Where is St Mary Rehabilitation Hospital?

1208 Langhorne-Newtown Road, Langhorne, PA 19047, in Bucks County, Pennsylvania.

What is the phone number of St Mary Rehabilitation Hospital?

(267) 688-0711, as listed by Medicare (CMS).

St Mary Rehabilitation Hospital

Quick answers

Where is St Mary Rehabilitation Hospital?: 1208 Langhorne-Newtown Road, Langhorne, PA 19047, in Bucks County, Pennsylvania.
What is the phone number of St Mary Rehabilitation Hospital?: (267) 688-0711, as listed by Medicare (CMS).

Specialties and care areas^[4]

Inpatient acute rehabilitation

Conditions treated^[4]

Treatments^[4][5]

Physical therapy
Occupational therapy
Speech/language therapy
Respiratory therapy
Neuropsychology
Biodex Gait Trainer
Bioness
Esko GT Robotic Suit
In Motion Upper Arm Robot
VitalStim

Programs and centers^[4][5]

Brain injury specialty unit
Stroke recovery specialty unit
Acute rehabilitation (inpatient)
Secure Neuro Recovery Unit (brain injury)
Interdisciplinary rehabilitation team

Visiting and practical information

Visiting	Visiting hours 10 a.m. to 8 p.m.; family encouraged at therapy times. Stroke/neuro units limit visitors to two at a time^[6]

Nearest emergency rooms

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

St Mary Medical Center1.6 mi · Langhorne, PA · Acute Care Hospital
Lower Bucks Hospital7.4 mi · Bristol, PA · Acute Care Hospital
Capital Health Regional Medical Center9.6 mi · Trenton, NJ · Acute Care Hospital
Jefferson Health- Northeast9.8 mi · Philadelphia, PA · Acute Care Hospital
Holy Redeemer Hospital and Medical Center10 mi · Meadowbrook, PA · Acute Care Hospital

Other hospitals nearby

Rothman Orthopaedic Specialty Hospital6.0 mi · Bensalem, PA · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Crestview Center0.9 mi · Langhorne, PA · 2 of 5 stars
Oxford Rehabilitation and Healthcare Center1.4 mi · Langhorne, PA · 5 of 5 stars
Chandler Hall Health Services1.7 mi · Newtown, PA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Vitality Hospice and Palliative Care1.6 mi · Langhorne, PA · 4 of 5 stars
Affinity Care of Pennsylvania LLC4.0 mi · Trevose, PA · 1 of 5 stars
All American Hospice LLC4.0 mi · Feasterville Trevose, PA

All hospice providers in the state →

Home health agencies

A-Team Home Care, Inc4.0 mi · Feasterville, PA
Aurora Home Care Inc4.0 mi · Feasterville, PA · 4 of 5 stars
Aveanna Healthcare4.0 mi · Trevose, PA

All home health agencies in the state →

Dialysis facilities

DaVita Dialysis Center at Oxford Court1.6 mi · Langhorne, PA · 3 of 5 stars
Innovative Renal Care Langhorne1.6 mi · Langhorne, PA · 4 of 5 stars
DaVita Newtown Dialysis Center4.2 mi · Newtown, PA · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Ambulatory Surgery Center at St Mary1.6 mi · Langhorne, PA
Jefferson Surgery Center - Langhorne1.6 mi · Langhorne, PA
Langhorne Surgical Center1.6 mi · Langhorne, PA

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

Henry J. Austin Health Center-Bellevue8.3 mi · Trenton, NJ · Community health center
Henry J Austin Health Center, Inc8.7 mi · Trenton, NJ · Community health center
Henry J. Austin Health Center-Warren8.8 mi · Trenton, NJ · Community health center

Clinics and urgent care

American Current Care P.A.1.6 mi · Langhorne, PA · Urgent care center
Trinity Health Mid-Atlantic Medical Group1.6 mi · Langhorne, PA · Urgent care center
Tower Health Urgent Care, LLC4.2 mi · Newtown, PA · Urgent care center

Pharmacies

Arman RX Inc1.6 mi · Langhorne, PA · Community/retail pharmacy
Bergman Pharmacy1.6 mi · Langhorne, PA · Community/retail pharmacy
Sams East Inc1.6 mi · Langhorne, PA · Community/retail pharmacy

Assisted living nearby

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

Beechwood Center 11.6 mi · Langhorne, PA
Beechwood Center 101.6 mi · Langhorne, PA
Beechwood Center 21.6 mi · Langhorne, PA
Beechwood Center 31.6 mi · Langhorne, PA

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 Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 71 common services exactly as St Mary Rehabilitation Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

