Does Trinity Health Muskegon Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Trinity Health Muskegon Hospital. In a medical emergency, call 911.

Where is Trinity Health Muskegon Hospital?

1500 E Sherman Blvd, Muskegon, MI 49441, in Muskegon County, Michigan.

What is the phone number of Trinity Health Muskegon Hospital?

(231) 726-3511, as listed by Medicare (CMS).

What is the Medicare star rating of Trinity Health Muskegon Hospital?

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

Trinity Health Muskegon Hospital

Quick answers

Does Trinity Health Muskegon Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Trinity Health Muskegon Hospital. In a medical emergency, call 911.
Where is Trinity Health Muskegon Hospital?: 1500 E Sherman Blvd, Muskegon, MI 49441, in Muskegon County, Michigan.
What is the phone number of Trinity Health Muskegon Hospital?: (231) 726-3511, as listed by Medicare (CMS).
What is the Medicare star rating of Trinity Health Muskegon Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Programs and centers^[6][7]

Behavioral Health Crisis Center
Trauma Survivors Network
SafERteens
SBIRT (screening and brief intervention for substance use)
Stop the Bleed classes

Emergency care (hospital website)^{[4][5][6][7][8]}

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level II
Stroke designation	Certified Primary Stroke Center

Recognition^[5][8]

Ranked #1 in Michigan for Vascular Surgery by Healthgrades 2026
Healthgrades Vascular Surgery Excellence Award 2026
Certified Primary Stroke Center
American College of Surgeons Commission on Cancer Quality Program and National Accreditation Program for Breast Centers

Doctors and clinicians (845)

845 doctors and other clinicians list Trinity Health Muskegon Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 821 more: the button below opens the full list.

Other emergency rooms nearby

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

Trinity Health Grand Haven Hospital11 mi · Grand Haven, MI · Acute Care Hospital
Corewell Health Gerber Hospital22 mi · Fremont, MI · Critical Access Hospital
Corewell Health Zeeland Hospital29 mi · Zeeland, MI · Acute Care Hospital
Mercy Health Lakeshore Campus29 mi · Shelby, MI · Critical Access Hospital
Holland Hospital30 mi · Holland, MI · Acute Care Hospital

Other hospitals nearby

Spectrum Health32 mi · Grand Rapids, MI · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Lake Woods Nursing & Rehabilitation Center1.2 mi · Muskegon, MI · 3 of 5 stars
Christian Care Nursing Center1.4 mi · Muskegon, MI · 3 of 5 stars
Harbor Terrace Senior Living2.9 mi · Muskegon, MI · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Harbor Hospice4.3 mi · Muskegon, MI · 5 of 5 stars
Trinity Health at Home - Grand Haven14 mi · Grand Haven, MI · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Trinity Health at Home - Muskegon4.5 mi · Muskegon, MI · 4 of 5 stars
Community Home Health Care of West Michigan, Inc7.4 mi · Muskegon, MI

All home health agencies in the state →

Dialysis facilities

DaVita Muskegon Dialysis2.0 mi · Muskegon, MI · 3 of 5 stars
DaVita Norton Shores Dialysis4.3 mi · Norton Shores, MI · 4 of 5 stars
RFMC West Norton - Muskegon4.3 mi · Muskegon, MI · 4 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.

Muskegon Surgery Center2.0 mi · Muskegon, MI
Muskegon Surgical Associates Surgicenter, PLLC2.0 mi · Muskegon, MI
Shoreline ASC, Inc.2.0 mi · Muskegon, MI

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Muskegon Family Care1.0 mi · Muskegon, MI · Community health center
Oakview Elementary School1.6 mi · Muskegon, MI · Community health center
Hackley Community Care Baker Site1.7 mi · Muskegon, MI · Community health center

Clinics and urgent care

Hackley Hospital2.0 mi · Muskegon, MI · Urgent care center
Mercy Urgent Care2.0 mi · Muskegon, MI · Urgent care center
Lakeshore Medical Center13 mi · Whitehall, MI · Urgent care center

Pharmacies

Cancer & Hematology Centers of Western Mi, P.C.2.0 mi · Norton Shores, MI · Community/retail pharmacy
Costco Wholesale Corporation2.0 mi · Muskegon, MI · Community/retail pharmacy
Hackley Healthcare Equipment2.0 mi · Muskegon, MI · Community/retail pharmacy

Assisted living nearby

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

Amanda CLF2.0 mi · Muskegon, MI
Baker Haven Home2.0 mi · Muskegon Heights, MI
Beacon Home at Morton Terrace2.0 mi · Norton Shores, MI
Black Creek Cove2.0 mi · Muskegon, MI

About the Medicare star rating

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

Medicare quality data

What Trinity Health Muskegon Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	62%National average: 72%
Would definitely recommend the hospital	62%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	86%National average: 86%
Room and bathroom “always” clean	59%National average: 74%
Area around the room “always” quiet at night	49%National average: 60%
Completed surveys	662Response rate: 24%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.34No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	1.094No different from the national benchmark
Surgical site infections after colon surgery	0.665No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	1.244No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.314Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	11.4%
Deaths within 30 days: heart failure patients	13.5%
Deaths within 30 days: pneumonia patients	13.3%
Deaths within 30 days: COPD patients	7.4%
Deaths within 30 days: stroke patients	11.4%
Deaths within 30 days: coronary bypass surgery (CABG)	2.9%
Serious complications (patient safety indicator PSI-90)	0.85No different from the national rate
Complications after hip or knee replacement	4.4%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	13.4%
Readmitted within 30 days: heart failure	17.9%
Readmitted within 30 days: pneumonia	14.4%
Readmitted within 30 days: COPD	17.8%
Readmitted within 30 days: coronary bypass surgery	9.1%
Readmitted within 30 days: hip or knee replacement	5.3%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	220 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	64%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Michigan Best hospitals in Michigan

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 80 common services exactly as Trinity Health Muskegon 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 →

