64
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $935.32
  • Aetna Whole Health — Commercial: $2,900.15
  • AmeriHealth — Managed Care/PPO: $2,895.07
  • AmeriHealth — Medicare Advantage: $1,421.64
  • Cigna — Out of Network Plans: $4,547
  • Clover Health — Medicare Advantage: $1,421.64
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: colonoscopy, fiberoptic, beyond splenic flexure; w $1,461.27 $1,461.27 $182.39 – $1,461.27
Colonoscopy with removal of polyps (snare): 10 of 26 insurance plan rates
  • Aetna — HTC: $340.47
  • Aetna — Managed Care: $296.69
  • Aetna — Medicare Advantage: $243.19
  • Aetna — PPO/Signature Administrators: $296.69
  • Aetna Better Health — Managed Medicaid: $407.81
  • Aetna Whole Health — Commercial: $279.67
  • AmeriHealth — Managed Care/PPO: $279.67
  • AmeriHealth — Medicare Advantage: $243.19
  • Cigna — Out of Network Plans: $1,461.27
  • Clover Health — Medicare Advantage: $243.19
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45385 Colon Tumor(S) Rem Snare $4,547 $4,547 $2,955.55 – $4,547
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $4,547
  • Consumer Health Network — Commercial: $4,092.30
  • Multiplan — All Products: $3,410.25
  • Private Healthcare Systems — All Products: $2,955.55
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: 45391 Eus Col $4,147 $4,147 $736.92 – $6,397
Ultrasound of the lower bowel by endoscope: 10 of 33 insurance plan rates
  • Aetna — HTC: $1,990.30
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,421.64
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $853.04
  • Aetna Whole Health — Commercial: $2,900.15
  • AmeriHealth — Managed Care/PPO: $2,640.39
  • AmeriHealth — Medicare Advantage: $1,421.64
  • Cigna — Out of Network Plans: $4,147
  • Clover Health — Medicare Advantage: $1,421.64
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · Doctor (professional) fee In the file: Colonoscopy; w/ limited EUS; 45391 $878.05 $878.05 $184.61 – $878.05
Ultrasound of the lower bowel by endoscope: 10 of 26 insurance plan rates
  • Aetna — HTC: $344.61
  • Aetna — Managed Care: $300.30
  • Aetna — Medicare Advantage: $246.15
  • Aetna — PPO/Signature Administrators: $300.30
  • Aetna Better Health — Managed Medicaid: $395.21
  • Aetna Whole Health — Commercial: $283.07
  • AmeriHealth — Managed Care/PPO: $283.07
  • AmeriHealth — Medicare Advantage: $246.15
  • Cigna — Out of Network Plans: $878.05
  • Clover Health — Medicare Advantage: $246.15
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Hospital (facility) fee In the file: 45391 Eus Col $4,147 $4,147 $2,695.55 – $4,147
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $4,147
  • Consumer Health Network — Commercial: $3,732.30
  • Multiplan — All Products: $3,110.25
  • Private Healthcare Systems — All Products: $2,695.55
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: G0121 Colon Cancer Scr Non Hr $3,516 $3,516 $624.79 – $6,397
Screening colonoscopy (not high risk): 10 of 33 insurance plan rates
  • Aetna — HTC: $1,546.74
  • Aetna — Managed Care: $5,694
  • Aetna — Medicare Advantage: $1,104.81
  • Aetna — PPO/Signature Administrators: $6,397
  • Aetna Better Health — Managed Medicaid: $723.24
  • Aetna Whole Health — Commercial: $2,253.82
  • AmeriHealth — Managed Care/PPO: $2,238.64
  • AmeriHealth — Medicare Advantage: $1,104.81
  • Cigna — Out of Network Plans: $3,516
  • Clover Health — Medicare Advantage: $1,104.81
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colorec Cncr Scr;Colnscpy No Hi Rsk G0121 $1,088.28 $1,088.28 $134.86 – $1,088.28
Screening colonoscopy (not high risk): 10 of 26 insurance plan rates
  • Aetna — HTC: $251.73
  • Aetna — Managed Care: $219.37
  • Aetna — Medicare Advantage: $179.81
  • Aetna — PPO/Signature Administrators: $219.37
  • Aetna Better Health — Managed Medicaid: $283.36
  • Aetna Whole Health — Commercial: $206.78
  • AmeriHealth — Managed Care/PPO: $206.78