$ 9 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$240	$240	$54.25 – $240
New patient office visit (about 30–44 minutes): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $119.53 AETNA — AETNA: $198.34 AETNA DOMESTIC — AETNA: $198.34 AETNA MEDICAID — AETNA MEDICAID: $78.66 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $131.48 AETNA MEDICARE TRANSPLANT — MEDICARE: $119.53 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $54.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.25 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $119.53 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.38
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$240	$240	$81 – $88.83
New patient office visit (about 30–44 minutes): rates for 2 insurance plans MEDICAID - OR — MEDICAID: $88.83 WC AETNA — AETNA WORKERS COMP: $81
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$240	$240	$74.07 – $93.39
New patient office visit (about 30–44 minutes): rates for 2 insurance plans MEDICAID - OR — MEDICAID: $93.39 WC AETNA — AETNA WORKERS COMP: $74.07
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$370	$370	$90.37 – $370
New patient office visit (about 45–59 minutes): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $180.17 AETNA — AETNA: $294.58 AETNA MEDICAID — AETNA MEDICAID: $131.04 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $180.17 ALIGN SENIOR CARE — MEDICARE: $180.17 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.56 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $198.56 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.56 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $198.56 ALLY ALIGN CARE ADV — MEDICARE: $180.17
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$285	$285	$90.37 – $272.07
New patient office visit (about 45–59 minutes): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $118.50 AETNA — AETNA: $236.03 AETNA DOMESTIC — AETNA: $236.03 AETNA MEDICAID — AETNA MEDICAID: $131.04 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.35 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $118.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $90.37 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.37 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.56 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $130.59
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$390	$390	$115.66 – $373.59
New patient office visit (about 60–74 minutes): 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.72 AETNA MEDICAID — AETNA MEDICAID: $170.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $178.99 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $162.72 AETNA MEDICARE TRANSPLANT — MEDICARE: $162.72 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $117.54 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.72 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $176.31 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $179.32 ALLY ALIGN CARE ADV — MEDICARE: $162.72
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$388	$388	$117.54 – $373.59
New patient office visit (about 60–74 minutes): 10 of 753 insurance plan rates AETNA — AETNA: $320.33 AETNA MEDICARE TRANSPLANT — MEDICARE: $162.72 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.72 ALLY ALIGN CARE ADV — MEDICARE: $162.72 AMBETTER — AMBETTER: $237.11 AMERIGROUP MEDICAID — MEDICAID: $117.54 AMERIHEALTH — AMERIHEALTH: $220.18 AMERIHEALTH MEDICARE — MEDICARE: $162.72 AVMED MEDICARE — MEDICARE: $162.72 BCBS GENERIC — INDEPENDENCE BLUE CROSS: $220.18
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$195	$195	$35 – $195
Established patient office visit (about 20–29 minutes): 10 of 748 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $96.58 AETNA — AETNA: $160.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $106.24 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $35 ALIGN SENIOR CARE — MEDICARE: $96.58 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $106.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $52.50 AMERIGROUP MEDICAID — MEDICAID: $35 AMERIHEALTH — AMERIHEALTH: $94.16 AMERIHEALTH MEDICARE — MEDICARE: $96.58
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	Not listed in the file	$140	$35 – $118.40
Established patient office visit (about 20–29 minutes): 10 of 748 insurance plan rates AETNA — AETNA: $98.89 AETNA DOMESTIC — AETNA: $98.89 AETNA MEDICAID — AETNA MEDICAID: $50.75 AETNA MEDICARE TRANSPLANT — MEDICARE: $49.36 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $49.36 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $52.50 ALLY ALIGN CARE ADV — MEDICARE: $49.36 AMBETTER — AMBETTER: $71.93 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $49.36 AMERIGROUP MEDICAID — MEDICAID: $35
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Visit Estab Low Pro 20-29 Mins (Restricted Method II CAH)	Not listed in the file	$1,959.59	$40.25 – $412.75
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $50.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $62.72 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $60.45 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $64 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $52.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $64 AMBETTER — AMBETTER MARKETPLACE: $409.31 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $59.26 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $160.24 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $231.46
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$280	$280	$54.42 – $268.52
Established patient office visit (about 30–39 minutes): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $116.95 AETNA — AETNA: $191.47 AETNA DOMESTIC — AETNA: $191.47 AETNA MEDICAID — AETNA MEDICAID: $78.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $128.65 ALIGN SENIOR CARE — MEDICARE: $116.95 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $128.89 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 ALLY ALIGN CARE ADV — MEDICARE: $116.95
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$207	$207	$54.42 – $196.65
Established patient office visit (about 30–39 minutes): 10 of 749 insurance plan rates AETNA — AETNA: $170.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $94 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $54.42 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $54.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $81.63 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $85.46 AMERIGROUP MEDICAID — MEDICAID: $54.42 AMERIHEALTH — AMERIHEALTH: $109.30 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $54.42 AMERIHEALTH MEDICARE — MEDICARE: $85.46
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Visit Estab Mod Pro 30-39 Mins (Restricted Method II CAH)	Not listed in the file	$1,624.19	$62.58 – $412.75
Established patient office visit (about 30–39 minutes): 10 of 35 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $78.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $88.94 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $94.18 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $81.63 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $94.18 AMBETTER — AMBETTER MARKETPLACE: $409.31 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $87.20 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $235.79 CIGNA — CIGNA: $72.14
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$199	$199	$20 – $190.51
Preventive checkup, new patient, age 18–39: 10 of 389 insurance plan rates AETNA — AETNA: $185.07 AETNA DOMESTIC — AETNA: $185.07 AETNA MEDICAID — AETNA MEDICAID: $29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.27 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $20 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $91.44 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $91.44
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$241	$241	$20 – $231.59
Preventive checkup, new patient, age 40–64: 10 of 389 insurance plan rates AETNA — AETNA: $224.27 AETNA DOMESTIC — AETNA: $224.27 AETNA MEDICAID — AETNA MEDICAID: $29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $110.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $20 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $111.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $30 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $111.16
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$250	$250	$44.94 – $250
Emergency room visit (moderate): 10 of 749 insurance plan rates AETNA — AETNA: $125.68 AETNA DOMESTIC — AETNA: $125.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.73 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $70.67 AETNA MEDICARE TRANSPLANT — MEDICARE: $70.67 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $56.65 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $56.65 ALIGN SENIOR CARE — MEDICARE: $70.67 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $77.88
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Low	$148	$148	$44.94 – $148
Emergency room visit (moderate): 10 of 749 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $82.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.73 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $70.67 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $56.65 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $84.98 AMBETTER — AMBETTER: $102.97 AMERICAN HEALTH PLAN — MEDICARE: $70.67 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $56.65 AMERIHEALTH MEDICARE — MEDICARE: $70.67 AMISH MENNONITE — MEDICAID: $56.65
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3	$823	$534.95	$35 – $1,636
Emergency room visit (moderate): 10 of 100 insurance plan rates AETNA — AETNA: $1,636 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $311.47 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $300.17 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $323.71 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $52.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $323.71 AMBETTER — AMBETTER MARKETPLACE: $525.30 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $746 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $746
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$250	$250	$76.68 – $250
Emergency room visit (moderately high): 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.30 AETNA — AETNA: $211.76 AETNA DOMESTIC — AETNA: $211.76 AETNA MEDICAID — AETNA MEDICAID: $138.23 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.34 AETNA MEDICARE TRANSPLANT — MEDICARE: $120.30 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $95.33 ALIGN SENIOR CARE — MEDICARE: $120.30 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $120.30 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $143
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Emergency Dept Visit Moderate	$253	$253	$76.68 – $253
Emergency room visit (moderately high): 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.30 AETNA MEDICAID — AETNA MEDICAID: $138.23 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $132.34 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $120.30 ALIGN SENIOR CARE — MEDICARE: $120.30 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $120.30 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $143 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $132.58 ALLY ALIGN CARE ADV — MEDICARE: $120.30
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4	$1,259	$818.35	$50 – $1,684
Emergency room visit (moderately high): 10 of 100 insurance plan rates AETNA — AETNA: $1,636 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $476.10 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $458.83 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $494.81 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $494.81 AMBETTER — AMBETTER MARKETPLACE: $802.95 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $746 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $746
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Emergency Dept Visit High	$367	$367	$111.19 – $367
Emergency room visit (high): 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $174.19 AETNA — AETNA: $307.53 AETNA MEDICAID — AETNA MEDICAID: $201.17 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $191.60 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $138.74 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $208.11 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $191.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $208.11 AMBETTER — AMBETTER: $253.81 AMERIGROUP MEDICAID — MEDICAID: $138.74
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5	$2,612	$1,697.80	$50 – $2,481.40
Emergency room visit (high): 10 of 100 insurance plan rates AETNA — AETNA: $1,636 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $679.51 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $654.86 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $706.22 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $706.22 AMBETTER — AMBETTER MARKETPLACE: $1,146 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $746 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $746
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5 OB Triage	$2,612	$1,697.80	$50 – $2,481.40
Emergency room visit (high): 10 of 100 insurance plan rates AETNA — AETNA: $1,636 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $300 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $679.51 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $654.86 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $706.22 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $706.22 AMBETTER — AMBETTER MARKETPLACE: $1,146 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $746 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $746