$ 6 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$194	Not listed in the file	$55.95 – $144.60
New patient office visit (about 30–44 minutes): 10 of 760 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $81.54 ACCESS HEALTH — ACCESS HEALTH: $67.65 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $59.19 AETNA — AETNA: $91.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $59.19 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $59.19 AETNA MEDICARE TRANSPLANT — MEDICARE: $59.19 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $62.90 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $59.19 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $62.90
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	$194	Not listed in the file	$57.90 – $175.38
New patient office visit (about 30–44 minutes): 10 of 760 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $152.75 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $110.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $113.15 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $152.75 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $110.89 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $112.57 AMERIGROUP MEDICAID — MEDICAID: $74.98 ANTHEM MYCARE OHIO — MEDICARE: $110.89 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $74.98 ASR HEALTH BENEFITS — ASR: $133.60
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	$194	Not listed in the file	$77.56 – $116.89
New patient office visit (about 30–44 minutes): 10 of 85 insurance plan rates ACCLAIM — COFINITY: $112.52 ADMINISTRATIVE CONCEPTS — COFINITY: $112.52 ALLEGEANT — COFINITY: $112.52 ALLIED BENEFIT SYSTEMS — COFINITY: $112.52 AMERIBEN — COFINITY: $112.52 AMERICAN FAMILY — COFINITY: $112.52 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $112.52 AMERICAN NATIONAL — COFINITY: $112.52 AMERICAN REPUBLIC — COFINITY: $112.52 AMERIHEALTH — COFINITY: $112.52
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	$296	Not listed in the file	$74.55 – $205.83
New patient office visit (about 45–59 minutes): 10 of 758 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $113.70 AETNA — AETNA: $173.27 AETNA DOMESTIC — AETNA: $173.27 AETNA MEDICAID — MEDICAID: $74.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.70 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $113.70 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $113.70 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $74.55 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $113.70 ALLY ALIGN CARE ADV — MEDICARE: $113.70
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	$296	Not listed in the file	$94.06 – $225.58
New patient office visit (about 45–59 minutes): 10 of 758 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $196.47 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $142.63 AETNA DOMESTIC — AETNA: $182.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $142.63 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $142.63 AETNA MEDICARE TRANSPLANT — MEDICARE: $142.63 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $113.10 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $196.47 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $142.63 ALLY ALIGN CARE ADV — MEDICARE: $142.63
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$296	Not listed in the file	$110.80 – $178.98
New patient office visit (about 45–59 minutes): 10 of 86 insurance plan rates ACCLAIM — COFINITY: $171.68 ADMINISTRATIVE CONCEPTS — COFINITY: $171.68 ALLEGEANT — COFINITY: $171.68 ALLIED BENEFIT SYSTEMS — COFINITY: $171.68 AMERIBEN — COFINITY: $171.68 AMERICAN FAMILY — COFINITY: $171.68 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $171.68 AMERICAN NATIONAL — COFINITY: $171.68 AMERICAN REPUBLIC — COFINITY: $171.68 AMERIHEALTH — COFINITY: $171.68
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$374	Not listed in the file	$115 – $354.92
New patient office visit (about 60–74 minutes): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $309.12 ACCLAIM — COFINITY: $216.92 ADMINISTRATIVE CONCEPTS — COFINITY: $216.92 AETNA — AETNA: $283 AETNA MEDICAID — MEDICAID: $151.02 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $151.02 ALLEGEANT — COFINITY: $216.92 ALLIED BENEFIT SYSTEMS — COFINITY: $216.92 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $309.12 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $151.02
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$142	Not listed in the file	$49.86 – $120.34
Established patient office visit (about 20–29 minutes): 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $86.96 AETNA DOMESTIC — AETNA: $98.24 AETNA MEDICAID — MEDICAID: $83.77 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $83.77 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $104.81 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $83.77 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $83.77 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $82.36 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $83.77 AMERIHEALTH MEDICARE — MEDICARE: $76.09
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	$256.10	$39.82 – $690.23
Established patient office visit (about 20–29 minutes): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $39.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $55.74 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $56.88 BCBS GENERIC — BCBS TRAD / TRUST: $690.23 BCN DOMESTIC — BCN HMO: $690.23 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $690.23 BLUE CARE NETWORK — BCN HMO: $690.23 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $55.74 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $690.23 BLUE CROSS - AL — BCBS TRAD / TRUST: $690.23
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	$205	Not listed in the file	$110.58 – $202.12
Established patient office visit (about 30–39 minutes): 10 of 484 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $176.04 ACCESS HEALTH — ACCESS HEALTH: $146.05 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $127.79 AETNA — AETNA: $163.74 AETNA DOMESTIC — AETNA: $163.74 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $127.79 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $127.79 AETNA MEDICARE TRANSPLANT — MEDICARE: $127.79 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $130.40 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $127.79
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	$205	Not listed in the file	$93.54 – $171.80
Established patient office visit (about 30–39 minutes): 10 of 484 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $149.63 ACCESS HEALTH — ACCESS HEALTH: $124.14 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $108.62 AETNA DOMESTIC — AETNA: $139.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $108.62 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $108.62 AETNA MEDICARE TRANSPLANT — MEDICARE: $108.62 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $110.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $108.62 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $108.62
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$205	Not listed in the file	$74.79 – $143.65
Established patient office visit (about 30–39 minutes): 10 of 361 insurance plan rates ACCLAIM — COFINITY: $118.90 ADMINISTRATIVE CONCEPTS — COFINITY: $118.90 AETNA MEDICAID — MEDICAID: $119.34 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $119.34 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $119.34 ALLEGEANT — COFINITY: $118.90 ALLIED BENEFIT SYSTEMS — COFINITY: $118.90 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $119.34 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $119.34 AMERIBEN — COFINITY: $118.90
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · Hospital (facility) fee In the file: HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	$86	$55.90	$17.20 – $384.94
Preventive checkup, new patient, age 18–39: 10 of 240 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $64.50 ACCLAIM — COFINITY PPO: $67.77 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $44.72 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $67.77 AETNA — AETNA PPO: $58.31 AETNA — AETNA PREFERRED: $36.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $32.68 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $73.10 ALLEGEANT — COFINITY PPO: $67.77 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $44.72
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	$248	Not listed in the file	$68.62 – $232.11
Preventive checkup, new patient, age 18–39: 10 of 626 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $175.01 ACCESS HEALTH — ACCESS HEALTH: $145.20 ADMINISTRATIVE CONCEPTS — COFINITY: $143.84 AETNA — AETNA: $223.50 AETNA DOMESTIC — AETNA: $223.50 AETNA MEDICAID — MEDICAID: $116.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $127.05 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $116.94 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $116.94 ALLIED BENEFIT SYSTEMS — COFINITY: $143.84
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years	Not listed in the file	$326.30	$70.45 – $384.94
Preventive checkup, new patient, age 18–39: 10 of 86 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $81.21 BCBS GENERIC — BCBS TRAD / TRUST: $384.94 BCN DOMESTIC — BCN HMO: $384.94 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $384.94 BLUE CARE NETWORK — BCN HMO: $384.94 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $130.54 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $384.94 BLUE CROSS - AL — BCBS TRAD / TRUST: $384.94 BLUE CROSS - AR — BCBS TRAD / TRUST: $384.94 BLUE CROSS - AZ — BCBS TRAD / TRUST: $384.94
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · Hospital (facility) fee In the file: HC E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$70	$45.50	$14 – $418.25
Preventive checkup, new patient, age 40–64: 10 of 240 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $52.50 ACCLAIM — COFINITY PPO: $55.16 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $36.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $55.16 AETNA — AETNA PPO: $47.46 AETNA — AETNA PREFERRED: $29.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $26.60 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $59.50 ALLEGEANT — COFINITY PPO: $55.16 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $36.40
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	$286	Not listed in the file	$104.96 – $214.50
Preventive checkup, new patient, age 40–64: 10 of 363 insurance plan rates ACCLAIM — COFINITY: $165.88 ADMINISTRATIVE CONCEPTS — COFINITY: $165.88 AETNA MEDICAID — MEDICAID: $135.21 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $135.21 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $135.21 ALLEGEANT — COFINITY: $165.88 ALLIED BENEFIT SYSTEMS — COFINITY: $165.88 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $135.21 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $135.21 AMERIBEN — COFINITY: $165.88
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years	$286	Not listed in the file	$109.87 – $229.63
Preventive checkup, new patient, age 40–64: 10 of 263 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $172.08 ACCESS HEALTH — ACCESS HEALTH: $142.76 AETNA — AETNA: $219.29 AETNA DOMESTIC — AETNA: $219.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $124.92 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $172.08 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $163.52 ANDRIE INC — WORKERS COMP: $186.93 ASR HEALTH BENEFITS — ASR: $157.22 ASRM - RELIANCE STANDARD LIFE INSURANCE — MULTIPLAN: $172.08
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 OB Triage	$812	$527.80	$152.47 – $812
Emergency room visit (moderate): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $609 ACCESS HEALTH — ACCESS HEALTH: $203.92 ACCLAIM — COFINITY PPO: $639.86 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $422.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $639.86 AETNA — AETNA PPO: $550.54 AETNA — AETNA PREFERRED: $341.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $285.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $291.31 ALLEGEANT — COFINITY PPO: $639.86
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 Sane_Safe	$814	$529.10	$152.47 – $814
Emergency room visit (moderate): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $610.50 ACCESS HEALTH — ACCESS HEALTH: $203.92 ACCLAIM — COFINITY PPO: $641.43 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $423.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $641.43 AETNA — AETNA PPO: $551.89 AETNA — AETNA PREFERRED: $342.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $285.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $291.31 ALLEGEANT — COFINITY PPO: $641.43
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3	$814	$529.10	$152.47 – $814
Emergency room visit (moderate): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $610.50 ACCESS HEALTH — ACCESS HEALTH: $203.92 ACCLAIM — COFINITY PPO: $641.43 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $423.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $641.43 AETNA — AETNA PPO: $551.89 AETNA — AETNA PREFERRED: $342.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $285.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $291.31 ALLEGEANT — COFINITY PPO: $641.43
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Trauma Evaluation W/O Pre Notification Level 4	$4,671	$3,036.15	$233.07 – $4,671
Emergency room visit (moderately high): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,503.25 ACCESS HEALTH — ACCESS HEALTH: $311.70 ACCLAIM — COFINITY PPO: $3,680.75 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,428.92 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,680.75 AETNA — AETNA PPO: $3,166.94 AETNA — AETNA PREFERRED: $1,966.49 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $436.38 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $445.28 ALLEGEANT — COFINITY PPO: $3,680.75
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Partial Trauma W/O Pre Notification Level 4	$7,234	$4,702.10	$233.07 – $7,234
Emergency room visit (moderately high): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $5,425.50 ACCESS HEALTH — ACCESS HEALTH: $311.70 ACCLAIM — COFINITY PPO: $5,700.39 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $3,761.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $5,700.39 AETNA — AETNA PPO: $4,904.65 AETNA — AETNA PREFERRED: $3,045.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $436.38 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $445.28 ALLEGEANT — COFINITY PPO: $5,700.39
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4	$1,436	$933.40	$233.07 – $1,436
Emergency room visit (moderately high): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,077 ACCESS HEALTH — ACCESS HEALTH: $311.70 ACCLAIM — COFINITY PPO: $1,131.57 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $746.72 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,131.57 AETNA — AETNA PPO: $973.61 AETNA — AETNA PREFERRED: $604.56 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $436.38 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $445.28 ALLEGEANT — COFINITY PPO: $1,131.57
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5 OB Triage	$1,902	$1,236.30	$332.64 – $1,902
Emergency room visit (high): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,426.50 ACCESS HEALTH — ACCESS HEALTH: $444.86 ACCLAIM — COFINITY PPO: $1,498.78 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $989.04 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,498.78 AETNA — AETNA PPO: $1,289.56 AETNA — AETNA PREFERRED: $800.74 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $622.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $635.52 ALLEGEANT — COFINITY PPO: $1,498.78
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Trauma Evaluation W/O Pre Notification Level 5	$5,393	$3,505.45	$332.64 – $5,393
Emergency room visit (high): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $4,044.75 ACCESS HEALTH — ACCESS HEALTH: $444.86 ACCLAIM — COFINITY PPO: $4,249.68 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,804.36 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4,249.68 AETNA — AETNA PPO: $3,656.45 AETNA — AETNA PREFERRED: $2,270.45 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $622.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $635.52 ALLEGEANT — COFINITY PPO: $4,249.68
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5	$2,158	$1,402.70	$332.64 – $2,158
Emergency room visit (high): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,618.50 ACCESS HEALTH — ACCESS HEALTH: $444.86 ACCLAIM — COFINITY PPO: $1,700.50 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,122.16 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,700.50 AETNA — AETNA PPO: $1,463.12 AETNA — AETNA PREFERRED: $908.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $622.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $635.52 ALLEGEANT — COFINITY PPO: $1,700.50