  • AmeriHealth — Medicare Advantage: $179.81
  • Cigna — Out of Network Plans: $1,088.28
  • Clover Health — Medicare Advantage: $179.81
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: G0121 Colon Cancer Scr Non Hr $3,516 $3,516 $2,285.40 – $3,516
Screening colonoscopy (not high risk): rates for 4 insurance plans
  • Cigna — Out of Network Plans: $3,516
  • Consumer Health Network — Commercial: $3,164.40
  • Multiplan — All Products: $2,637
  • Private Healthcare Systems — All Products: $2,285.40
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · Doctor (professional) fee In the file: Laparoscopy, surgical cholecystectomy 47562 $2,242.84 $2,242.84 $450 – $2,242.84
Gallbladder removal by laparoscope: 10 of 26 insurance plan rates
  • Aetna — HTC: $968.48
  • Aetna — Managed Care: $843.96
  • Aetna — Medicare Advantage: $691.77
  • Aetna — PPO/Signature Administrators: $843.96
  • Aetna Better Health — Managed Medicaid: $450
  • Aetna Whole Health — Commercial: $795.54
  • AmeriHealth — Managed Care/PPO: $795.54
  • AmeriHealth — Medicare Advantage: $691.77
  • Cigna — Out of Network Plans: $2,242.84
  • Clover Health — Medicare Advantage: $691.77
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY Not listed in the file Not listed in the file $7,182.25 – $20,450.73
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates
  • Aetna — HTC: $10,055.14
  • Aetna — Medicare Advantage: $7,182.25
  • Aetna Whole Health — Commercial: $14,651.78
  • AmeriHealth — Medicare Advantage: $7,182.25
  • Clover Health — Medicare Advantage: $7,182.25
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $7,541.36
  • Horizon Blue Cross Blue Shield — Indemnity: $20,450.73
  • Horizon Blue Cross Blue Shield — Managed Care: $20,450.73
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $7,182.25
  • Horizon Blue Cross Blue Shield — Omnia: $15,245.75
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Doctor (professional) fee In the file: Prp I/Hern Init Reduc>5 Yr 49505 $1,747.83 $1,747.83 $325 – $1,747.83
Groin (inguinal) hernia repair, age 5 or older: 10 of 26 insurance plan rates
  • Aetna — HTC: $781.02
  • Aetna — Managed Care: $680.60
  • Aetna — Medicare Advantage: $557.87
  • Aetna — PPO/Signature Administrators: $680.60
  • Aetna Better Health — Managed Medicaid: $325
  • Aetna Whole Health — Commercial: $641.55
  • AmeriHealth — Managed Care/PPO: $641.55
  • AmeriHealth — Medicare Advantage: $557.87
  • Cigna — Out of Network Plans: $1,747.83
  • Clover Health — Medicare Advantage: $557.87
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR Not listed in the file Not listed in the file $4,253.61 – $12,111.73
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates
  • Aetna — HTC: $5,955.05
  • Aetna — Medicare Advantage: $4,253.61
  • Aetna Whole Health — Commercial: $8,677.37
  • AmeriHealth — Medicare Advantage: $4,253.61
  • Clover Health — Medicare Advantage: $4,253.61
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $4,466.29
  • Horizon Blue Cross Blue Shield — Indemnity: $12,111.73
  • Horizon Blue Cross Blue Shield — Managed Care: $12,111.73
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $4,253.61
  • Horizon Blue Cross Blue Shield — Omnia: $9,029.14
Prostate biopsy CPT 55700 · Inpatient or outpatient · Doctor (professional) fee In the file: Biopsy Of Prostate 55700 $865.32 $865.32 $173.06 – $865.32
Prostate biopsy: 10 of 12 insurance plan rates
  • Cigna — Out of Network Plans: $865.32
  • Consumer Health Network — Commercial: $227.50
  • Horizon Blue Cross Blue Shield — Indemnity: $408.01
  • Horizon Blue Cross Blue Shield — Managed Care: $416.18
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $266.78
  • Horizon Blue Cross Blue Shield — Omnia: $408.01
  • Horizon Blue Cross Blue Shield — PPO: $408.01
  • Horizon Blue Cross Blue Shield — SHBP: $408.01
  • Horizon New Jersey Health — Managed Medicaid: $735.52
  • Multiplan — All Products: $562.46