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	$185	$120.25	$8.46 – $175.75
Basic metabolic panel (blood test): 10 of 99 insurance plan rates AETNA — AETNA: $164.65 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.63 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.04 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.14 AMBETTER — AMBETTER MARKETPLACE: $15.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $39.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $39.81
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$259	$168.35	$10.56 – $246.05
Comprehensive metabolic panel (blood test): 10 of 99 insurance plan rates AETNA — AETNA: $230.51 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $16.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $10.77 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $17.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 AMBETTER — AMBETTER MARKETPLACE: $18.85 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $49.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $49.68
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	Not listed in the file	$707.85	$10.56 – $128.03
Comprehensive metabolic panel (blood test): 10 of 88 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $16.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11.18 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $10.77 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $17.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $11.40 AMBETTER — AMBETTER MARKETPLACE: $18.85 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $49.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $49.68 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $49.68
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Lipid Panel	$215	$139.75	$13.39 – $204.25
Cholesterol panel (lipid panel): 10 of 99 insurance plan rates AETNA — AETNA: $191.35 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13.66 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $64.65 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $64.65
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 92145 Lipid Panel	$215	$139.75	$13.39 – $204.25
Cholesterol panel (lipid panel): 10 of 99 insurance plan rates AETNA — AETNA: $191.35 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13.66 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $64.65 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $64.65
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 37849 Lipid Panel	$215	$139.75	$13.39 – $204.25
Cholesterol panel (lipid panel): 10 of 99 insurance plan rates AETNA — AETNA: $191.35 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $20.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.17 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $13.66 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14.46 AMBETTER — AMBETTER MARKETPLACE: $23.90 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $64.65 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $64.65
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$57	$37.05	$5.70 – $105.23
Kidney function panel: 10 of 99 insurance plan rates AETNA — AETNA: $50.73 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9.19 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.85 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $14.40 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $9.37 AMBETTER — AMBETTER MARKETPLACE: $15.49 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $40.83 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $40.83
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$222	$144.30	$8.17 – $210.90
Liver function panel: 10 of 99 insurance plan rates AETNA — AETNA: $197.58 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $13.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.65 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $8.33 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.82 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $13.55 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.82 AMBETTER — AMBETTER MARKETPLACE: $14.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $38.45 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $38.45
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$74	$48.10	$3.17 – $70.30
Urine test (automated, with microscope): 10 of 99 insurance plan rates AETNA — AETNA: $65.86 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.23 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Urinalysis With Microscopy Automated	$74	$48.10	$3.17 – $70.30
Urine test (automated, with microscope): 10 of 99 insurance plan rates AETNA — AETNA: $65.86 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.23 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	Not listed in the file	$256.10	$3.17 – $38.58
Urine test (automated, with microscope): 10 of 89 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.23 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.42 AMBETTER — AMBETTER MARKETPLACE: $5.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $14.97
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Nonautomated	$15	$9.75	$1.50 – $43.85
Urine test (manual, without microscope): 10 of 99 insurance plan rates AETNA — AETNA: $13.35 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.68 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3.55 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.76 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $5.36 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3.76 AMBETTER — AMBETTER MARKETPLACE: $6.21 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $17.01 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $17.01
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Urinalysis Without Microscopy Automated	$27	$17.55	$2.25 – $29.82
Urine test (automated, without microscope): 10 of 99 insurance plan rates AETNA — AETNA: $24.03 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2.30 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 AMBETTER — AMBETTER MARKETPLACE: $4.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$27	$17.55	$2.25 – $29.82
Urine test (automated, without microscope): 10 of 99 insurance plan rates AETNA — AETNA: $24.03 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2.30 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2.43 AMBETTER — AMBETTER MARKETPLACE: $4.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	Not listed in the file	$137.80	$3.57 – $171.97
Urine test (automated, without microscope): 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $4.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $67.31 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $64.87 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $68.68 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $4.65 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $68.68 AMBETTER — AMBETTER MARKETPLACE: $113.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $11.57
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$170	$110.50	$17 – $228.88
PSA (prostate specific antigen) blood test: 10 of 99 insurance plan rates AETNA — AETNA: $151.30 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $35.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $18.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $88.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $88.81
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 31348 Prostate Specific Antigen Total	$105	$68.25	$10.50 – $228.88
PSA (prostate specific antigen) blood test: 10 of 99 insurance plan rates AETNA — AETNA: $93.45 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $35.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $18.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $88.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $88.81
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Prostate Specific Antigen Total	$329	$213.85	$18.39 – $312.55
PSA (prostate specific antigen) blood test: 10 of 99 insurance plan rates AETNA — AETNA: $292.81 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $35.32 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $19.46 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $18.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $36.54 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $19.86 AMBETTER — AMBETTER MARKETPLACE: $32.83 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $88.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $88.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest Thyroid Stimulating Hormone	$211	$137.15	$16.80 – $229.75
Thyroid stimulating hormone (TSH) test: 10 of 99 insurance plan rates AETNA — AETNA: $187.79 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $33.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $17.14 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $34.82 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 AMBETTER — AMBETTER MARKETPLACE: $29.99 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $89.15 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $89.15
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$211	$137.15	$16.80 – $229.75
Thyroid stimulating hormone (TSH) test: 10 of 99 insurance plan rates AETNA — AETNA: $187.79 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $33.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $17.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $17.14 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $34.82 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $18.14 AMBETTER — AMBETTER MARKETPLACE: $29.99 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $89.15 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $89.15
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Cbc Automated/Differential Wbc Automated	$111	$72.15	$6.90 – $105.45
Complete blood count (CBC) with differential: 10 of 99 insurance plan rates AETNA — AETNA: $98.79 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $37.43 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $37.43
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Labcorp Cbc Automated/Differential Wbc Automated	$111	$72.15	$6.90 – $105.45
Complete blood count (CBC) with differential: 10 of 99 insurance plan rates AETNA — AETNA: $98.79 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $37.43 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $37.43
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$111	$72.15	$6.90 – $105.45
Complete blood count (CBC) with differential: 10 of 99 insurance plan rates AETNA — AETNA: $98.79 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $8.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.22 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7.93 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $9 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8.39 AMBETTER — AMBETTER MARKETPLACE: $13.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $37.43 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $37.43
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated Intrauterine	$96	$62.40	$6.47 – $91.20
Complete blood count (CBC), automated: 10 of 99 insurance plan rates AETNA — AETNA: $85.44 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$96	$62.40	$6.47 – $91.20
Complete blood count (CBC), automated: 10 of 99 insurance plan rates AETNA — AETNA: $85.44 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated	Not listed in the file	$727.35	$6.47 – $87.69
Complete blood count (CBC), automated: 10 of 89 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.85 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.28 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.99 AMBETTER — AMBETTER MARKETPLACE: $11.55 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $34.03
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prothrombin Time	$40	$26	$4 – $49.11
Blood clotting time test (prothrombin time, PT): 10 of 99 insurance plan rates AETNA — AETNA: $35.60 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.54 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $4.38 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $6 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 AMBETTER — AMBETTER MARKETPLACE: $7.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $19.06 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $19.06
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Prothrombin Time	$40	$26	$4 – $49.11
Blood clotting time test (prothrombin time, PT): 10 of 99 insurance plan rates AETNA — AETNA: $35.60 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $5.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.54 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $4.38 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $6 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4.63 AMBETTER — AMBETTER MARKETPLACE: $7.66 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $19.06 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $19.06
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 7079 Thromboplastin Time Partial (Ptt)	$65	$42.25	$6.01 – $82.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 99 insurance plan rates AETNA — AETNA: $57.85 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $31.99 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $31.99
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 19790 Thromboplastin Time Partial (Ptt)	$65	$42.25	$6.01 – $82.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 99 insurance plan rates AETNA — AETNA: $57.85 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $31.99 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $31.99
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Quest 19872 Thromboplastin Time Partial (Ptt)	$65	$42.25	$6.01 – $82.43
Blood clotting test (partial thromboplastin time, PTT): 10 of 99 insurance plan rates AETNA — AETNA: $57.85 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $10.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.36 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $11.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $6.49 AMBETTER — AMBETTER MARKETPLACE: $10.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $31.99 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $31.99