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)	$70	$45.50	$4.63 – $70
Basic metabolic panel (blood test): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $52.50 ACCESS HEALTH — ACCESS HEALTH: $5.92 ACCLAIM — COFINITY PPO: $55.16 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $36.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $55.16 AETNA — AETNA PPO: $12.54 AETNA — AETNA PREFERRED: $29.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.29 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.46 ALLEGEANT — COFINITY PPO: $55.16
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	Not listed in the file	$234	$8.29 – $220.22
Basic metabolic panel (blood test): 10 of 97 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $99.45 AETNA — AETNA PPO: $12.54 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.54 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $130.54 BCBS GENERIC — BCBS TRAD / TRUST: $14.78 BCN DOMESTIC — BCN HMO: $14.78 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $14.78 BLUE CARE NETWORK — BCN HMO: $14.78 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $130.54 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $14.78
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$100	$65	$5.77 – $100
Comprehensive metabolic panel (blood test): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $75 ACCESS HEALTH — ACCESS HEALTH: $7.39 ACCLAIM — COFINITY PPO: $78.80 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $78.80 AETNA — AETNA PPO: $15.65 AETNA — AETNA PREFERRED: $42.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $10.56 ALLEGEANT — COFINITY PPO: $78.80
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	$299	$5.77 – $99.54
Comprehensive metabolic panel (blood test): 10 of 96 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $7.39 AETNA — AETNA PPO: $15.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $10.56 BCBS GENERIC — BCBS TRAD / TRUST: $25.87 BCN DOMESTIC — BCN HMO: $25.87 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $25.87 BLUE CARE NETWORK — BCN HMO: $25.87 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $10.35 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $25.87
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Obstetric Panel	$276	$179.40	$26.14 – $276
Obstetric blood test panel: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $207 ACCESS HEALTH — ACCESS HEALTH: $33.47 ACCLAIM — COFINITY PPO: $217.49 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $143.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $217.49 AETNA — AETNA PPO: $70.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $46.85 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $47.81 ALLEGEANT — COFINITY PPO: $217.49 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $143.52
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde Lipid Panel	$5	$3.25	$2.11 – $89.10
Cholesterol panel (lipid panel): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.75 ACCESS HEALTH — ACCESS HEALTH: $9.37 ACCLAIM — COFINITY PPO: $3.94 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.60 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.94 AETNA — AETNA PPO: $19.84 AETNA — AETNA PREFERRED: $2.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39 ALLEGEANT — COFINITY PPO: $3.94
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$87	$56.55	$7.32 – $89.10
Cholesterol panel (lipid panel): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $65.25 ACCESS HEALTH — ACCESS HEALTH: $9.37 ACCLAIM — COFINITY PPO: $68.56 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $45.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $68.56 AETNA — AETNA PPO: $19.84 AETNA — AETNA PREFERRED: $36.63 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39 ALLEGEANT — COFINITY PPO: $68.56
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$95	$61.75	$4.75 – $95
Kidney function panel: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $71.25 ACCESS HEALTH — ACCESS HEALTH: $6.08 ACCLAIM — COFINITY PPO: $74.86 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $49.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $74.86 AETNA — AETNA PPO: $12.87 AETNA — AETNA PREFERRED: $40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.51 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.68 ALLEGEANT — COFINITY PPO: $74.86
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$86	$55.90	$4.47 – $86
Liver function panel: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $64.50 ACCESS HEALTH — ACCESS HEALTH: $5.72 ACCLAIM — COFINITY PPO: $67.77 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $44.72 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $67.77 AETNA — AETNA PPO: $12.11 AETNA — AETNA PREFERRED: $36.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.17 ALLEGEANT — COFINITY PPO: $67.77
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$44	$28.60	$1.73 – $44
Urine test (automated, with microscope): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $33 ACCESS HEALTH — ACCESS HEALTH: $2.22 ACCLAIM — COFINITY PPO: $34.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $22.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $34.67 AETNA — AETNA PPO: $4.70 AETNA — AETNA PREFERRED: $18.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.17 ALLEGEANT — COFINITY PPO: $34.67
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	$235.30	$3.11 – $220.22
Urine test (automated, with microscope): 10 of 97 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $81.21 AETNA — AETNA PPO: $4.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $130.54 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $130.54 BCBS GENERIC — BCBS TRAD / TRUST: $4.05 BCN DOMESTIC — BCN HMO: $4.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $4.05 BLUE CARE NETWORK — BCN HMO: $4.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $130.54 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $4.05
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Non-Automated	$8	$8	$2.78 – $8
Urine test (manual, without microscope): 10 of 840 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $3.90 ACCLAIM — COFINITY: $4.64 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $3.41 AETNA DOMESTIC — AETNA: $3.18 AETNA MEDICAID — MEDICAID: $2.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $3.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $2.88 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $3.41 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $5.60
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Nonautomated	$19	$12.35	$1.90 – $19
Urine test (manual, without microscope): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $14.25 ACCESS HEALTH — ACCESS HEALTH: $2.44 ACCLAIM — COFINITY PPO: $14.97 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $9.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $14.97 AETNA — AETNA PPO: $5.16 AETNA — AETNA PREFERRED: $8 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.48 ALLEGEANT — COFINITY PPO: $14.97
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Non-Automated	Not listed in the file	$9.12	$2.78 – $9.11
Urine test (manual, without microscope): 10 of 847 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $3.90 ADMINISTRATIVE CONCEPTS — COFINITY: $5.29 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $3.41 AETNA — AETNA: $3.74 AETNA DOMESTIC — AETNA: $3.74 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $3.41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $2.88 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $3.41 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $2.88
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	$5	$5	$1.80 – $5
Urine test (automated, without microscope): 10 of 840 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.50 AETNA MEDICAID — MEDICAID: $1.87 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $2.21 AETNA MEDICARE TRANSPLANT — MEDICARE: $2.21 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1.87 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1.87 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $3.50 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1.87 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $2.21
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$25	$16.25	$1.23 – $25
Urine test (automated, without microscope): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $18.75 ACCESS HEALTH — ACCESS HEALTH: $1.58 ACCLAIM — COFINITY PPO: $19.70 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $13 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $19.70 AETNA — AETNA PPO: $3.34 AETNA — AETNA PREFERRED: $10.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $2.25 ALLEGEANT — COFINITY PPO: $19.70
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	Not listed in the file	$7.53	$1.80 – $7.49
Urine test (automated, without microscope): 10 of 847 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $2.52 ACCLAIM — COFINITY: $4.37 AETNA DOMESTIC — AETNA: $2.42 AETNA MEDICAID — MEDICAID: $1.87 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1.87 ALLEGEANT — COFINITY: $4.37 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $5.27 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1.87 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $1.87 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $4.37
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde Prostate Specific Antigen Total Ultrasensitive	$24.95	$16.22	$10.05 – $107.20
PSA (prostate specific antigen) blood test: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $18.71 ACCESS HEALTH — ACCESS HEALTH: $12.87 ACCLAIM — COFINITY PPO: $19.66 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $12.97 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $19.66 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $10.50 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39 ALLEGEANT — COFINITY PPO: $19.66
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 1012090 Prostate Specific Antigen Total	$109	$70.85	$10.05 – $109
PSA (prostate specific antigen) blood test: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $81.75 ACCESS HEALTH — ACCESS HEALTH: $12.87 ACCLAIM — COFINITY PPO: $85.89 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $56.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $85.89 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $45.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39 ALLEGEANT — COFINITY PPO: $85.89
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$109	$70.85	$10.05 – $109
PSA (prostate specific antigen) blood test: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $81.75 ACCESS HEALTH — ACCESS HEALTH: $12.87 ACCLAIM — COFINITY PPO: $85.89 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $56.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $85.89 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $45.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39 ALLEGEANT — COFINITY PPO: $85.89
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3400781 Thyroid Stimulating Hormone	$4.83	$3.14	$2.03 – $97.95
Thyroid stimulating hormone (TSH) test: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.62 ACCESS HEALTH — ACCESS HEALTH: $11.76 ACCLAIM — COFINITY PPO: $3.81 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.51 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.81 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $2.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80 ALLEGEANT — COFINITY PPO: $3.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3400781 Thyroid Stimulating Hormone Hama Treated	$4.83	$3.14	$2.03 – $97.95
Thyroid stimulating hormone (TSH) test: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.62 ACCESS HEALTH — ACCESS HEALTH: $11.76 ACCLAIM — COFINITY PPO: $3.81 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.51 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.81 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $2.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80 ALLEGEANT — COFINITY PPO: $3.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$108	$70.20	$9.18 – $108
Thyroid stimulating hormone (TSH) test: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $81 ACCESS HEALTH — ACCESS HEALTH: $11.76 ACCLAIM — COFINITY PPO: $85.10 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $56.16 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $85.10 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $45.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80 ALLEGEANT — COFINITY PPO: $85.10
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$66	$42.90	$4.25 – $66
Complete blood count (CBC) with differential: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $49.50 ACCESS HEALTH — ACCESS HEALTH: $5.44 ACCLAIM — COFINITY PPO: $52.01 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $34.32 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $52.01 AETNA — AETNA PPO: $11.51 AETNA — AETNA PREFERRED: $27.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7.77 ALLEGEANT — COFINITY PPO: $52.01
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	Not listed in the file	$317.20	$4.25 – $45.27
Complete blood count (CBC) with differential: 10 of 97 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $5.44 AETNA — AETNA PPO: $11.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7.77 BCBS GENERIC — BCBS TRAD / TRUST: $9.93 BCN DOMESTIC — BCN HMO: $9.93 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $9.93 BLUE CARE NETWORK — BCN HMO: $9.93 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $7.61 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $9.93
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$41	$26.65	$3.54 – $41
Complete blood count (CBC), automated: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $30.75 ACCESS HEALTH — ACCESS HEALTH: $4.53 ACCLAIM — COFINITY PPO: $32.31 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $21.32 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $32.31 AETNA — AETNA PPO: $9.59 AETNA — AETNA PREFERRED: $17.26 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.47 ALLEGEANT — COFINITY PPO: $32.31
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	$319.15	$3.54 – $36.10
Complete blood count (CBC), automated: 10 of 97 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $4.53 AETNA — AETNA PPO: $9.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.47 BCBS GENERIC — BCBS TRAD / TRUST: $8.26 BCN DOMESTIC — BCN HMO: $8.26 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $8.26 BLUE CARE NETWORK — BCN HMO: $8.26 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $6.34 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $8.26
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Prothrombin Time	$10	$10	$3.43 – $10
Blood clotting time test (prothrombin time, PT): 10 of 847 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $7 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $4.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $4.20 AETNA MEDICARE TRANSPLANT — MEDICARE: $4.20 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $3.55 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $4.29 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $4.20 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $4.20 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $4.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3500044 Prothrombin Time	$13.52	$8.79	$2.35 – $22.08
Blood clotting time test (prothrombin time, PT): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $10.14 ACCESS HEALTH — ACCESS HEALTH: $3 ACCLAIM — COFINITY PPO: $10.65 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $7.03 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $10.65 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $5.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29 ALLEGEANT — COFINITY PPO: $10.65
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3514930 Prothrombin Time	$6.67	$4.34	$2.35 – $22.08
Blood clotting time test (prothrombin time, PT): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $5 ACCESS HEALTH — ACCESS HEALTH: $3 ACCLAIM — COFINITY PPO: $5.26 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $3.47 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $5.26 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $2.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29 ALLEGEANT — COFINITY PPO: $5.26
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3500044 Thromboplastin Time Partial (Ptt)	$20.63	$13.41	$3.29 – $51.96
Blood clotting test (partial thromboplastin time, PTT): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $15.47 ACCESS HEALTH — ACCESS HEALTH: $4.21 ACCLAIM — COFINITY PPO: $16.26 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $10.73 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $16.26 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $8.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01 ALLEGEANT — COFINITY PPO: $16.26
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3502730 Thromboplastin Time Partial (Ptt)	$26.13	$16.98	$3.29 – $51.96
Blood clotting test (partial thromboplastin time, PTT): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $19.60 ACCESS HEALTH — ACCESS HEALTH: $4.21 ACCLAIM — COFINITY PPO: $20.59 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $13.59 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $20.59 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01 ALLEGEANT — COFINITY PPO: $20.59
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 2500780 Thromboplastin Time Partial (Ptt)	$56	$36.40	$3.29 – $56
Blood clotting test (partial thromboplastin time, PTT): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $42 ACCESS HEALTH — ACCESS HEALTH: $4.21 ACCLAIM — COFINITY PPO: $44.13 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $29.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $44.13 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $23.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01 ALLEGEANT — COFINITY PPO: $44.13