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OP Surgery Not listed in the file Not listed in the file $1,547 – $4,206
Prostate biopsy: rates for 2 insurance plans
  • Oxford — Commercial: $4,206
  • United Healthcare — Commercial: $3,425
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Same Day Surgery Not listed in the file Not listed in the file $1,547 – $4,206
Prostate biopsy: rates for 1 insurance plan
  • Horizon New Jersey Health — Managed Medicaid: $1,547
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient · Doctor (professional) fee In the file: Laparoscopy/surg/prostatect/robot 55866 $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) $0.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,090.58
Prostate removal by laparoscope (radical prostatectomy): 10 of 26 insurance plan rates
  • Aetna — HTC: $1,645.42
  • Aetna — Managed Care: $1,433.87
  • Aetna — Medicare Advantage: $1,175.30
  • Aetna — PPO/Signature Administrators: $1,433.87
  • Aetna Better Health — Managed Medicaid: $2,454.02
  • Aetna Whole Health — Commercial: $1,351.60
  • AmeriHealth — Managed Care/PPO: $1,351.60
  • AmeriHealth — Medicare Advantage: $1,175.30
  • Cigna — Out of Network Plans: $1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Clover Health — Medicare Advantage: $1,175.30
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD Not listed in the file Not listed in the file $12,628.52 – $35,958.46
Prostate removal by laparoscope (radical prostatectomy): 10 of 19 insurance plan rates
  • Aetna — HTC: $17,679.93
  • Aetna — Medicare Advantage: $12,628.52
  • Aetna Whole Health — Commercial: $25,762.19
  • AmeriHealth — Medicare Advantage: $12,628.52
  • Clover Health — Medicare Advantage: $12,628.52
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $13,259.95
  • Horizon Blue Cross Blue Shield — Indemnity: $35,958.46
  • Horizon Blue Cross Blue Shield — Managed Care: $35,958.46
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $12,628.52
  • Horizon Blue Cross Blue Shield — Omnia: $26,806.57
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Doctor (professional) fee In the file: hysteroscopy,biopsy 58558 $4,833 $4,833 $166.29 – $4,833
Hysteroscopy with biopsy of the uterus lining: 10 of 26 insurance plan rates
  • Aetna — HTC: $310.41
  • Aetna — Managed Care: $270.50
  • Aetna — Medicare Advantage: $221.72
  • Aetna — PPO/Signature Administrators: $270.50
  • Aetna Better Health — Managed Medicaid: $371.83
  • Aetna Whole Health — Commercial: $254.98
  • AmeriHealth — Managed Care/PPO: $254.98
  • AmeriHealth — Medicare Advantage: $221.72
  • Cigna — Out of Network Plans: $4,833
  • Clover Health — Medicare Advantage: $221.72
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY Not listed in the file Not listed in the file $3,845.79 – $10,950.51
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates
  • Aetna — HTC: $5,384.11
  • Aetna — Medicare Advantage: $3,845.79
  • Aetna Whole Health — Commercial: $7,845.41
  • AmeriHealth — Medicare Advantage: $3,845.79
  • Clover Health — Medicare Advantage: $3,845.79
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $4,038.08
  • Horizon Blue Cross Blue Shield — Indemnity: $10,950.51
  • Horizon Blue Cross Blue Shield — Managed Care: $10,950.51
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $3,845.79
  • Horizon Blue Cross Blue Shield — Omnia: $8,163.46
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ OF DIAG OR THER, W IMG GUIDANCE $2,220 $2,220 $205.37 – $2,387.84
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates
  • Aetna — HTC: $1,174.05
  • Aetna — Managed Care: $259.62
  • Aetna — Medicare Advantage: $838.61
  • Aetna — PPO/Signature Administrators: $259.62
  • Aetna Better Health — Managed Medicaid: $456.65
  • Aetna Whole Health — Commercial: $1,710.75
  • AmeriHealth — Managed Care/PPO: $1,413.47
  • AmeriHealth — Medicare Advantage: $838.61
  • Cigna — Out of Network Plans: $2,220