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	$2,589	$1,682.85	$89.13 – $2,459.55
CT scan of the head or brain, without contrast: 10 of 46 insurance plan rates AETNA — AETNA: $2,304.21 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $169.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $175.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	Not listed in the file	$1,682.85	$90.16 – $1,701
CT scan of the head or brain, without contrast: 10 of 36 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $112.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $175.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76 CIGNA — CIGNA: $1,701
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Head/Brain W/O Contrast\|TECHNICAL COMPONENT	$2,589	$1,682.85	$89.13 – $2,459.55
CT scan of the head or brain, without contrast: rates for 7 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $112.38 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $116.25 HIGHMARK WHOLECARE MEDICAID — GATEWAY HEALTH MEDICAID: $89.13 KEYSTONE FIRST — KEYSTONE MEDICAID: $186 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $186 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $186 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $116.25
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	$4,259	$2,768.35	$300.88 – $4,046.05
MRI of the brain, before and after contrast: 10 of 46 insurance plan rates AETNA — AETNA: $1,963 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $491.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $398.07 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $383.63 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $508.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 AMBETTER — AMBETTER MARKETPLACE: $671.35 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $376.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $1,016.99
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$315	$204.75	$17.08 – $299.25
Chest X-ray, 2 views: 10 of 100 insurance plan rates AETNA — AETNA: $280.35 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $34.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.30 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $95.69 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $101.32 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $35.46 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $101.32 AMBETTER — AMBETTER MARKETPLACE: $167.46 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $115.69 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $115.69
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC Xr Chest 2 Views\|TECHNICAL COMPONENT	$315	$204.75	$17.08 – $299.25
Chest X-ray, 2 views: 10 of 11 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $21.53 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $22.28 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $93.82 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $94.70 HIGHMARK WHOLECARE MEDICAID — GATEWAY HEALTH MEDICAID: $17.08 KEYSTONE FIRST — KEYSTONE MEDICAID: $35.64 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $35.64 KEYSTONE FIRST CHC MEDICARE ADVANTAGE — KEYSTONE FIRST MEDICARE ADVANTAGE: $96.63 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $35.64 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $22.28
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	$601	$390.65	$36.95 – $570.95
X-ray of the lower spine, at least 4 views: 10 of 100 insurance plan rates AETNA — AETNA: $534.89 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $53.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $54.93 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $170.14 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $170.14
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	Not listed in the file	$390.65	$32.63 – $304.76
X-ray of the lower spine, at least 4 views: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $32.63 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $54.93 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $170.14 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $170.14 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $170.14
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: PR Xr Lumbosacral Spine >= 4 Views\|PROFESSIONAL COMPONENT	$27	$27	$8.09 – $27
X-ray of the lower spine, at least 4 views: 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $12.86 AETNA — AETNA: $27 AETNA DOMESTIC — AETNA: $27 AETNA MEDICAID — AETNA MEDICAID: $20.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.14 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $12.86 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $14.12 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $14.12 ALIGN SENIOR CARE — MEDICARE: $12.86 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $21.18
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$3,297	$2,143.05	$205.78 – $3,132.15
MRI of the lower back (lumbar spine), without contrast: 10 of 46 insurance plan rates AETNA — AETNA: $1,963 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $371.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $262.37 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $384.23 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$2,339	$1,520.35	$99.48 – $2,222.05
CT scan of the pelvis, with contrast: 10 of 46 insurance plan rates AETNA — AETNA: $2,081.71 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $203.13 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $200.13 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $192.87 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $204.22 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $210.14 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $204.22 AMBETTER — AMBETTER MARKETPLACE: $337.53 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $189.09 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $511.30
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Pelvis W/Contrast\|TECHNICAL COMPONENT	$2,339	$1,520.35	$99.48 – $2,222.05
CT scan of the pelvis, with contrast: rates for 7 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $125.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $129.75 HIGHMARK WHOLECARE MEDICAID — GATEWAY HEALTH MEDICAID: $99.48 KEYSTONE FIRST — KEYSTONE MEDICAID: $207.60 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $207.60 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $207.60 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $129.75
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Bl	$4,946	$3,214.90	$205.78 – $4,698.70
MRI of a leg joint (such as the knee), without contrast: 10 of 46 insurance plan rates AETNA — AETNA: $1,963 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $480.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $262.37 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Lt	$3,297	$2,143.05	$205.78 – $3,132.15
MRI of a leg joint (such as the knee), without contrast: 10 of 46 insurance plan rates AETNA — AETNA: $1,963 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $480.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $262.37 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Rt	$3,297	$2,143.05	$205.78 – $3,132.15
MRI of a leg joint (such as the knee), without contrast: 10 of 46 insurance plan rates AETNA — AETNA: $1,963 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $480.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $272.25 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $262.37 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $497.09 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $277.80 AMBETTER — AMBETTER MARKETPLACE: $459.15 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $257.23 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $695.54
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	$4,448	$2,891.20	$221.64 – $4,225.60
CT scan of the abdomen and pelvis, with contrast: 10 of 46 insurance plan rates AETNA — AETNA: $3,958.72 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $381.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $398.07 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $383.63 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $394.74 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 AMBETTER — AMBETTER MARKETPLACE: $671.35 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $376.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $1,016.99
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	Not listed in the file	$3,227.22	$279.46 – $1,701
CT scan of the abdomen and pelvis, with contrast: 10 of 36 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $279.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $398.07 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $383.63 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $394.74 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 AMBETTER — AMBETTER MARKETPLACE: $671.35 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $376.10 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $1,016.99 CIGNA — CIGNA: $1,701
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC CT Abdomen & Pelvis W/Contrast\|TECHNICAL COMPONENT	$4,448	$2,891.20	$221.64 – $4,225.60
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $279.46 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $289.10 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $406.19 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $376.10 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $379.64 HIGHMARK WHOLECARE MEDICAID — GATEWAY HEALTH MEDICAID: $221.64 HIGHMARK WHOLECARE MEDICARE ADVANTAGE — HIGHMARK WHOLECARE MEDICARE ADVANTAGE: $432.52 KEYSTONE FIRST — KEYSTONE MEDICAID: $462.55 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $462.55
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$875	$568.75	$66.13 – $831.25
Ultrasound of the abdomen, complete: 10 of 46 insurance plan rates AETNA — AETNA: $778.75 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $138.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $142.91 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US Abdomen Complete	Not listed in the file	$568.75	$83.38 – $384.60
Ultrasound of the abdomen, complete: 10 of 36 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $83.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $142.91 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 BLUE SHIELD - PA (HIGHMARK) — HIGHMARK HEALTH PLAN: $304.76 CIGNA — CIGNA: $384.60
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC US Abdomen Complete\|TECHNICAL COMPONENT	$875	$568.75	$66.13 – $831.25
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $83.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $86.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $135.25 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $115.52 HEALTH AMERICA ADVANTRA — HEALTH AMERICA MEDICARE ADVANTAGE: $135.25 HEALTH PARTNERS MEDICARE ADVANTAGE — HEALTH PARTNERS MEDICARE ADVANTAGE: $119.47
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$300	$300	$30.03 – $300
Pregnancy ultrasound (after the first trimester): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $137.96 AETNA — AETNA: $300 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $137.96 AETNA MEDICARE TRANSPLANT — MEDICARE: $137.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $77.50 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $77.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $137.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $116.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $152.04 AMBETTER — AMBETTER: $201.03
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$743	$482.95	$76.36 – $705.85
Pregnancy ultrasound (after the first trimester): 10 of 100 insurance plan rates AETNA — AETNA: $661.27 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $112.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $116.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $340.27 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $340.27
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR US Pregnant Uterus >= 14 Weeks Single/1st Gestation	Not listed in the file	$328.54	$30.03 – $328.54
Pregnancy ultrasound (after the first trimester): 10 of 748 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $137.96 AETNA — AETNA: $307.30 AETNA MEDICAID — AETNA MEDICAID: $112.38 AETNA MEDICARE TRANSPLANT — MEDICARE: $137.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $77.50 ALIGN SENIOR CARE — MEDICARE: $137.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $137.96 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $116.25 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $116.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $152.04
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$1,254	$815.10	$53.48 – $1,191.30
Transvaginal ultrasound: 10 of 100 insurance plan rates AETNA — AETNA: $1,116.06 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $110.93 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $114.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 AMBETTER — AMBETTER MARKETPLACE: $201.18 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $316.45 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $316.45
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: PR US Transvaginal Non Obstetric\|PROFESSIONAL COMPONENT	$72	$72	$20.87 – $72
Transvaginal ultrasound: 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $32.75 AETNA — AETNA: $72 AETNA MEDICAID — AETNA MEDICAID: $43.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $36.03 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $32.75 AETNA MEDICARE TRANSPLANT — MEDICARE: $32.75 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $30 ALIGN SENIOR CARE — MEDICARE: $32.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $32.75 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $45
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC US Transvaginal Non Obstetric\|TECHNICAL COMPONENT	$1,254	$815.10	$53.48 – $1,191.30
Transvaginal ultrasound: 10 of 23 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $67.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $119.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $114.96 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $69.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $121.72 BLUE CROSS - PA (INDEPENDENCE) MEDICARE ADVANTAGE — INDEPENDENCE BLUE CROSS MEDICARE ADV: $112.71 CIGNA MEDICARE ADVANTAGE — CIGNA HEALTHSPRING MEDICARE ADVANTAGE: $113.77 COVENTRY MEDICARE ADVANTAGE — COVENTRY ADVANTRA MEDICARE ADVANTAGE: $135.25 DEVOTED HEALTH MEDICARE ADVANTAGE — DEVOTED HEALTH MEDICARE ADVANTAGE: $115.52
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$653	$424.45	$71.81 – $620.35
Diagnostic mammogram, one breast: 10 of 100 insurance plan rates AETNA — AETNA: $581.17 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $148.49 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $91.56 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$653	$424.45	$71.81 – $620.35
Diagnostic mammogram, one breast: 10 of 100 insurance plan rates AETNA — AETNA: $581.17 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $148.49 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $91.56 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	Not listed in the file	$915.85	$71.81 – $255.61
Diagnostic mammogram, one breast: 10 of 86 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $102.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $91.56 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $96.94 AMBETTER — AMBETTER MARKETPLACE: $160.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $210.97
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$805	$523.25	$88.55 – $764.75
Diagnostic mammogram, both breasts: 10 of 100 insurance plan rates AETNA — AETNA: $716.45 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $188.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.92 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $117.49 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $124.41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $194.78 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $124.41 AMBETTER — AMBETTER MARKETPLACE: $205.61 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $268.81 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $268.81
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$806	$523.90	$75.98 – $765.70
Screening mammogram, both breasts: 10 of 100 insurance plan rates AETNA — AETNA: $717.34 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $151.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $96.87 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $157.05 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 AMBETTER — AMBETTER MARKETPLACE: $169.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $204.16 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $204.16
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$806	$523.90	$75.98 – $765.70
Screening mammogram, both breasts: 10 of 100 insurance plan rates AETNA — AETNA: $717.34 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $151.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $100.52 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $96.87 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $157.05 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $102.57 AMBETTER — AMBETTER MARKETPLACE: $169.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $204.16 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $204.16