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	$1,199	$779.35	$58.40 – $1,199
CT scan of the head or brain, without contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $899.25 ACCESS HEALTH — ACCESS HEALTH: $78.10 ACCLAIM — COFINITY PPO: $944.81 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $623.48 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $944.81 AETNA — AETNA PPO: $83.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 ALLEGEANT — COFINITY PPO: $944.81 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $623.48
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	$869.70	$58.40 – $920.18
CT scan of the head or brain, without contrast: 10 of 97 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $78.10 AETNA — AETNA PPO: $83.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 BCBS GENERIC — BCBS TRAD / TRUST: $109.18 BCN DOMESTIC — BCN HMO: $109.18 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $109.18 BLUE CARE NETWORK — BCN HMO: $109.18 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $109.33 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $109.18
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	$3,155	$2,050.75	$194.87 – $3,155
MRI of the brain, before and after contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,366.25 ACCESS HEALTH — ACCESS HEALTH: $260.61 ACCLAIM — COFINITY PPO: $2,486.14 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,640.60 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,486.14 AETNA — AETNA PPO: $269.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $364.85 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $372.30 ALLEGEANT — COFINITY PPO: $2,486.14 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,640.60
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$244	$158.60	$48.61 – $244
Chest X-ray, 2 views: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $183 ACCESS HEALTH — ACCESS HEALTH: $65.01 ACCLAIM — COFINITY PPO: $192.27 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $126.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $192.27 AETNA — AETNA PPO: $81.12 AETNA — AETNA PREFERRED: $102.72 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $92.87 ALLEGEANT — COFINITY PPO: $192.27
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Chest 2 Views	Not listed in the file	$158.60	$48.61 – $143.95
Chest X-ray, 2 views: 10 of 97 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $65.01 AETNA — AETNA PPO: $81.12 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $91.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $92.87 BCBS GENERIC — BCBS TRAD / TRUST: $63.50 BCN DOMESTIC — BCN HMO: $63.50 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $63.50 BLUE CARE NETWORK — BCN HMO: $63.50 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $91.01 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $63.50
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee · modifier 26\|51 In the file: PR Xr Chest 2 Views\|PROFESSIONAL COMPONENT\|MULTIPLE PROCEDURES	$23	$23	$3.20 – $23
Chest X-ray, 2 views: 10 of 847 insurance plan rates ACCLAIM — COFINITY: $13.34 ADMINISTRATIVE CONCEPTS — COFINITY: $13.34 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $4.82 AETNA — AETNA: $7.99 AETNA DOMESTIC — AETNA: $7.99 AETNA MEDICAID — MEDICAID: $3.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.82 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $4.82 AETNA MEDICARE TRANSPLANT — MEDICARE: $4.82 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $3.20
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	$459	$298.35	$58.40 – $459
X-ray of the lower spine, at least 4 views: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $344.25 ACCESS HEALTH — ACCESS HEALTH: $78.10 ACCLAIM — COFINITY PPO: $361.69 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $238.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $361.69 AETNA — AETNA PPO: $135.44 AETNA — AETNA PREFERRED: $193.24 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 ALLEGEANT — COFINITY PPO: $361.69
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee · modifier FY In the file: HC Xr Lumbosacral Spine >= 4 Views\|COMPUTED RADIOGRAPHY X-RAY	$459	$298.35	$58.40 – $459
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $78.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $109.33 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $109.33 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $58.40 CORRECTIONAL RECOVERY — CORRECTIONAL RECOVERY: $111.57 HAP MEDICAID — HAP CARESOURCE MEDICAID: $58.40 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $109.33 HEARTLAND HOSPICE — HEARTLAND HOSPICE: $111.57
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	$2,379	$1,546.35	$133.27 – $2,379
MRI of the lower back (lumbar spine), without contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,784.25 ACCESS HEALTH — ACCESS HEALTH: $178.24 ACCLAIM — COFINITY PPO: $1,874.65 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,237.08 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,874.65 AETNA — AETNA PPO: $155.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $249.53 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $254.62 ALLEGEANT — COFINITY PPO: $1,874.65 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,237.08
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$1,644	$1,068.60	$97.97 – $1,644
CT scan of the pelvis, with contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,233 ACCESS HEALTH — ACCESS HEALTH: $131.03 ACCLAIM — COFINITY PPO: $1,295.47 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $854.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,295.47 AETNA — AETNA PPO: $213.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $183.44 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $187.18 ALLEGEANT — COFINITY PPO: $1,295.47 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $854.88
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	$2,306	$1,498.90	$133.27 – $3,866.56
MRI of a leg joint (such as the knee), without contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,729.50 ACCESS HEALTH — ACCESS HEALTH: $178.24 ACCLAIM — COFINITY PPO: $1,817.13 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,199.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,817.13 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $249.53 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $254.62 ALLEGEANT — COFINITY PPO: $1,817.13 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,199.12
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	$3,460	$2,249	$133.27 – $3,866.56
MRI of a leg joint (such as the knee), without contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,595 ACCESS HEALTH — ACCESS HEALTH: $178.24 ACCLAIM — COFINITY PPO: $2,726.48 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,799.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,726.48 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $249.53 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $254.62 ALLEGEANT — COFINITY PPO: $2,726.48 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,799.20
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	$2,306	$1,498.90	$133.27 – $3,866.56
MRI of a leg joint (such as the knee), without contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,729.50 ACCESS HEALTH — ACCESS HEALTH: $178.24 ACCLAIM — COFINITY PPO: $1,817.13 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,199.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,817.13 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $249.53 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $254.62 ALLEGEANT — COFINITY PPO: $1,817.13 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,199.12
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	$3,099	$2,014.35	$194.87 – $3,099
CT scan of the abdomen and pelvis, with contrast: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,324.25 ACCESS HEALTH — ACCESS HEALTH: $260.61 ACCLAIM — COFINITY PPO: $2,442.01 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,611.48 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,442.01 AETNA — AETNA PPO: $278.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $364.85 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $372.30 ALLEGEANT — COFINITY PPO: $2,442.01 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,611.48
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$770	$500.50	$58.40 – $770
Ultrasound of the abdomen, complete: 10 of 250 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $577.50 ACCESS HEALTH — ACCESS HEALTH: $78.10 ACCLAIM — COFINITY PPO: $606.76 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $400.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $606.76 AETNA — AETNA PPO: $87.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 ALLEGEANT — COFINITY PPO: $606.76 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $400.40
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	$707	$459.55	$58.40 – $707
Pregnancy ultrasound (after the first trimester): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $530.25 ACCESS HEALTH — ACCESS HEALTH: $78.10 ACCLAIM — COFINITY PPO: $557.12 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $367.64 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $557.12 AETNA — AETNA PPO: $309.04 AETNA — AETNA PREFERRED: $297.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 ALLEGEANT — COFINITY PPO: $557.12
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee In the file: PR US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$341	Not listed in the file	$30.03 – $341
Pregnancy ultrasound (after the first trimester): 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $142.39 ACCLAIM — COFINITY: $197.78 AETNA DOMESTIC — AETNA: $200.69 AETNA MEDICAID — MEDICAID: $86.69 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $86.69 ALLEGEANT — COFINITY: $197.78 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $171.63 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $86.69 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $86.69 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $197.78
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: PR US Pregnant Uterus >= 14 Weeks Single/1st Gestation\|PROFESSIONAL COMPONENT	$117	Not listed in the file	$30.03 – $341
Pregnancy ultrasound (after the first trimester): 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $51.37 ACCLAIM — COFINITY: $67.86 AETNA DOMESTIC — AETNA: $72.56 AETNA MEDICAID — MEDICAID: $30.03 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $30.03 ALLEGEANT — COFINITY: $67.86 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $61.92 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $30.03 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $30.03 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $67.86
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$522	$339.30	$58.40 – $522
Transvaginal ultrasound: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $391.50 ACCESS HEALTH — ACCESS HEALTH: $78.10 ACCLAIM — COFINITY PPO: $411.34 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $271.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $411.34 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $219.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 ALLEGEANT — COFINITY PPO: $411.34
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee In the file: PR US Transvaginal Non Obstetric	$303	Not listed in the file	$20.66 – $303
Transvaginal ultrasound: 10 of 845 insurance plan rates ACCLAIM — COFINITY: $175.74 ADMINISTRATIVE CONCEPTS — COFINITY: $175.74 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $107.53 AETNA — AETNA: $176.68 AETNA DOMESTIC — AETNA: $176.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $107.53 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $74.98 ALLEGEANT — COFINITY: $175.74 ALLIED BENEFIT SYSTEMS — COFINITY: $175.74 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $148.12
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: HC US Transvaginal Non Obstetric\|TECHNICAL COMPONENT	$522	$339.30	$58.40 – $522
Transvaginal ultrasound: rates for 6 insurance plans AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $109.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $111.57 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $109.33 LONGEVITY IPA OF MICHIGAN LLC HEALTH PLAN ISNP — LONGEVITY IPA MEDICARE ADVANTAGE: $125.73 MOLINA MEDICARE ADVANTAGE — MOLINA MEDICARE ADVANTAGE: $109.33 UNITED HEALTHCARE MEDICARE — UNITED HEALTHCARE MEDICARE ADVANTAGE: $114.91
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$328	$213.20	$43.05 – $328
Diagnostic mammogram, one breast: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $246 ACCESS HEALTH — ACCESS HEALTH: $55.13 ACCLAIM — COFINITY PPO: $258.46 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $170.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $258.46 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $138.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.18 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $78.75 ALLEGEANT — COFINITY PPO: $258.46
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$328	$213.20	$43.05 – $328
Diagnostic mammogram, one breast: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $246 ACCESS HEALTH — ACCESS HEALTH: $55.13 ACCLAIM — COFINITY PPO: $258.46 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $170.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $258.46 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $138.09 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $77.18 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $78.75 ALLEGEANT — COFINITY PPO: $258.46
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$452	$293.80	$55.26 – $452
Diagnostic mammogram, both breasts: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $339 ACCESS HEALTH — ACCESS HEALTH: $70.76 ACCLAIM — COFINITY PPO: $356.18 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $235.04 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $356.18 AETNA — AETNA PPO: $386.26 AETNA — AETNA PREFERRED: $190.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $99.06 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $101.08 ALLEGEANT — COFINITY PPO: $356.18
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$367	$238.55	$45.55 – $367
Screening mammogram, both breasts: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $275.25 ACCESS HEALTH — ACCESS HEALTH: $58.32 ACCLAIM — COFINITY PPO: $289.20 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $190.84 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $289.20 AETNA — AETNA PPO: $320.36 AETNA — AETNA PREFERRED: $154.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.65 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $83.32 ALLEGEANT — COFINITY PPO: $289.20
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$312	$202.80	$45.55 – $320.36
Screening mammogram, both breasts: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $234 ACCESS HEALTH — ACCESS HEALTH: $58.32 ACCLAIM — COFINITY PPO: $245.86 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $162.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $245.86 AETNA — AETNA PPO: $320.36 AETNA — AETNA PREFERRED: $131.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.65 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $83.32 ALLEGEANT — COFINITY PPO: $245.86