  • Clover Health — Medicare Advantage: $838.61
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Doctor (professional) fee In the file: Profee 62323: NJX Interlaminar LMBR $886.29 $886.29 $72.92 – $886.29
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates
  • Aetna — HTC: $136.11
  • Aetna — Managed Care: $118.61
  • Aetna — Medicare Advantage: $97.22
  • Aetna — PPO/Signature Administrators: $118.61
  • Aetna Better Health — Managed Medicaid: $154.32
  • Aetna Whole Health — Commercial: $111.80
  • AmeriHealth — Managed Care/PPO: $111.80
  • AmeriHealth — Medicare Advantage: $97.22
  • Cigna — Out of Network Plans: $886.29
  • Clover Health — Medicare Advantage: $97.22
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJ OF DIAG OR THER, W IMG GUIDANCE $2,220 $2,220 $1,443 – $2,220
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans
  • Cigna — Out of Network Plans: $2,220
  • Consumer Health Network — Commercial: $1,998
  • Multiplan — All Products: $1,665
  • Private Healthcare Systems — All Products: $1,443
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee In the file: Pro Fee 64483: Inj /trans/epi-lumb/sac-single $847.05 $847.05 $81.71 – $847.05
Nerve root injection, lower back, with imaging guidance: 10 of 26 insurance plan rates
  • Aetna — HTC: $152.52
  • Aetna — Managed Care: $132.91
  • Aetna — Medicare Advantage: $108.94
  • Aetna — PPO/Signature Administrators: $132.91
  • Aetna Better Health — Managed Medicaid: $153.78
  • Aetna Whole Health — Commercial: $125.28
  • AmeriHealth — Managed Care/PPO: $125.28
  • AmeriHealth — Medicare Advantage: $108.94
  • Cigna — Out of Network Plans: $847.05
  • Clover Health — Medicare Advantage: $108.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 Not listed in the file Not listed in the file $1,050.78 – $2,991.98
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates
  • Aetna — HTC: $1,471.09
  • Aetna — Medicare Advantage: $1,050.78
  • Aetna Whole Health — Commercial: $2,143.59
  • AmeriHealth — Medicare Advantage: $1,050.78
  • Clover Health — Medicare Advantage: $1,050.78
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $1,103.32
  • Horizon Blue Cross Blue Shield — Indemnity: $2,991.98
  • Horizon Blue Cross Blue Shield — Managed Care: $2,991.98
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $1,050.78
  • Horizon Blue Cross Blue Shield — Omnia: $2,230.48
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: NJX AA&/STRD TFRM EPI L/S 1 Not listed in the file Not listed in the file $153.78
Nerve root injection, lower back, with imaging guidance: rates for 5 insurance plans
  • Aetna — Managed Care: $153.78
  • Aetna — Medicare Advantage: $153.78
  • Aetna — PPO/Signature Administrators: $153.78
  • Aetna Better Health — Managed Medicaid: $153.78
  • Aetna Whole Health — Commercial: $153.78
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Doctor (professional) fee In the file: Carpal tunnel surgery 64721 $1,472.10 $1,472.10 $354.11 – $1,472.10
Carpal tunnel release: 10 of 26 insurance plan rates
  • Aetna — HTC: $661
  • Aetna — Managed Care: $576.01
  • Aetna — Medicare Advantage: $472.14
  • Aetna — PPO/Signature Administrators: $576.01
  • Aetna Better Health — Managed Medicaid: $591.21
  • Aetna Whole Health — Commercial: $542.96
  • AmeriHealth — Managed Care/PPO: $542.96
  • AmeriHealth — Medicare Advantage: $472.14
  • Cigna — Out of Network Plans: $1,472.10
  • Clover Health — Medicare Advantage: $472.14
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY Not listed in the file Not listed in the file $2,319.89 – $6,605.65
Carpal tunnel release: 10 of 20 insurance plan rates
  • Aetna — HTC: $3,247.84
  • Aetna — Medicare Advantage: $2,319.89
  • Aetna Whole Health — Commercial: $4,732.57
  • AmeriHealth — Medicare Advantage: $2,319.89
  • Clover Health — Medicare Advantage: $2,319.89
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $2,435.88