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$9,930	$6,454.50	$1,125.20 – $10,307.20
Left heart catheterization (diagnostic): 10 of 97 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,699.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,564.88 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,774.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,774.58 AMBETTER — AMBETTER MARKETPLACE: $6,238.54 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $6,805.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $6,805.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $6,805.40
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR Comprehensive Electrophysiologic Evaluation WO Arrhythmia Induction\|PROFESSIONAL COMPONENT	$950	$950	$119.07 – $902.50
Heart rhythm study (electrophysiology evaluation): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $192.39 AETNA MEDICAID — AETNA MEDICAID: $492.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $211.63 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $192.39 AETNA MEDICARE TRANSPLANT — MEDICARE: $192.39 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $339.96 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $339.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $192.39 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $509.94 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $212.02
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR Comprehensive Electrophysiologic Evaluation WO Arrhythmia Induction\|PROFESSIONAL COMPONENT	Not listed in the file	$1,106.67	$119.07 – $1,051.34
Heart rhythm study (electrophysiology evaluation): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $192.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $211.63 AETNA MEDICARE TRANSPLANT — MEDICARE: $192.39 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $339.96 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $339.96 ALIGN SENIOR CARE — MEDICARE: $192.39 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $192.39 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $212.02 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $509.94 ALLY ALIGN CARE ADV — MEDICARE: $192.39
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	$2,675	$2,675	$295.22 – $2,541.25
Heart rhythm study with ablation for atrial fibrillation: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $414.94 AETNA DOMESTIC — AETNA: $1,442.57 AETNA MEDICAID — AETNA MEDICAID: $634.02 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $414.94 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $437.25 ALIGN SENIOR CARE — MEDICARE: $414.94 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $655.88 AMERIGROUP MEDICAID — MEDICAID: $437.25 AMERIHEALTH — AMERIHEALTH: $624.57 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $437.25
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Electrophysiologic Comprehensive Transeptal Atrial Fibrillation	$23,610	$15,346.50	$3,069.30 – $50,720.49
Heart rhythm study with ablation for atrial fibrillation: 10 of 97 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $29,823.65 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $28,741.61 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $30,432.29 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $30,432.29 AMBETTER — AMBETTER MARKETPLACE: $50,297.82 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $6,805.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $6,805.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $6,805.40
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	Not listed in the file	$2,675	$295.22 – $2,440.09
Heart rhythm study with ablation for atrial fibrillation: 10 of 749 insurance plan rates AETNA — AETNA: $1,442.57 AETNA MEDICAID — AETNA MEDICAID: $634.02 AETNA MEDICARE TRANSPLANT — MEDICARE: $414.94 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $437.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $437.25 ALIGN SENIOR CARE — MEDICARE: $414.94 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $655.88 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $655.88 AMERICAN HEALTH PLAN — MEDICARE: $414.94 AMERIGROUP MEDICAID — MEDICAID: $437.25

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$195	$126.75	$9.64 – $358
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 100 insurance plan rates AETNA — AETNA: $173.55 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $12.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $30.70 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $12.57 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $123.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $123.68
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$195	$126.75	$9.64 – $358
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 100 insurance plan rates AETNA — AETNA: $173.55 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $12.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $30.70 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $12.57 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $123.68 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $123.68
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	Not listed in the file	$1,275.95	$19.27 – $358
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $24.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $31.86 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $30.70 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $25.14 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $32.51 AMBETTER — AMBETTER MARKETPLACE: $53.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $247.37 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $247.37 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $247.37
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$578	$375.70	$75.14 – $549.10
Physical therapy evaluation (low complexity): 10 of 97 insurance plan rates AETNA — AETNA: $514.42 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $202.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $103.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $164.91 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $164.91 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $164.91
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$578	$375.70	$41.60 – $549.10
Physical therapy evaluation (moderate complexity): 10 of 97 insurance plan rates AETNA — AETNA: $514.42 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $202.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $103.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $206.14 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $206.14 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $206.14
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$578	$375.70	$75.14 – $549.10
Physical therapy evaluation (high complexity): 10 of 97 insurance plan rates AETNA — AETNA: $514.42 AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $202.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.16 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $103.28 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $109.35 AMBETTER — AMBETTER MARKETPLACE: $180.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $247.37 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $247.37 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $247.37