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	$32	Not listed in the file	$9.60 – $32
Electrocardiogram (ECG/EKG) with reading: 10 of 578 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $19.80 ACCESS HEALTH — ACCESS HEALTH: $16.43 ADMINISTRATIVE CONCEPTS — COFINITY: $18.56 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $14.38 AETNA — AETNA: $26.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.38 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $14.38 AETNA MEDICARE TRANSPLANT — MEDICARE: $14.38 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $14.67 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $14.38
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Ecg 12 Lead Interpretation & Report	Not listed in the file	Not listed in the file	$11.11 – $50.95
Electrocardiogram (ECG/EKG) with reading: 10 of 578 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $16.43 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $14.38 AETNA DOMESTIC — AETNA: $26.92 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14.38 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $14.38 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $14.67 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $14.38 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $14.38 AMERICAN FAMILY — COFINITY: $18.56 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $14.38
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$7,654	$4,975.10	$1,741.83 – $7,654
Left heart catheterization (diagnostic): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $5,740.50 ACCESS HEALTH — ACCESS HEALTH: $2,421.74 ACCLAIM — COFINITY PPO: $6,031.35 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $3,980.08 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $6,031.35 AETNA — AETNA PPO: $5,189.41 AETNA — AETNA PREFERRED: $3,222.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,390.43 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,459.62 ALLEGEANT — COFINITY PPO: $6,031.35
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Doctor (professional) fee · modifier 26 In the file: PR Lt Heart Catheterization Incl Intraproc Inj for Lt Ventriculography Img\|PROFESSIONAL COMPONENT	$573	$573	$73.70 – $332.34
Left heart catheterization (diagnostic): 10 of 847 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $128.75 ADMINISTRATIVE CONCEPTS — COFINITY: $332.34 AETNA DOMESTIC — AETNA: $222.65 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $114.96 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $112.66 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $155.19 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $112.66 ALLY ALIGN CARE ADV — MEDICARE: $112.66 AMERICAN FAMILY — COFINITY: $332.34 AMERICAN NATIONAL — COFINITY: $332.34
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: PR Lt Heart Catheterization Incl Intraproc Inj for Lt Ventriculography Img\|PROFESSIONAL COMPONENT	Not listed in the file	$488.91	$73.70 – $283.57
Left heart catheterization (diagnostic): 10 of 847 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $128.75 ACCLAIM — COFINITY: $283.57 ADMINISTRATIVE CONCEPTS — COFINITY: $283.57 AETNA — AETNA: $222.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $112.66 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $112.66 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $73.70 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $112.66 ALLEGEANT — COFINITY: $283.57 ALLIED BENEFIT SYSTEMS — COFINITY: $283.57
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Comprehensive Rt Atrial/Ventricular Pacing/Record W/O Arrhythmia	$9,086	$5,905.90	$878.79 – $40,641.86
Heart rhythm study (electrophysiology evaluation): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $6,814.50 ACCESS HEALTH — ACCESS HEALTH: $5,826.38 ACCLAIM — COFINITY PPO: $7,159.77 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $4,724.72 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $7,159.77 AETNA — AETNA PPO: $6,160.31 AETNA — AETNA PREFERRED: $3,825.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8,156.93 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8,323.40 ALLEGEANT — COFINITY PPO: $7,159.77
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Comprehensive Electrophysiologic Evaluation WO Arrhythmia Induction	$11,727	$11,727	$37.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,801.66
Heart rhythm study (electrophysiology evaluation): 10 of 178 insurance plan rates ACCLAIM — COFINITY: $6,801.66 ADMINISTRATIVE CONCEPTS — COFINITY: $6,801.66 AETNA — AETNA: $622.35 AETNA DOMESTIC — AETNA: $622.35 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $433.63 ALLEGEANT — COFINITY: $6,801.66 ALLIED BENEFIT SYSTEMS — COFINITY: $6,801.66 AMERIBEN — COFINITY: $6,801.66 AMERICAN FAMILY — COFINITY: $6,801.66 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $6,801.66
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	$954	$954	$37.50 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,801.66
Heart rhythm study (electrophysiology evaluation): 10 of 847 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $251.55 ACCLAIM — COFINITY: $553.32 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $182.61 AETNA — AETNA: $365.21 AETNA MEDICAID — MEDICAID: $119.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $182.61 AETNA MEDICARE TRANSPLANT — MEDICARE: $182.61 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $182.61 ALLEGEANT — COFINITY: $553.32 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $251.55
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	$27,695	$18,001.75	$1,971.17 – $43,234.12
Heart rhythm study with ablation for atrial fibrillation: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $20,771.25 ACCESS HEALTH — ACCESS HEALTH: $19,525.09 ACCLAIM — COFINITY PPO: $21,823.66 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $14,401.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $21,823.66 AETNA — AETNA PPO: $18,777.21 AETNA — AETNA PREFERRED: $11,659.60 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27,335.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $27,892.98 ALLEGEANT — COFINITY PPO: $21,823.66
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	$2,733	Not listed in the file	$257.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,585.14
Heart rhythm study with ablation for atrial fibrillation: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $455.19 ACCLAIM — COFINITY: $1,585.14 AETNA DOMESTIC — AETNA: $907.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $398.29 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $398.29 AETNA MEDICARE TRANSPLANT — MEDICARE: $398.29 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $257.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) ALIGN SENIOR CARE — ALIGN SENIOR CARE: $406.42 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $398.29 ALLEGEANT — COFINITY: $1,585.14
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Eval Electrophysiologic Comprehensive Transeptal Cath	Not listed in the file	Not listed in the file	$257.20 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,585.14
Heart rhythm study with ablation for atrial fibrillation: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $455.19 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $398.29 AETNA — AETNA: $907.84 AETNA DOMESTIC — AETNA: $907.84 AETNA MEDICARE TRANSPLANT — MEDICARE: $398.29 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $406.42 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $548.67 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $398.29 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $398.29 ALLY ALIGN CARE ADV — MEDICARE: $398.29
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$4,322	$2,809.30	$479.66 – $4,322
Sleep study (overnight, in a sleep lab): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,241.50 ACCESS HEALTH — ACCESS HEALTH: $641.48 ACCLAIM — COFINITY PPO: $3,405.74 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,247.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,405.74 AETNA — AETNA PPO: $2,930.32 AETNA — AETNA PREFERRED: $1,819.56 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $898.08 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $916.40 ALLEGEANT — COFINITY PPO: $3,405.74
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$1,307	Not listed in the file	$76.25 – $1,307
Sleep study (overnight, in a sleep lab): 10 of 845 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $758.06 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $612.17 AETNA — AETNA: $939.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $612.17 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $612.17 AETNA MEDICARE TRANSPLANT — MEDICARE: $612.17 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $429.62 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $429.62 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $624.66 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $612.17
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years\|PROFESSIONAL COMPONENT	$267	Not listed in the file	$76.25 – $1,307
Sleep study (overnight, in a sleep lab): 10 of 845 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $154.86 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $114.72 AETNA — AETNA: $190.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $114.72 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $114.72 AETNA MEDICARE TRANSPLANT — MEDICARE: $114.72 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $76.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $76.25 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $117.06 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $114.72