  • Horizon Blue Cross Blue Shield — Indemnity: $6,605.65
  • Horizon Blue Cross Blue Shield — Managed Care: $6,605.65
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $2,319.89
  • Horizon Blue Cross Blue Shield — Omnia: $4,924.43
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · Doctor (professional) fee In the file: After Cataract Laser Surgery 66821 $1,140.06 $1,140.06 $230.78 – $1,140.06
Laser treatment of clouding after cataract surgery: 10 of 26 insurance plan rates
  • Aetna — HTC: $430.78
  • Aetna — Managed Care: $375.39
  • Aetna — Medicare Advantage: $307.70
  • Aetna — PPO/Signature Administrators: $375.39
  • Aetna Better Health — Managed Medicaid: $394.83
  • Aetna Whole Health — Commercial: $353.86
  • AmeriHealth — Managed Care/PPO: $353.86
  • AmeriHealth — Medicare Advantage: $307.70
  • Cigna — Out of Network Plans: $1,140.06
  • Clover Health — Medicare Advantage: $307.70
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY Not listed in the file Not listed in the file $653.41 – $1,860.52
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates
  • Aetna — HTC: $914.78
  • Aetna — Medicare Advantage: $653.41
  • Aetna Whole Health — Commercial: $1,332.96
  • AmeriHealth — Medicare Advantage: $653.41
  • Clover Health — Medicare Advantage: $653.41
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $686.08
  • Horizon Blue Cross Blue Shield — Indemnity: $1,860.52
  • Horizon Blue Cross Blue Shield — Managed Care: $1,860.52
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $653.41
  • Horizon Blue Cross Blue Shield — Omnia: $1,387
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee In the file: Cataract Surg W/Iol, 1 Stage 66984 $2,179.62 $2,179.62 $383.80 – $2,179.62
Cataract removal with lens implant: 10 of 29 insurance plan rates
  • Aetna — HTC: $716.42
  • Aetna — Managed Care: $624.31
  • Aetna — Medicare Advantage: $511.73
  • Aetna — PPO/Signature Administrators: $624.31
  • Aetna Better Health — Managed Medicaid: $986.33
  • Aetna Whole Health — Commercial: $588.49
  • AmeriHealth — Managed Care/PPO: $588.49
  • AmeriHealth — Medicare Advantage: $511.73
  • Cigna — Out of Network Plans: $2,179.62
  • Clover Health — Medicare Advantage: $511.73
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file Not listed in the file $2,741.76 – $7,806.88
Cataract removal with lens implant: 10 of 20 insurance plan rates
  • Aetna — HTC: $3,838.46
  • Aetna — Medicare Advantage: $2,741.76
  • Aetna Whole Health — Commercial: $5,593.18
  • AmeriHealth — Medicare Advantage: $2,741.76
  • Clover Health — Medicare Advantage: $2,741.76
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $2,878.84
  • Horizon Blue Cross Blue Shield — Indemnity: $7,806.88
  • Horizon Blue Cross Blue Shield — Managed Care: $7,806.88
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $2,741.76
  • Horizon Blue Cross Blue Shield — Omnia: $5,819.93
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file Not listed in the file $986.33
Cataract removal with lens implant: rates for 5 insurance plans
  • Aetna — Managed Care: $986.33
  • Aetna — Medicare Advantage: $986.33
  • Aetna — PPO/Signature Administrators: $986.33
  • Aetna Better Health — Managed Medicaid: $986.33
  • Aetna Whole Health — Commercial: $986.33

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Delivery Vaginal Ldr $25,116 $25,116 $1,712 – $25,116
Vaginal delivery, with care before and after: 10 of 33 insurance plan rates
  • Aetna — HTC: $3,383.15
  • Aetna — Managed Care: $12,558
  • Aetna — Medicare Advantage: $2,416.53
  • Aetna — PPO/Signature Administrators: $12,558
  • Aetna Better Health — Managed Medicaid: $5,166.36
  • Aetna Whole Health — Commercial: $4,929.73
  • AmeriHealth — Managed Care/PPO: $15,991.36
  • AmeriHealth — Medicare Advantage: $2,416.53
  • Cigna — Out of Network Plans: $25,116
  • Clover Health — Medicare Advantage: $2,416.53