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$920	$920	$86.50 – $883.50
Removal of breast growth (open surgery): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $209.46 AETNA — AETNA: $434.40 AETNA DOMESTIC — AETNA: $434.40 AETNA MEDICARE TRANSPLANT — MEDICARE: $209.46 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $86.50 ALIGN SENIOR CARE — MEDICARE: $209.46 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $230.84 AMBETTER — AMBETTER: $305.22 AMERIGROUP MEDICAID — MEDICAID: $86.50 AMERIHEALTH — AMERIHEALTH: $235.18
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$930	$930	$86.50 – $1,767
Removal of breast growth (open surgery): 10 of 749 insurance plan rates AETNA DOMESTIC — AETNA: $434.40 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $209.46 AETNA MEDICARE TRANSPLANT — MEDICARE: $209.46 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $86.50 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $129.75 ALLY ALIGN CARE ADV — MEDICARE: $209.46 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $209.46 AMERICAN HEALTH PLAN — MEDICARE: $209.46 AMERIGROUP MEDICAID — MEDICAID: $86.50 AMERIHEALTH — AMERIHEALTH: $235.18
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt	Not listed in the file	$12,209.53	$198.95 – $11,413.73
Removal of breast growth (open surgery): 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,207.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,467.56 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $4,305.47 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,558.74 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,249.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,558.74 AMBETTER — AMBETTER MARKETPLACE: $7,534.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,615.93 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,615.93 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,615.93
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$3,030	$3,030	$414.61 – $2,878.50
Total hip replacement: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $595.42 AETNA — AETNA: $1,497.74 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE TRANSPLANT — MEDICARE: $595.42 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $500 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $500 ALIGN SENIOR CARE — MEDICARE: $595.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $595.42 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement	$2,825	$2,825	$32.54 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,683.75
Total hip replacement: 10 of 749 insurance plan rates AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $654.96 AETNA MEDICARE TRANSPLANT — MEDICARE: $595.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $595.42 AMBETTER — AMBETTER: $867.61 AMERIGROUP MEDICAID — MEDICAID: $500 AMERIHEALTH — AMERIHEALTH: $752.36 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $500 AMERIHEALTH MEDICARE — MEDICARE: $595.42 AMISH MENNONITE — MEDICAID: $500
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH)	Not listed in the file	$54,172.66	$40.25 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $37,425.54
Total hip replacement: 10 of 91 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14,649.11 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $14,117.62 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,948.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,948.07 AMBETTER — AMBETTER MARKETPLACE: $24,705.84 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $4,829.40 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $4,829.40 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $4,829.40
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$3,030	$3,030	$414.07 – $2,878.50
Total knee replacement: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $594.35 AETNA DOMESTIC — AETNA: $1,496.10 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $594.35 AETNA MEDICARE TRANSPLANT — MEDICARE: $594.35 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $500 ALIGN SENIOR CARE — MEDICARE: $594.35 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $594.35 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $655
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing	$2,821	$2,821	$414.07 – $2,679.95
Total knee replacement: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $594.35 AETNA — AETNA: $1,496.10 AETNA DOMESTIC — AETNA: $1,496.10 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $653.78 AETNA MEDICARE TRANSPLANT — MEDICARE: $594.35 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $500 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $500 ALIGN SENIOR CARE — MEDICARE: $594.35 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $594.35
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH)	Not listed in the file	$38,707.92	$28.22 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $37,425.54
Total knee replacement: 10 of 91 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14,649.11 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $14,117.62 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,948.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $14,948.07 AMBETTER — AMBETTER MARKETPLACE: $24,705.84 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $4,225.73 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $4,225.73 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $4,225.73
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty	$890	$890	$109.70 – $890
Shoulder arthroscopy: shaving of shoulder bone: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $151.29 AETNA MEDICAID — AETNA MEDICAID: $788.08 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $166.42 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $151.29 AETNA MEDICARE TRANSPLANT — MEDICARE: $151.29 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $543.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $151.29 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $815.25 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $166.73 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $815.25
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty	$370	$370	$109.70 – $370
Shoulder arthroscopy: shaving of shoulder bone: 10 of 749 insurance plan rates AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $151.29 AETNA MEDICARE TRANSPLANT — MEDICARE: $151.29 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $370 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $370 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $151.29 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $370 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $166.73 ALLY ALIGN CARE ADV — MEDICARE: $151.29 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $151.29 AMERICAN HEALTH PLAN — MEDICARE: $151.29
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH)	Not listed in the file	$29,252.79	$625.03 – $21,152.31
Shoulder arthroscopy: shaving of shoulder bone: 10 of 90 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8,279.44 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $7,979.05 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8,448.41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $8,448.41 AMBETTER — AMBETTER MARKETPLACE: $13,963.34 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,722.16 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,722.16 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,722.16
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,215	$1,215	$177.22 – $1,159
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 749 insurance plan rates ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $271.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $264.14 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $407.63 ALLY ALIGN CARE ADV — MEDICARE: $264.14 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $264.14 AMERIHEALTH MEDICARE — MEDICARE: $264.14 ANTHEM MYCARE OHIO — MEDICARE: $264.14 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $271.75 AURORA SPECIAL NEEDS — MEDICARE: $264.14 AVMED MEDICARE — MEDICARE: $264.14
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage	$1,220	$1,220	$14.05 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,159
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 749 insurance plan rates AETNA — AETNA: $636.67 AETNA DOMESTIC — AETNA: $636.67 AETNA MEDICAID — AETNA MEDICAID: $394.04 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $290.55 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $264.14 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $271.75 ALIGN SENIOR CARE — MEDICARE: $264.14 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $264.14 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $291.09 ALLY ALIGN CARE ADV — MEDICARE: $264.14
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH)	Not listed in the file	$14,766.23	$625.03 – $9,538.08
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,351.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,733.40 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,597.94 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,809.59 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,398 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,809.59 AMBETTER — AMBETTER MARKETPLACE: $6,296.40 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,765 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,765 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,765
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$285	$285	$38.88 – $270.75
Upper GI endoscopy (diagnostic): 10 of 749 insurance plan rates AETNA — AETNA: $143.29 AETNA MEDICARE TRANSPLANT — MEDICARE: $56.23 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $62.61 ALIGN SENIOR CARE — MEDICARE: $56.23 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $56.23 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $61.96 ALLY ALIGN CARE ADV — MEDICARE: $56.23 AMERIGROUP MEDICAID — MEDICAID: $62.61 AMERIHEALTH — AMERIHEALTH: $80.89
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$267	$267	$38.88 – $253.65
Upper GI endoscopy (diagnostic): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $56.23 AETNA — AETNA: $143.29 AETNA DOMESTIC — AETNA: $143.29 AETNA MEDICAID — AETNA MEDICAID: $90.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $61.85 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $62.61 ALIGN SENIOR CARE — MEDICARE: $56.23 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $93.92 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $61.96 AMBETTER — AMBETTER: $81.93
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	Not listed in the file	$3,492.64	$144 – $2,581
Upper GI endoscopy (diagnostic): rates for 9 insurance plans AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $414.70 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $429 HIGHMARK WHOLECARE MEDICAID — GATEWAY HEALTH MEDICAID: $144 JEFFERSON HEALTH PLANS MEDICAID — HEALTH PARTNERS MEDICAID: $782.22 KEYSTONE FIRST — KEYSTONE MEDICAID: $2,581 KEYSTONE FIRST CHC MEDICAID — KEYSTONE MEDICAID: $2,581 KEYSTONE FIRST CHIP — KEYSTONE MEDICAID: $2,581 UNITED HEALTHCARE MEDICAID — UHC COMMUNITY PLAN MEDICAID: $1,958.40 UPMC MEDICAID ADVANTAGE — UPMC HEALTH PLAN MEDICAID: $429
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	Not listed in the file	$4,619.80	$39.10 – $5,593.73
Upper GI endoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,189.50 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2,110.06 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2,234.18 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $51 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2,234.18 AMBETTER — AMBETTER MARKETPLACE: $3,692.61 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROC	Not listed in the file	$3,256.76	$39.10 – $5,593.73
Upper GI endoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,034.88 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $997.34 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,056 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $103.02 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,056 AMBETTER — AMBETTER MARKETPLACE: $1,745.34 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$475	$475	$58.36 – $451.25
Colonoscopy (diagnostic): 10 of 749 insurance plan rates AETNA — AETNA: $215.36 AETNA MEDICAID — AETNA MEDICAID: $130.87 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $83.82 AETNA MEDICARE TRANSPLANT — MEDICARE: $83.82 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.25 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.38 AMBETTER — AMBETTER: $122.14 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $83.82 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $90.25 AMISH MENNONITE — MEDICAID: $90.25
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	Not listed in the file	$475	$58.36 – $451.25
Colonoscopy (diagnostic): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $83.82 AETNA — AETNA: $215.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $83.82 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $90.25 ALIGN SENIOR CARE — MEDICARE: $83.82 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.38 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $135.38 AMERICAN HEALTH PLAN — MEDICARE: $83.82
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	Not listed in the file	$2,810.37	$207.58 – $4,966.89
Colonoscopy (diagnostic): 10 of 87 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,061.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $1,022.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,082.75 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,082.75 AMBETTER — AMBETTER MARKETPLACE: $1,789.54 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AR — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$560	$560	$63.48 – $532
Colonoscopy with biopsy: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $90.38 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $90.38 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $112.71 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLY ALIGN CARE ADV — MEDICARE: $90.38 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $90.38 AMERICAN HEALTH PLAN — MEDICARE: $90.38 ANTHEM MYCARE OHIO — MEDICARE: $90.38 AURORA SPECIAL NEEDS — MEDICARE: $90.38
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	Not listed in the file	$560	$63.48 – $635.47
Colonoscopy with biopsy: 10 of 749 insurance plan rates AETNA — AETNA: $233.55 AETNA MEDICAID — AETNA MEDICAID: $163.43 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.42 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $90.38 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $112.71 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $112.71 ALIGN SENIOR CARE — MEDICARE: $90.38 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $169.07 ALLY ALIGN CARE ADV — MEDICARE: $90.38 AMBETTER — AMBETTER: $131.69
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	Not listed in the file	$4,180.57	$78.20 – $4,966.89
Colonoscopy with biopsy: 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,365.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $1,315.85 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,393.25 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $102 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,393.25 AMBETTER — AMBETTER MARKETPLACE: $2,302.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$660	$660	$79.98 – $627
Colonoscopy with removal of polyps (snare): 10 of 749 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $124.93 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $134.04 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $134.04 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $125.16 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $113.57 AMERIGROUP MEDICAID — MEDICAID: $134.04 AMERIHEALTH — AMERIHEALTH: $167.10 ANDRIE INC — WORKERS COMP: $130.96 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $134.04
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$551	$551	$79.98 – $523.45
Colonoscopy with removal of polyps (snare): 10 of 749 insurance plan rates AETNA — AETNA: $296.90 AETNA DOMESTIC — AETNA: $296.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $124.93 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $134.04 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $134.04 ALIGN SENIOR CARE — MEDICARE: $113.57 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $125.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $201.06 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $125.16
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)	Not listed in the file	$4,153.01	$117.30 – $4,966.89
Colonoscopy with removal of polyps (snare): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,365.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $1,315.85 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,393.25 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $153 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,393.25 AMBETTER — AMBETTER MARKETPLACE: $2,302.73 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	$470	$470	$58.47 – $446.50
Screening colonoscopy (not high risk): 10 of 490 insurance plan rates AETNA — AETNA: $231.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.01 ALIGN SENIOR CARE — MEDICARE: $84.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.01 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $235 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59 AMBETTER — AMBETTER: $122.42 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $84.01 AMERICAN HEALTH PLAN — MEDICARE: $84.01
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	Not listed in the file	$582.81	$58.47 – $553.67
Screening colonoscopy (not high risk): 10 of 490 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $84.01 AETNA — AETNA: $231.39 AETNA DOMESTIC — AETNA: $231.39 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $84.01 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.01 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $291.41 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $92.59
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	Not listed in the file	$4,892.58	$78.98 – $4,966.89
Screening colonoscopy (not high risk): 10 of 90 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,061.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $1,022.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,082.75 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $103.02 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,082.75 AMBETTER — AMBETTER MARKETPLACE: $1,789.54 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,460	$1,460	$213.64 – $1,387
Gallbladder removal by laparoscope: 10 of 749 insurance plan rates AETNA DOMESTIC — AETNA: $796.46 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $324.96 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $358.11 ALLY ALIGN CARE ADV — MEDICARE: $324.96 AMBETTER — AMBETTER: $473.51 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $324.96 AMERIGROUP MEDICAID — MEDICAID: $294.68 AMERIHEALTH — AMERIHEALTH: $373.06 AMERIHEALTH MEDICARE — MEDICARE: $324.96 AMISH MENNONITE — MEDICAID: $294.68
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,451	$1,451	$16.72 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,378.45
Gallbladder removal by laparoscope: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $324.96 AETNA DOMESTIC — AETNA: $796.46 AETNA MEDICAID — AETNA MEDICAID: $427.28 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $357.45 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $324.96 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $294.68 ALIGN SENIOR CARE — MEDICARE: $324.96 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $442.02 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $358.11 AMBETTER — AMBETTER: $473.51
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH)	Not listed in the file	$27,105.98	$19.01 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $17,623.08
Gallbladder removal by laparoscope: 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,898.03 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $6,647.76 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $7,038.80 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $7,038.80 AMBETTER — AMBETTER MARKETPLACE: $11,633.58 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $4,857 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $4,857 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $4,857
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,155	$1,155	$158.75 – $1,099.15
Groin (inguinal) hernia repair, age 5 or older: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $261.12 AETNA MEDICAID — AETNA MEDICAID: $230.19 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $287.24 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $158.75 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $158.75 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLY ALIGN CARE ADV — MEDICARE: $261.12
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,157	$1,157	$13.33 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,099.15
Groin (inguinal) hernia repair, age 5 or older: 10 of 749 insurance plan rates AETNA — AETNA: $631.60 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $261.12 AETNA MEDICARE TRANSPLANT — MEDICARE: $261.12 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $158.75 ALIGN SENIOR CARE — MEDICARE: $261.12 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $261.12 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $238.13 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $287.77 ALLY ALIGN CARE ADV — MEDICARE: $261.12 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $261.12
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH)	Not listed in the file	$28,756.52	$365.13 – $10,437.09
Groin (inguinal) hernia repair, age 5 or older: 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,168.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,085.29 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,937.07 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,168.66 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,209 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,168.66 AMBETTER — AMBETTER MARKETPLACE: $6,889.87 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $3,440 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $3,440 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $3,440
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$325	$325	$26.67 – $308.75
Prostate biopsy: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $162.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $162.50 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $162.50 AETNA MEDICARE TRANSPLANT — MEDICARE: $162.50 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $44.75 ALIGN SENIOR CARE — MEDICARE: $162.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $162.50 ALLY ALIGN CARE ADV — MEDICARE: $162.50 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $162.50
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Biopsy Prostate Needle/Punch Single/Multiple Any Approach	Not listed in the file	$325	$26.67 – $308.75
Prostate biopsy: 10 of 749 insurance plan rates AETNA — AETNA: $127.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $162.50 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $162.50 AETNA MEDICARE TRANSPLANT — MEDICARE: $162.50 ALIGN SENIOR CARE — MEDICARE: $162.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $162.50 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $67.13 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $162.50 AMERICAN HEALTH PLAN — MEDICARE: $162.50 AMERIGROUP MEDICAID — MEDICAID: $44.75
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	Not listed in the file	$12,005.31	$102.93 – $10,275.53
Prostate biopsy: 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,022.05 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,876.13 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,104.13 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $4,104.13 AMBETTER — AMBETTER MARKETPLACE: $6,783.22 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,213.48
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst	$3,965	$3,965	$380.85 – $3,766.75
Prostate removal by laparoscope (radical prostatectomy): 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $550.45 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $605.49 AETNA MEDICARE TRANSPLANT — MEDICARE: $550.45 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $606.62 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $606.62 AMBETTER — AMBETTER: $802.08 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $550.45 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $500
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst	$2,557	$2,557	$380.85 – $2,429.15
Prostate removal by laparoscope (radical prostatectomy): 10 of 749 insurance plan rates AETNA DOMESTIC — AETNA: $1,414.99 AETNA MEDICAID — AETNA MEDICAID: $725 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $550.45 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $750 AMBETTER — AMBETTER: $802.08 AMERIGROUP MEDICAID — MEDICAID: $500 AMERIHEALTH — AMERIHEALTH: $791.34 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $500 AMERIHEALTH MEDICARE — MEDICARE: $550.45 AMISH MENNONITE — MEDICAID: $500
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst	Not listed in the file	$44,962.60	$104.65 – $30,986.61
Prostate removal by laparoscope (radical prostatectomy): 10 of 91 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,128.78 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $11,688.74 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $12,376.31 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $12,376.31 AMBETTER — AMBETTER MARKETPLACE: $20,455.29 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $3,219.60 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $3,219.60 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $3,219.60
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$660	$660	$73.91 – $627
Hysteroscopy with biopsy of the uterus lining: 10 of 753 insurance plan rates AETNA DOMESTIC — AETNA: $229.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $114.98 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $119.39 ALIGN SENIOR CARE — MEDICARE: $104.53 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $104.53 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $179.08 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $179.08 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $115.20 ALLY ALIGN CARE ADV — MEDICARE: $104.53 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $104.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$498	$498	$5.74 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $473.10
Hysteroscopy with biopsy of the uterus lining: 10 of 753 insurance plan rates AETNA DOMESTIC — AETNA: $229.75 AETNA MEDICAID — AETNA MEDICAID: $173.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $114.98 AETNA MEDICARE TRANSPLANT — MEDICARE: $104.53 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $115.20 AMBETTER — AMBETTER: $152.31 AMERICAN HEALTH PLAN — MEDICARE: $104.53 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $119.39 ANTHEM MYCARE OHIO — MEDICARE: $104.53 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $119.39
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	Not listed in the file	$15,329	$274.59 – $9,436.42
Hysteroscopy with biopsy of the uterus lining: 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $1,125.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,693.60 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $3,559.60 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,768.98 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $1,164 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $3,768.98 AMBETTER — AMBETTER MARKETPLACE: $6,229.29 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $2,615.93 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $2,615.93 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $2,615.93
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Injection(S) Epidural Lumbar Needle Placement W/Guidance	$240	$240	$31.63 – $228
Spinal injection, lower back (epidural), with imaging guidance: 10 of 749 insurance plan rates AETNA — AETNA: $111.07 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $49.78 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $45.25 AETNA MEDICARE TRANSPLANT — MEDICARE: $45.25 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $40.66 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $45.25 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $60.99 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $49.87 ALLY ALIGN CARE ADV — MEDICARE: $45.25 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $45.25
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Injection(S) Epidural Lumbar Needle Placement W/Guidance	$213	$213	$31.63 – $202.35
Spinal injection, lower back (epidural), with imaging guidance: 10 of 749 insurance plan rates AETNA — AETNA: $111.07 AETNA DOMESTIC — AETNA: $111.07 AETNA MEDICAID — AETNA MEDICAID: $58.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $49.78 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $45.25 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $40.66 ALIGN SENIOR CARE — MEDICARE: $45.25 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $45.25 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $60.99 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $60.99
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance	$2,515	$1,634.75	$93.52 – $3,782
Spinal injection, lower back (epidural), with imaging guidance: 10 of 98 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $117.91 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $805.42 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $776.20 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $821.86 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $121.98 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $821.86 AMBETTER — AMBETTER MARKETPLACE: $1,358.35 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,207.35 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,207.35 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,207.35
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Doctor (professional) fee In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$255	$255	$25.81 – $484.50
Nerve root injection, lower back, with imaging guidance: 10 of 749 insurance plan rates AETNA DOMESTIC — AETNA: $124.59 AETNA MEDICAID — AETNA MEDICAID: $68.91 AETNA MEDICARE TRANSPLANT — MEDICARE: $50.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $47.52 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $50.50 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $71.28 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $71.28 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $55.65 ALLY ALIGN CARE ADV — MEDICARE: $50.50 AMBETTER — AMBETTER: $73.59
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt	$3,212	$2,087.80	$109.30 – $3,782
Nerve root injection, lower back, with imaging guidance: 10 of 98 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $137.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,009.20 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $972.58 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,029.79 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $142.56 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $1,029.79 AMBETTER — AMBETTER MARKETPLACE: $1,702.02 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,207.35 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,207.35 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,207.35
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	Not listed in the file	$255	$25.81 – $583.41
Nerve root injection, lower back, with imaging guidance: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $50.50 AETNA — AETNA: $124.59 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $47.52 ALIGN SENIOR CARE — MEDICARE: $50.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $50.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $55.65 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $55.65 ALLY ALIGN CARE ADV — MEDICARE: $50.50 AMERICAN HEALTH PLAN — MEDICARE: $50.50 AMERIGROUP MEDICAID — MEDICAID: $47.52
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$960	$960	$122.01 – $912
Carpal tunnel release: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $216.50 AETNA — AETNA: $502.39 AETNA MEDICARE TRANSPLANT — MEDICARE: $216.50 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $150 ALIGN SENIOR CARE — MEDICARE: $216.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $216.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $238.60 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $225 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $238.60 ALLY ALIGN CARE ADV — MEDICARE: $216.50
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$995	$995	$122.01 – $945.25
Carpal tunnel release: 10 of 749 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $216.50 AETNA — AETNA: $502.39 AETNA DOMESTIC — AETNA: $502.39 AETNA MEDICAID — AETNA MEDICAID: $217.50 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $216.50 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $225 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $238.60 AMBETTER — AMBETTER: $315.48 AMERICAN HEALTH PLAN — MEDICARE: $216.50 AMERIHEALTH MEDICARE — MEDICARE: $216.50
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Neuroplasty Median Nerve Carpal Rt	Not listed in the file	$9,968.07	$345 – $5,692.31
Carpal tunnel release: 10 of 92 insurance plan rates AETNA MEDICAID — AETNA BETTER HEALTH MEDICAID: $962.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,228.09 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $2,147.25 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2,273.56 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH AND WELLNESS MEDICAID: $996 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $2,273.56 AMBETTER — AMBETTER MARKETPLACE: $3,757.68 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $1,780 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $1,780 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $1,780