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	$157	$102.05	$43.48 – $157
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $117.75 ACCESS HEALTH — ACCESS HEALTH: $19.64 ACCLAIM — COFINITY PPO: $123.72 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $81.64 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $123.72 AETNA — AETNA PPO: $106.45 AETNA — AETNA PREFERRED: $66.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.49 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.05 ALLEGEANT — COFINITY PPO: $123.72
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	$157	$102.05	$15.33 – $157
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $117.75 ACCESS HEALTH — ACCESS HEALTH: $19.64 ACCLAIM — COFINITY PPO: $123.72 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $81.64 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $123.72 AETNA — AETNA PPO: $106.45 AETNA — AETNA PREFERRED: $66.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.49 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.05 ALLEGEANT — COFINITY PPO: $123.72
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier CO In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes\|CO	$157	$102.05	$43.48 – $157
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $19.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $27.49 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $27.49 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $27.49 CORRECTIONAL RECOVERY — CORRECTIONAL RECOVERY: $28.05 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $27.49 HEARTLAND HOSPICE — HEARTLAND HOSPICE: $28.05 HOSPICE HARBOR HOSPICE — HARBOR HOSPICE: $28.05 LONGEVITY IPA OF MICHIGAN LLC HEALTH PLAN ISNP — LONGEVITY IPA MEDICARE ADVANTAGE: $31.61
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$314	$204.10	$51.59 – $314
Physical therapy evaluation (low complexity): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $235.50 ACCESS HEALTH — ACCESS HEALTH: $66.06 ACCLAIM — COFINITY PPO: $247.43 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $163.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $247.43 AETNA — AETNA PPO: $212.89 AETNA — AETNA PREFERRED: $132.19 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $94.37 ALLEGEANT — COFINITY PPO: $247.43
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$326	$211.90	$51.59 – $326
Physical therapy evaluation (moderate complexity): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $244.50 ACCESS HEALTH — ACCESS HEALTH: $66.06 ACCLAIM — COFINITY PPO: $256.89 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $169.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $256.89 AETNA — AETNA PPO: $221.03 AETNA — AETNA PREFERRED: $137.25 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $94.37 ALLEGEANT — COFINITY PPO: $256.89
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$338	$219.70	$51.59 – $338
Physical therapy evaluation (high complexity): 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $253.50 ACCESS HEALTH — ACCESS HEALTH: $66.06 ACCLAIM — COFINITY PPO: $266.34 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $175.76 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $266.34 AETNA — AETNA PPO: $229.16 AETNA — AETNA PREFERRED: $142.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $92.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $94.37 ALLEGEANT — COFINITY PPO: $266.34
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 30 Minutes	$165	$107.25	$69.47 – $165
Psychotherapy, 30 minutes: 10 of 230 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $123.75 ACCLAIM — COFINITY PPO: $130.02 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $85.80 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $130.02 AETNA — AETNA PPO: $111.87 AETNA — AETNA PREFERRED: $69.47 ALLEGEANT — COFINITY PPO: $130.02 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $85.80 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $123.75 AMERIBEN — COFINITY PPO: $130.02
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Patient 30 Minutes	$146	Not listed in the file	$55.10 – $146
Psychotherapy, 30 minutes: 10 of 570 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $85.13 ACCLAIM — COFINITY: $84.68 ADMINISTRATIVE CONCEPTS — COFINITY: $84.68 AETNA DOMESTIC — AETNA: $124.59 AETNA MEDICARE TRANSPLANT — MEDICARE: $61.80 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $63.06 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $61.80 ALLEGEANT — COFINITY: $84.68 ALLIED BENEFIT SYSTEMS — COFINITY: $84.68 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $85.13
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Psychotherapy Patient 30 Minutes	$146	Not listed in the file	$49.27 – $101.87
Psychotherapy, 30 minutes: 10 of 275 insurance plan rates AETNA MEDICAID — MEDICAID: $49.27 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $49.27 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $49.27 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $49.27 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $49.27 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $71.05 AMERIGROUP MEDICAID — MEDICAID: $49.27 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $49.27 AMISH MENNONITE — MEDICAID: $49.27 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $49.27
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 45 Minutes Phd	$151	$98.15	$63.57 – $194.20
Psychotherapy, 45 minutes: 10 of 230 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $113.25 ACCLAIM — COFINITY PPO: $118.99 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $78.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $118.99 AETNA — AETNA PPO: $102.38 AETNA — AETNA PREFERRED: $63.57 ALLEGEANT — COFINITY PPO: $118.99 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $78.52 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $113.25 AMERIBEN — COFINITY PPO: $118.99
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 45 Minutes	$199	$129.35	$83.78 – $199
Psychotherapy, 45 minutes: 10 of 230 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $149.25 ACCLAIM — COFINITY PPO: $156.81 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $103.48 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $156.81 AETNA — AETNA PPO: $134.92 AETNA — AETNA PREFERRED: $83.78 ALLEGEANT — COFINITY PPO: $156.81 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $103.48 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $149.25 AMERIBEN — COFINITY PPO: $156.81
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Patient 45 Minutes	$194	Not listed in the file	$75.24 – $194
Psychotherapy, 45 minutes: 10 of 570 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $93.72 ACCLAIM — COFINITY: $112.52 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $82 AETNA — AETNA: $164.83 AETNA DOMESTIC — AETNA: $164.83 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $82 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $82 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $83.68 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $112.96 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $82
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 60 Minutes	$253	$164.45	$106.51 – $271.99
Psychotherapy, 60 minutes: 10 of 230 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $189.75 ACCLAIM — COFINITY PPO: $199.36 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $131.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $199.36 AETNA — AETNA PPO: $171.53 AETNA — AETNA PREFERRED: $106.51 ALLEGEANT — COFINITY PPO: $199.36 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $131.56 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $189.75 AMERIBEN — COFINITY PPO: $199.36
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Psychotherapy Patient 60 Minutes	$287	Not listed in the file	$99.75 – $287
Psychotherapy, 60 minutes: 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $165.65 ACCLAIM — COFINITY: $166.46 ADMINISTRATIVE CONCEPTS — COFINITY: $166.46 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $120.25 AETNA — AETNA: $242.49 AETNA MEDICAID — MEDICAID: $110.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $120.25 AETNA MEDICARE TRANSPLANT — MEDICARE: $120.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $110.81 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $122.70
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Family W/Patient 50 Minutes	$232	$150.80	$97.67 – $232
Family psychotherapy, with the patient: 10 of 230 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $174 ACCLAIM — COFINITY PPO: $182.82 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $120.64 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $182.82 AETNA — AETNA PPO: $157.30 AETNA — AETNA PREFERRED: $97.67 ALLEGEANT — COFINITY PPO: $182.82 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $120.64 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $174 AMERIBEN — COFINITY PPO: $182.82
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy	$84	$54.60	$35.36 – $111.04
Group psychotherapy: 10 of 230 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $63 ACCLAIM — COFINITY PPO: $66.19 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $43.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $66.19 AETNA — AETNA PPO: $56.95 AETNA — AETNA PREFERRED: $35.36 ALLEGEANT — COFINITY PPO: $66.19 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $43.68 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $63 AMERIBEN — COFINITY PPO: $66.19