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Delivery,Vaginal Operative $25,116 $25,116 $1,712 – $25,116
Vaginal delivery, with care before and after: 10 of 33 insurance plan rates
  • Aetna — HTC: $3,383.15
  • Aetna — Managed Care: $12,558
  • Aetna — Medicare Advantage: $2,416.53
  • Aetna — PPO/Signature Administrators: $12,558
  • Aetna Better Health — Managed Medicaid: $5,166.36
  • Aetna Whole Health — Commercial: $4,929.73
  • AmeriHealth — Managed Care/PPO: $15,991.36
  • AmeriHealth — Medicare Advantage: $2,416.53
  • Cigna — Out of Network Plans: $25,116
  • Clover Health — Medicare Advantage: $2,416.53
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · Doctor (professional) fee In the file: GLBL Vaginal Del 59400 $7,757.40 $7,757.40 $1,112 – $7,757.40
Vaginal delivery, with care before and after: 10 of 29 insurance plan rates
  • Aetna — HTC: $3,383.14
  • Aetna — Managed Care: $2,948.17
  • Aetna — Medicare Advantage: $2,416.53
  • Aetna — PPO/Signature Administrators: $2,948.17
  • Aetna Better Health — Managed Medicaid: $1,112
  • Aetna Whole Health — Commercial: $2,779.01
  • AmeriHealth — Managed Care/PPO: $2,779.01
  • AmeriHealth — Medicare Advantage: $2,416.53
  • Cigna — Out of Network Plans: $7,757.40
  • Clover Health — Medicare Advantage: $2,416.53
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee In the file: C/S Delivery Global 59510 $8,602.32 $8,602.32 $1,231 – $8,602.32
Cesarean delivery (C-section), with care before and after: 10 of 29 insurance plan rates
  • Aetna — HTC: $3,774.58
  • Aetna — Managed Care: $3,289.28
  • Aetna — Medicare Advantage: $2,696.13
  • Aetna — PPO/Signature Administrators: $3,289.28
  • Aetna Better Health — Managed Medicaid: $1,231
  • Aetna Whole Health — Commercial: $3,100.55
  • AmeriHealth — Managed Care/PPO: $3,100.55
  • AmeriHealth — Medicare Advantage: $2,696.13
  • Cigna — Out of Network Plans: $8,602.32
  • Clover Health — Medicare Advantage: $2,696.13
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY Not listed in the file Not listed in the file $2,696.13 – $7,676.95
Cesarean delivery (C-section), with care before and after: 10 of 17 insurance plan rates
  • Aetna — HTC: $3,774.58
  • Aetna — Medicare Advantage: $2,696.13
  • Aetna Whole Health — Commercial: $5,500.10
  • AmeriHealth — Medicare Advantage: $2,696.13
  • Clover Health — Medicare Advantage: $2,696.13
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $2,830.93
  • Horizon Blue Cross Blue Shield — Indemnity: $7,676.95
  • Horizon Blue Cross Blue Shield — Managed Care: $7,676.95
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $2,696.13
  • Horizon Blue Cross Blue Shield — Omnia: $5,723.07
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · Doctor (professional) fee In the file: GLBL VD after previous C/S 59610 $8,110.17 $8,110.17 $1,904.99 – $8,110.17
Vaginal delivery after a previous C-section, with care before and after: 10 of 26 insurance plan rates
  • Aetna — HTC: $3,555.99
  • Aetna — Managed Care: $3,098.79
  • Aetna — Medicare Advantage: $2,539.99
  • Aetna — PPO/Signature Administrators: $3,098.79
  • Aetna Better Health — Managed Medicaid: $3,640
  • Aetna Whole Health — Commercial: $2,920.99
  • AmeriHealth — Managed Care/PPO: $2,920.99
  • AmeriHealth — Medicare Advantage: $2,539.99
  • Cigna — Out of Network Plans: $8,110.17
  • Clover Health — Medicare Advantage: $2,539.99
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY Not listed in the file Not listed in the file $2,539.99 – $7,232.36
Vaginal delivery after a previous C-section, with care before and after: 10 of 17 insurance plan rates
  • Aetna — HTC: $3,555.98
  • Aetna — Medicare Advantage: $2,539.99
  • Aetna Whole Health — Commercial: $5,181.57
  • AmeriHealth — Medicare Advantage: $2,539.99
  • Clover Health — Medicare Advantage: $2,539.99
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $2,666.99
  • Horizon Blue Cross Blue Shield — Indemnity: $7,232.36