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	$5,130	$5,130	$893 – $4,873.50
Vaginal delivery, with care before and after: 10 of 753 insurance plan rates AETNA — AETNA: $2,572.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,255.85 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,141.68 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $893 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $893 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,339.50 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,339.50 AMBETTER — AMBETTER: $1,663.59 ANDRIE INC — WORKERS COMP: $1,316.43 ANTHEM MYCARE OHIO — MEDICARE: $1,141.68
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	$5,277	$5,277	$893 – $5,013.15
Vaginal delivery, with care before and after: 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,141.68 AETNA — AETNA: $2,572.79 AETNA DOMESTIC — AETNA: $2,572.79 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $893 ALIGN SENIOR CARE — MEDICARE: $1,141.68 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,339.50 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $1,141.68 AMERICAN HEALTH PLAN — MEDICARE: $1,141.68 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $893 AURORA SPECIAL NEEDS — MEDICARE: $1,141.68
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	$5,715	$5,715	$893 – $5,429.25
Cesarean delivery (C-section), with care before and after: 10 of 753 insurance plan rates AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,278.69 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,278.69 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $893 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $893 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,278.69 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,339.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $1,409.16 ALLY ALIGN CARE ADV — MEDICARE: $1,278.69 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $1,278.69 AMERIGROUP MEDICAID — MEDICAID: $893
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	$5,860	$5,860	$893 – $5,567
Cesarean delivery (C-section), with care before and after: 10 of 753 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,278.69 AETNA DOMESTIC — AETNA: $2,844.78 AETNA MEDICAID — AETNA MEDICAID: $1,294.85 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $893 ALIGN SENIOR CARE — MEDICARE: $1,278.69 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,339.50 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $1,409.16 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $1,339.50 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $1,409.16 ALLY ALIGN CARE ADV — MEDICARE: $1,278.69
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · Doctor (professional) fee · modifier 80 In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care\|ASSISTANT SURGEON	$937.60	$937.60	$37.48 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $937.60
Cesarean delivery (C-section), with care before and after: 10 of 753 insurance plan rates AETNA — AETNA: $455.16 AETNA DOMESTIC — AETNA: $455.16 AETNA MEDICAID — AETNA MEDICAID: $258.97 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $225.05 AMBETTER — AMBETTER: $298.12 AMERIHEALTH — AMERIHEALTH: $297.01 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $178.60 AMERIHEALTH MEDICARE — MEDICARE: $204.59 AMISH MENNONITE — MEDICAID: $178.60 AVMED MEDICARE — MEDICARE: $204.59
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	$5,400	$5,400	$675 – $5,130
Vaginal delivery after a previous C-section, with care before and after: 10 of 491 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,205.25 AETNA — AETNA: $2,694.41 AETNA MEDICAID — AETNA MEDICAID: $2,700 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,325.78 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,205.25 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,205.25 ALIGN SENIOR CARE — MEDICARE: $1,205.25 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,205.25 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $2,700 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $1,328.24
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	Not listed in the file	$5,936.96	$742.12 – $5,640.11
Vaginal delivery after a previous C-section, with care before and after: 10 of 491 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,205.25 AETNA — AETNA: $2,694.41 AETNA DOMESTIC — AETNA: $2,694.41 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,325.78 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,205.25 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,205.25 ALIGN SENIOR CARE — MEDICARE: $1,205.25 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,205.25 ALLWELL MEDICAID ADVANTAGE — PA HEALTH & WELLNESS MEDICAID: $2,968.48 ALLWELL MEDICARE ADVANTAGE — WELLCARE MEDICARE ADVANTAGE: $1,328.24