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt	Not listed in the file	$11,991.67	$1,027.63 – $9,929.76
Removal of breast growth (open surgery): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $2,924.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,094.78 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4,178.35 BCBS GENERIC — BCBS TRAD / TRUST: $3,237.80 BCN DOMESTIC — BCN HMO: $3,237.80 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,237.80 BLUE CARE NETWORK — BCN HMO: $3,237.80 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $4,094.78 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,237.80 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,237.80
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt\|BILATERAL PROCEDURE	Not listed in the file	$11,892.89	$1,027.63 – $9,929.76
Removal of breast growth (open surgery): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $2,924.85 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4,094.78 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4,178.35 BCBS GENERIC — BCBS TRAD / TRUST: $4,047.24 BCN DOMESTIC — BCN HMO: $4,047.24 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $4,047.24 BLUE CARE NETWORK — BCN HMO: $4,047.24 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $4,094.78 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $4,047.24 BLUE CROSS - AL — BCBS TRAD / TRUST: $4,047.24
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	$33,929.64	$2,767.78 – $21,236.21
Total hip replacement: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $9,590.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,426.77 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13,700.78 BCBS GENERIC — BCBS TRAD / TRUST: $20,973.47 BCN DOMESTIC — BCN HMO: $20,973.47 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $20,973.47 BLUE CARE NETWORK — BCN HMO: $20,973.47 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $13,426.77 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $20,973.47 BLUE CROSS - AL — BCBS TRAD / TRUST: $20,973.47
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	$38,026.95	$2,764.23 – $34,375.78
Total knee replacement: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $9,590.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,426.77 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13,700.78 BCBS GENERIC — BCBS TRAD / TRUST: $20,452.39 BCN DOMESTIC — BCN HMO: $20,452.39 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $20,452.39 BLUE CARE NETWORK — BCN HMO: $20,452.39 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $13,426.77 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $20,452.39 BLUE CROSS - AL — BCBS TRAD / TRUST: $20,452.39
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH)\|BILATERAL PROCEDURE	Not listed in the file	$52,095.22	$2,764.23 – $34,375.78
Total knee replacement: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $9,590.55 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13,426.77 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13,700.78 BCBS GENERIC — BCBS TRAD / TRUST: $25,565.49 BCN DOMESTIC — BCN HMO: $25,565.49 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $25,565.49 BLUE CARE NETWORK — BCN HMO: $25,565.49 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $13,426.77 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $25,565.49 BLUE CROSS - AL — BCBS TRAD / TRUST: $25,565.49
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	$26,202.70	$369.25 – $12,002.36
Shoulder arthroscopy: shaving of shoulder bone: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $5,420.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7,588.59 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7,743.46 BCBS GENERIC — BCBS TRAD / TRUST: $3,709.95 BCN DOMESTIC — BCN HMO: $3,709.95 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,709.95 BLUE CARE NETWORK — BCN HMO: $3,709.95 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $7,588.59 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,709.95 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,709.95
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	$16,641.53	$1,170.67 – $5,412.15
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $2,444.20 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,421.88 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,491.71 BCBS GENERIC — BCBS TRAD / TRUST: $3,716.71 BCN DOMESTIC — BCN HMO: $3,716.71 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,716.71 BLUE CARE NETWORK — BCN HMO: $3,716.71 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,421.88 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,716.71 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,716.71
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PR Tonsillectomy & Adenoidectomy Younger Than Age 12	Not listed in the file	$14,075.09	$625.04 – $9,791.87
Removal of tonsils and adenoids (under age 12): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $4,422.14 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,190.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6,317.34 BCBS GENERIC — BCBS TRAD / TRUST: $3,259.16 BCN DOMESTIC — BCN HMO: $3,259.16 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,259.16 BLUE CARE NETWORK — BCN HMO: $3,259.16 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $6,190.99 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,259.16 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,259.16
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	$297	Not listed in the file	$35.25 – $180.54
Upper GI endoscopy (diagnostic): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $73.31 ADMINISTRATIVE CONCEPTS — COFINITY: $172.26 AETNA — AETNA: $180.54 AETNA DOMESTIC — AETNA: $180.54 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $53.22 AETNA MEDICARE TRANSPLANT — MEDICARE: $53.22 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $35.25 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $54.30 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $53.22 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $53.22
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	Not listed in the file	$35.25 – $180.54
Upper GI endoscopy (diagnostic): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $73.31 ACCESS HEALTH — ACCESS HEALTH: $60.82 ADMINISTRATIVE CONCEPTS — COFINITY: $154.86 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $53.22 AETNA — AETNA: $180.54 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $53.22 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $53.22 AETNA MEDICARE TRANSPLANT — MEDICARE: $53.22 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $35.25 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $35.25
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	$2,954.44	$506.61 – $2,042.60
Upper GI endoscopy (diagnostic): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $677.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $948.53 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $967.89 BCBS GENERIC — BCBS TRAD / TRUST: $805.07 BCN DOMESTIC — BCN HMO: $805.07 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $805.07 BLUE CARE NETWORK — BCN HMO: $805.07 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $948.53 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $805.07 BLUE CROSS - AL — BCBS TRAD / TRUST: $805.07
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$335	Not listed in the file	$39.41 – $194.30
Upper GI endoscopy with biopsy: 10 of 845 insurance plan rates ACCLAIM — COFINITY: $194.30 ADMINISTRATIVE CONCEPTS — COFINITY: $194.30 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $59.56 AETNA — AETNA: $158.67 AETNA DOMESTIC — AETNA: $158.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $59.56 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $59.56 ALLEGEANT — COFINITY: $194.30 ALLIED BENEFIT SYSTEMS — COFINITY: $194.30 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $59.56
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$301	Not listed in the file	$39.41 – $183.05
Upper GI endoscopy with biopsy: 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $82.05 ACCESS HEALTH — ACCESS HEALTH: $68.07 ACCLAIM — COFINITY: $174.58 AETNA DOMESTIC — AETNA: $158.67 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $39.41 ALLEGEANT — COFINITY: $174.58 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $82.05 AMERIBEN — COFINITY: $174.58 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $174.58 AMERICAN NATIONAL — COFINITY: $174.58
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	$4,953.91	$506.61 – $1,889.12
Upper GI endoscopy with biopsy: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $677.52 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $948.53 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $967.89 BCBS GENERIC — BCBS TRAD / TRUST: $977.03 BCN DOMESTIC — BCN HMO: $977.03 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $977.03 BLUE CARE NETWORK — BCN HMO: $977.03 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $948.53 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $977.03 BLUE CROSS - AL — BCBS TRAD / TRUST: $977.03
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$450	Not listed in the file	$52.51 – $261
Colonoscopy (diagnostic): 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $91.02 ACCLAIM — COFINITY: $261 ADMINISTRATIVE CONCEPTS — COFINITY: $261 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $79.65 AETNA — AETNA: $200.06 AETNA DOMESTIC — AETNA: $200.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $79.65 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $52.51 ALLEGEANT — COFINITY: $261 ALLIED BENEFIT SYSTEMS — COFINITY: $261
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	$3,482.47	$519.44 – $2,103.55
Colonoscopy (diagnostic): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $694.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $972.56 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $992.40 BCBS GENERIC — BCBS TRAD / TRUST: $911.89 BCN DOMESTIC — BCN HMO: $911.89 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $911.89 BLUE CARE NETWORK — BCN HMO: $911.89 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $972.56 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $911.89 BLUE CROSS - AL — BCBS TRAD / TRUST: $911.89
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	Not listed in the file	Not listed in the file	$52.51 – $261
Colonoscopy (diagnostic): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $109.72 ADMINISTRATIVE CONCEPTS — COFINITY: $261 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $79.65 AETNA — AETNA: $200.06 AETNA DOMESTIC — AETNA: $200.06 AETNA MEDICAID — MEDICAID: $52.51 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $79.65 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $79.65 ALLEGEANT — COFINITY: $261 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $109.72
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$504	Not listed in the file	$56.66 – $292.32
Colonoscopy with biopsy: 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $118.36 ADMINISTRATIVE CONCEPTS — COFINITY: $292.32 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $85.92 AETNA — AETNA: $239.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $85.92 AETNA MEDICARE TRANSPLANT — MEDICARE: $85.92 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $87.68 ALLIED BENEFIT SYSTEMS — COFINITY: $292.32 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $85.92 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $85.92
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	$5,065.22	$668.40 – $2,076.13
Colonoscopy with biopsy: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $893.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,251.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,276.99 BCBS GENERIC — BCBS TRAD / TRUST: $1,000.47 BCN DOMESTIC — BCN HMO: $1,000.47 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,000.47 BLUE CARE NETWORK — BCN HMO: $1,000.47 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,251.45 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,000.47 BLUE CROSS - AL — BCBS TRAD / TRUST: $1,000.47
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	Not listed in the file	Not listed in the file	$56.66 – $443.89
Colonoscopy with biopsy: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $98.20 ACCLAIM — COFINITY: $292.32 AETNA DOMESTIC — AETNA: $239.33 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $56.66 ALLEGEANT — COFINITY: $292.32 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $118.36 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $56.66 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $292.32 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $167.12 AMERIHEALTH MEDICARE — MEDICARE: $85.92
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	$615	Not listed in the file	$71.25 – $356.70
Colonoscopy with removal of polyps (snare): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $148.94 AETNA MEDICAID — MEDICAID: $71.25 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $108.12 AETNA MEDICARE TRANSPLANT — MEDICARE: $108.12 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $71.25 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $110.33 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $108.12 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $71.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $108.12 ALLY ALIGN CARE ADV — MEDICARE: $108.12
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	Not listed in the file	$71.25 – $319.58
Colonoscopy with removal of polyps (snare): 10 of 845 insurance plan rates AETNA DOMESTIC — AETNA: $284.43 AETNA MEDICAID — MEDICAID: $71.25 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $108.12 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $108.12 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $71.25 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $108.12 ALLY ALIGN CARE ADV — MEDICARE: $108.12 AMERICAN FAMILY — COFINITY: $319.58 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $108.12 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $319.58
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	$4,197.47	$668.40 – $2,360.16
Colonoscopy with removal of polyps (snare): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $893.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,251.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,276.99 BCBS GENERIC — BCBS TRAD / TRUST: $1,000.47 BCN DOMESTIC — BCN HMO: $1,000.47 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,000.47 BLUE CARE NETWORK — BCN HMO: $1,000.47 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,251.45 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,000.47 BLUE CROSS - AL — BCBS TRAD / TRUST: $1,000.47
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	$451	Not listed in the file	$52.61 – $261.58
Screening colonoscopy (not high risk): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $109.97 ACCESS HEALTH — ACCESS HEALTH: $91.24 ADMINISTRATIVE CONCEPTS — COFINITY: $261.58 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $79.83 AETNA — AETNA: $143.69 AETNA MEDICAID — MEDICAID: $52.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $79.83 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $79.83 AETNA MEDICARE TRANSPLANT — MEDICARE: $79.83 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $52.61
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	$3,305.22	$519.44 – $4,058.64
Screening colonoscopy (not high risk): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $694.68 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $972.56 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $992.40 BCBS GENERIC — BCBS TRAD / TRUST: $911.89 BCN DOMESTIC — BCN HMO: $911.89 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $911.89 BLUE CARE NETWORK — BCN HMO: $911.89 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $972.56 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $911.89 BLUE CROSS - AL — BCBS TRAD / TRUST: $911.89
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	Not listed in the file	Not listed in the file	$52.61 – $291.41
Screening colonoscopy (not high risk): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $109.97 ADMINISTRATIVE CONCEPTS — COFINITY: $261.58 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $79.83 AETNA — AETNA: $143.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $79.83 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $79.83 AETNA MEDICARE TRANSPLANT — MEDICARE: $79.83 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $52.61 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $79.83 ALLIED BENEFIT SYSTEMS — COFINITY: $261.58
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	$24,205.21	$1,438.76 – $9,999.79
Gallbladder removal by laparoscope: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $4,516.03 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,322.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6,451.48 BCBS GENERIC — BCBS TRAD / TRUST: $5,861.28 BCN DOMESTIC — BCN HMO: $5,861.28 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $5,861.28 BLUE CARE NETWORK — BCN HMO: $5,861.28 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $6,322.45 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $5,861.28 BLUE CROSS - AL — BCBS TRAD / TRUST: $5,861.28
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	$24,460.54	$1,139.81 – $14,649.42
Groin (inguinal) hernia repair, age 5 or older: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $2,674.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,744.40 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,820.82 BCBS GENERIC — BCBS TRAD / TRUST: $4,432.24 BCN DOMESTIC — BCN HMO: $4,432.24 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $4,432.24 BLUE CARE NETWORK — BCN HMO: $4,432.24 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,744.40 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $4,432.24 BLUE CROSS - AL — BCBS TRAD / TRUST: $4,432.24
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH)\|BILATERAL PROCEDURE	Not listed in the file	$26,988.49	$1,139.81 – $14,649.42
Groin (inguinal) hernia repair, age 5 or older: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $4,534.99 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6,348.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6,478.55 BCBS GENERIC — BCBS TRAD / TRUST: $5,540.30 BCN DOMESTIC — BCN HMO: $5,540.30 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $5,540.30 BLUE CARE NETWORK — BCN HMO: $5,540.30 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $6,348.98 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $5,540.30 BLUE CROSS - AL — BCBS TRAD / TRUST: $5,540.30
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$2,585	$1,680.25	$472.42 – $2,585
Prostate biopsy: 10 of 242 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,938.75 ACCLAIM — COFINITY PPO: $2,036.98 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,344.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,036.98 AETNA — AETNA PPO: $1,752.63 AETNA — AETNA PREFERRED: $1,088.29 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $982.30 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $2,197.25 ALLEGEANT — COFINITY PPO: $2,036.98 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $1,344.20
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	$11,993.40	$267.76 – $1,803.58
Prostate biopsy: 10 of 80 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $267.76 BCBS GENERIC — BCBS TRAD / TRUST: $1,803.58 BCN DOMESTIC — BCN HMO: $1,803.58 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,803.58 BLUE CARE NETWORK — BCN HMO: $1,803.58 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $374.87 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,803.58 BLUE CROSS - AL — BCBS TRAD / TRUST: $1,803.58 BLUE CROSS - AR — BCBS TRAD / TRUST: $1,803.58 BLUE CROSS - AZ — BCBS TRAD / TRUST: $1,803.58
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	$46,215.19	$2,411.55 – $17,582.60
Prostate removal by laparoscope (radical prostatectomy): 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $7,940.53 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $11,116.74 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $11,343.61 BCBS GENERIC — BCBS TRAD / TRUST: $16,283.75 BCN DOMESTIC — BCN HMO: $16,283.75 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $16,283.75 BLUE CARE NETWORK — BCN HMO: $16,283.75 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $11,116.74 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $16,283.75 BLUE CROSS - AL — BCBS TRAD / TRUST: $16,283.75
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$2,834	$1,842.10	$1,193.11 – $5,354.47
Hysteroscopy with biopsy of the uterus lining: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,125.50 ACCESS HEALTH — ACCESS HEALTH: $2,418.15 ACCLAIM — COFINITY PPO: $2,233.19 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,473.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,233.19 AETNA — AETNA PPO: $1,921.45 AETNA — AETNA PREFERRED: $1,193.11 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,385.40 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,454.49 ALLEGEANT — COFINITY PPO: $2,233.19
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	$565	Not listed in the file	$65.18 – $332.11
Hysteroscopy with biopsy of the uterus lining: 10 of 845 insurance plan rates ACCLAIM — COFINITY: $327.70 AETNA DOMESTIC — AETNA: $230.28 AETNA MEDICAID — MEDICAID: $65.18 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $65.18 ALLEGEANT — COFINITY: $327.70 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $137.47 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $65.18 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $327.70 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $158.14 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $65.18
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	$3,570	Not listed in the file	$52.39 – $2,070.60
Hysteroscopy with biopsy of the uterus lining: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $659.32 AETNA DOMESTIC — AETNA: $1,273.05 AETNA MEDICAID — MEDICAID: $404.92 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $404.92 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $794.72 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $404.92 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $404.92 AMERIBEN — COFINITY: $2,070.60 AMERICAN NATIONAL — COFINITY: $2,070.60 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $966.77
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance	$1,201	$780.65	$394.28 – $1,201
Spinal injection, lower back (epidural), with imaging guidance: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $900.75 ACCESS HEALTH — ACCESS HEALTH: $527.30 ACCLAIM — COFINITY PPO: $946.39 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $624.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $946.39 AETNA — AETNA PPO: $814.28 AETNA — AETNA PREFERRED: $505.62 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $738.21 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $753.28 ALLEGEANT — COFINITY PPO: $946.39
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	$654	Not listed in the file	$33.72 – $379.32
Spinal injection, lower back (epidural), with imaging guidance: 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $172.66 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $125.34 AETNA — AETNA: $195.88 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $125.34 AETNA MEDICARE TRANSPLANT — MEDICARE: $125.34 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $87.12 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $87.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $127.90 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $125.34 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $172.66
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	Not listed in the file	$28.44 – $123.96
Spinal injection, lower back (epidural), with imaging guidance: 10 of 845 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $123.54 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $43 AETNA — AETNA: $77.10 AETNA DOMESTIC — AETNA: $77.10 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $43 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $28.44 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $28.44 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $43 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $59.24 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $43
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl	$2,448	$1,591.20	$494.03 – $2,645.20
Nerve root injection, lower back, with imaging guidance: 10 of 251 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,836 ACCESS HEALTH — ACCESS HEALTH: $660.70 ACCLAIM — COFINITY PPO: $1,929.02 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,272.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,929.02 AETNA — AETNA PPO: $1,659.74 AETNA — AETNA PREFERRED: $1,030.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $924.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $943.86 ALLEGEANT — COFINITY PPO: $1,929.02
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	$610	Not listed in the file	$44.13 – $915
Nerve root injection, lower back, with imaging guidance: 10 of 845 insurance plan rates ADMINISTRATIVE CONCEPTS — COFINITY: $353.80 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $121.73 AETNA — AETNA: $186.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $121.73 AETNA MEDICARE TRANSPLANT — MEDICARE: $121.73 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $84.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $124.22 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $121.73 ALLIED BENEFIT SYSTEMS — COFINITY: $353.80 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $167.69
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	Not listed in the file	$25.81 – $460.59
Nerve root injection, lower back, with imaging guidance: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $54.59 ACCLAIM — COFINITY: $186.30 AETNA DOMESTIC — AETNA: $85.96 AETNA MEDICAID — MEDICAID: $31.74 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $31.74 ALLEGEANT — COFINITY: $186.30 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $31.74 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $31.74 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $186.30 AMERIHEALTH CARITAS MEDICAID — MEDICAID: $31.74
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$1,068	Not listed in the file	$122.01 – $619.44
Carpal tunnel release: 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $275.14 ACCLAIM — COFINITY: $619.44 ADMINISTRATIVE CONCEPTS — COFINITY: $619.44 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $199.73 AETNA — AETNA: $341.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $199.73 AETNA MEDICARE TRANSPLANT — MEDICARE: $199.73 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $134.94 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $203.81 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $199.73
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$995	Not listed in the file	$122.01 – $577.10
Carpal tunnel release: 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $275.14 ACCESS HEALTH — ACCESS HEALTH: $228.26 ACCLAIM — COFINITY: $577.10 AETNA MEDICAID — MEDICAID: $134.94 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $199.73 AETNA MEDICARE TRANSPLANT — MEDICARE: $199.73 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $134.94 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $203.81 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $199.73 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $275.14
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	$10,644.59	$975.18 – $3,899.22
Carpal tunnel release: 10 of 94 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $1,458.69 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2,042.17 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $2,083.85 BCBS GENERIC — BCBS TRAD / TRUST: $2,322.43 BCN DOMESTIC — BCN HMO: $2,322.43 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $2,322.43 BLUE CARE NETWORK — BCN HMO: $2,322.43 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $2,042.17 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $2,322.43 BLUE CROSS - AL — BCBS TRAD / TRUST: $2,322.43