  • Horizon Blue Cross Blue Shield — Managed Care: $7,232.36
  • Horizon Blue Cross Blue Shield — Medicare and Braven Health: $2,539.99
  • Horizon Blue Cross Blue Shield — Omnia: $5,391.63

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance 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 $6,818 – $424,143.08
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 25 insurance plan rates
  • Aetna — HTC: $145,664.90
  • Aetna — Managed Care: $264,517.06
  • Aetna — Medicare Advantage: $104,046.36
  • Aetna — PPO/Signature Administrators: $306,093.99
  • Aetna Whole Health — Commercial: $249,711.26
  • AmeriHealth — Managed Care/PPO: $165,621
  • AmeriHealth — Medicare Advantage: $104,046.36
  • Clover Health — Medicare Advantage: $105,607.06
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $109,248.68
  • Horizon Blue Cross Blue Shield — Indemnity: $424,143.08
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Inpatient MS-DRG Not listed in the file Not listed in the file $25,861
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • Horizon New Jersey Health — Managed Medicaid: $25,861
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 $15,931 – $83,629.39
Hip or knee replacement (major joint of the leg), without major complications: 10 of 24 insurance plan rates
  • Aetna — HTC: $33,240.76
  • Aetna — Managed Care: $60,362.85
  • Aetna — Medicare Advantage: $23,743.40
  • Aetna — PPO/Signature Administrators: $69,850.71
  • Aetna Whole Health — Commercial: $56,984.16
  • AmeriHealth — Managed Care/PPO: $37,794.74
  • AmeriHealth — Medicare Advantage: $23,743.40
  • Clover Health — Medicare Advantage: $24,099.55
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $24,930.57
  • Horizon Blue Cross Blue Shield — Indemnity: $83,629.39
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 $18,998 – $105,845
Neck (cervical) spinal fusion, without complications: 10 of 24 insurance plan rates
  • Aetna — HTC: $40,575.46
  • Aetna — Managed Care: $73,682.13
  • Aetna — Medicare Advantage: $28,982.47
  • Aetna — PPO/Signature Administrators: $85,263.53
  • Aetna Whole Health — Commercial: $69,557.93
  • AmeriHealth — Managed Care/PPO: $46,134.30
  • AmeriHealth — Medicare Advantage: $28,982.47
  • Clover Health — Medicare Advantage: $29,417.21
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $30,431.59
  • Horizon Blue Cross Blue Shield — Indemnity: $105,845
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 $3,845 – $53,791.79
Uterus and ovary surgery (not for cancer), without complications: 10 of 24 insurance plan rates
  • Aetna — HTC: $23,389.59
  • Aetna — Managed Care: $42,473.82
  • Aetna — Medicare Advantage: $16,706.85
  • Aetna — PPO/Signature Administrators: $49,149.88
  • Aetna Whole Health — Commercial: $40,096.44
  • AmeriHealth — Managed Care/PPO: $26,593.96
  • AmeriHealth — Medicare Advantage: $16,706.85
  • Clover Health — Medicare Advantage: $16,957.45
  • Fidelis Care of New Jersey — Medicare Advantage/Dual Plan: $17,542.19
  • Horizon Blue Cross Blue Shield — Indemnity: $53,791.79

Source: St Joseph's University Medical Center Inc’s standard charges file (sthpiprd.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 24, 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 typeAcute Care Hospital
Address703 Main St, Paterson, NJ 07503
CountyPassaic County
StateNew Jersey
Phone(973) 754‑2010
Emergency servicesYes
OwnershipVoluntary non-profit - Church
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number310019
Name in Medicare recordsST JOSEPH'S UNIVERSITY MEDICAL CENTER INC
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(973) 754‑2000[4]
Name on the hospital’s websiteSt. Joseph's University Medical Center
Official websitestjosephshealth.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. St. Joseph's University Medical Center - St. Joseph's Health — stjosephshealth.org
  2. Emergency and Trauma Care - St. Joseph's Health — stjosephshealth.org