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	$172,676	$68,611.82 – $220,328.22
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 86 insurance plan rates AETNA — AETNA: $220,328.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $80,687.49 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $77,760.06 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $82,334.18 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $82,334.18 AMBETTER — AMBETTER MARKETPLACE: $136,080.10 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $150,459.80 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $150,459.80 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $150,459.80 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $150,459.80
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	$50,068.45	$13,816.24 – $43,442.69
Hip or knee replacement (major joint of the leg), without major complications: 10 of 86 insurance plan rates AETNA — AETNA: $43,442.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16,247.90 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $15,658.41 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $16,579.49 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $16,579.49 AMBETTER — AMBETTER MARKETPLACE: $27,402.21 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $30,023.84 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $30,023.84 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $30,023.84 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $30,023.84
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	$67,779.71	$17,391.19 – $57,017.87
Neck (cervical) spinal fusion, without complications: 10 of 84 insurance plan rates AETNA — AETNA: $54,982.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $20,452.03 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $19,710.01 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $20,869.42 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $20,869.42 AMBETTER — AMBETTER MARKETPLACE: $34,492.52 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $39,609.49 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $39,609.49 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $39,609.49 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $39,609.49
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	$27,834.34	$3,796 – $27,943.05
Uterus and ovary surgery (not for cancer), without complications: 10 of 86 insurance plan rates AETNA — AETNA: $27,943.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10,601.38 ALIGN SENIOR CARE — ALLY ALIGN HEALTH: $10,216.75 ALLWELL MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $10,817.73 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — PA HEALTH & WELLNESS MEDICARE ADVANTAGE: $10,817.73 AMBETTER — AMBETTER MARKETPLACE: $17,879.31 AMERIHEALTH — INDEPENDENCE BLUE CROSS HMO/PPO: $7,147 BCBS GENERIC — INDEPENDENCE BLUE CROSS HMO/PPO: $7,147 BLUE CROSS - AK (PREMERA) — INDEPENDENCE BLUE CROSS HMO/PPO: $7,147 BLUE CROSS - AL — INDEPENDENCE BLUE CROSS HMO/PPO: $7,147

Source: St Mary Rehabilitation Hospital’s standard charges file (hpt.trinity-health.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Inpatient Rehabilitation Hospital
Address	1208 Langhorne-Newtown Road, Langhorne, PA 19047
County	Bucks County
State	Pennsylvania
Phone	(267) 688‑0711
Ownership	Proprietary
CMS Certification Number	393055
Name in Medicare records	ST MARY REHABILITATION HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(267) 560‑1112^[4]
Official website	trinityhealthma.org
Corrections	Report an error or suggest an update →

Sources

Inpatient Rehabilitation Facility - General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-08-12, retrieved 2026-10-29
Medicare Care Compare — official Medicare tool to look up and compare this type of hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

St. Mary Rehabilitation Hospital — trinityhealthma.org
SMRH Specialty Units | Trinity Health Mid-Atlantic — trinityhealthma.org
What to Expect During Your Stay | Trinity Health Mid-Atlantic — trinityhealthma.org

St Mary Rehabilitation Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas^[4]

Conditions treated^[4]

Treatments^[4][5]

Programs and centers^[4][5]

Visiting and practical information

Nearest emergency rooms

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Hospice providers

Home health agencies

Dialysis facilities

Outpatient surgery centers nearby

Community care nearby

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

St Mary Rehabilitation Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas[4]

Conditions treated[4]

Treatments[4][5]

Programs and centers[4][5]

Visiting and practical information

Nearest emergency rooms

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Hospice providers

Home health agencies

Dialysis facilities

Outpatient surgery centers nearby

Community care nearby

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

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

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Pregnancy and childbirth

Hospital stays (whole stay, MS-DRG)

Hospital information

Sources

From the hospital’s website

Specialties and care areas^[4]

Conditions treated^[4]

Treatments^[4][5]

Programs and centers^[4][5]