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	$5,330	Not listed in the file	$908.68 – $3,091.40
Vaginal delivery, with care before and after: 10 of 845 insurance plan rates AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,080.45 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,080.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,102.50 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,080.45 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,488.38 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $1,080.45 ALLY ALIGN CARE ADV — MEDICARE: $1,080.45 AMERICAN FAMILY — COFINITY: $3,091.40 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $1,080.45
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	Not listed in the file	$908.68 – $3,060.66
Vaginal delivery, with care before and after: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $1,234.80 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,080.45 AETNA MEDICAID — MEDICAID: $1,047.38 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,080.45 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,080.45 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1,047.38 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,047.38 ALLIED BENEFIT SYSTEMS — COFINITY: $3,060.66 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,047.38 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $1,080.45
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	$5,892	Not listed in the file	$1,002.29 – $3,417.36
Cesarean delivery (C-section), with care before and after: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $1,384.06 ACCLAIM — COFINITY: $3,417.36 AETNA DOMESTIC — AETNA: $1,842.82 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1,173.98 ALLEGEANT — COFINITY: $3,417.36 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,668.29 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,173.98 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $1,173.98 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $3,417.36 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $1,848.45
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	Not listed in the file	$1,002.29 – $3,398.80
Cesarean delivery (C-section), with care before and after: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $1,384.06 ACCLAIM — COFINITY: $3,398.80 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,211.06 AETNA MEDICARE TRANSPLANT — MEDICARE: $1,211.06 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1,173.98 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,173.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,235.77 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,211.06 ALLEGEANT — COFINITY: $3,398.80 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,668.29
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 847 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $266.93 ACCESS HEALTH — ACCESS HEALTH: $221.45 ACCLAIM — COFINITY: $543.81 ADMINISTRATIVE CONCEPTS — COFINITY: $543.81 AETNA MEDICAID — MEDICAID: $187.84 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $193.77 AETNA MEDICARE TRANSPLANT — MEDICARE: $193.77 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $187.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $193.77 ALLEGEANT — COFINITY: $543.81
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	$5,578	Not listed in the file	$944.29 – $3,235.24
Vaginal delivery after a previous C-section, with care before and after: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $1,304.90 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICAID — MEDICAID: $1,106.84 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,141.79 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,106.84 ALLIED BENEFIT SYSTEMS — COFINITY: $3,235.24 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,572.87 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,106.84 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $1,106.84 ALLY ALIGN CARE ADV — MEDICARE: $1,141.79
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S	Not listed in the file	Not listed in the file	$944.29 – $3,436.31
Vaginal delivery after a previous C-section, with care before and after: 10 of 845 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $1,304.90 ADMINISTRATIVE CONCEPTS — COFINITY: $3,436.31 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,141.79 AETNA — AETNA: $1,842.82 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICAID — MEDICAID: $1,106.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,141.79 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1,106.84 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,106.84 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,141.79

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	$181,158.22	$986.07 – $221,310.31
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 88 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $50,817.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $71,144.22 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $72,596.14 BCBS GENERIC — BCBS TRAD / TRUST: $221,310.31 BCN DOMESTIC — BCN HMO: $221,310.31 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $221,310.31 BLUE CARE NETWORK — BCN HMO: $221,310.31 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $71,144.22 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $221,310.31 BLUE CROSS - AL — BCBS TRAD / TRUST: $221,310.31
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	$43,505.69	$986.07 – $40,288.99
Hip or knee replacement (major joint of the leg), without major complications: 10 of 96 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $10,522.47 AETNA — AETNA PPO: $32,073.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14,731.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $15,032.10 BCBS GENERIC — BCBS TRAD / TRUST: $40,288.99 BCN DOMESTIC — BCN HMO: $40,288.99 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $40,288.99 BLUE CARE NETWORK — BCN HMO: $40,288.99 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $14,731.46 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $40,288.99
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	$45,457.32	$986.07 – $45,237.29
Neck (cervical) spinal fusion, without complications: 10 of 96 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $13,151.36 AETNA — AETNA PPO: $40,593.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18,411.91 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18,787.66 BCBS GENERIC — BCBS TRAD / TRUST: $43,031.74 BCN DOMESTIC — BCN HMO: $43,031.74 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $43,031.74 BLUE CARE NETWORK — BCN HMO: $43,031.74 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $18,411.91 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $43,031.74
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	$39,309.47	$986.07 – $25,383.22
Uterus and ovary surgery (not for cancer), without complications: 10 of 96 insurance plan rates ACCESS HEALTH — ACCESS HEALTH: $6,991.62 AETNA — AETNA PPO: $20,630.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9,788.27 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $9,988.03 BCBS GENERIC — BCBS TRAD / TRUST: $25,383.22 BCN DOMESTIC — BCN HMO: $25,383.22 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $25,383.22 BLUE CARE NETWORK — BCN HMO: $25,383.22 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $9,788.27 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $25,383.22

Source: Trinity Health Muskegon 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	Acute Care Hospital
Address	1500 E Sherman Blvd, Muskegon, MI 49441
County	Muskegon County
State	Michigan
Phone	(231) 726‑3511
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	230066
Name in Medicare records	TRINITY HEALTH MUSKEGON HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(231) 672‑2000^[4]
Official website	trinityhealthmichigan.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Trinity Health Muskegon Hospital — trinityhealthmichigan.org
Trinity Health Muskegon Hospital | Trinity Health Michigan — trinityhealthmichigan.org
Trinity Health Emergency Center - Muskegon Hospital | Trinity Health Michigan — trinityhealthmichigan.org
Trauma Services | Trinity Health Emergency Center – Muskegon Hospital — trinityhealthmichigan.org
Awards and Recognition | Trinity Health Michigan — trinityhealthmichigan.org