Does Trinity Health Oakland Hospital have an emergency room?

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

Where is Trinity Health Oakland Hospital?

44405 Woodward Ave, Pontiac, MI 48341, in Oakland County, Michigan.

What is the phone number of Trinity Health Oakland Hospital?

(248) 858-3000, as listed by Medicare (CMS).

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

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

Trinity Health Oakland Hospital — Pontiac, MI

Quick answers

Does Trinity Health Oakland Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Trinity Health Oakland Hospital. In a medical emergency, call 911.
Where is Trinity Health Oakland Hospital?: 44405 Woodward Ave, Pontiac, MI 48341, in Oakland County, Michigan.
What is the phone number of Trinity Health Oakland Hospital?: (248) 858-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Trinity Health Oakland Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5]

Bariatric surgery
Cancer care
Cardiovascular care
Emergency services
Maternity services
Orthopedics
Radiology
Obstetrics
Gynecology
Stroke care
Pediatric cardiology
Pediatric gastroenterology
Pediatric hematology oncology
Pediatric ophthalmology
Pediatric surgery

Conditions treated^[4]

Stroke

Treatments^[4]

Laboratory testing
Minimally invasive interventional radiology procedures

Programs and centers^[5][7][8]

Birth Center (Trinity Health Birth Center - Oakland Hospital)
Cancer Center (Trinity Health Cancer Center - Oakland Hospital)
Pediatric specialty clinics with U-M Health C.S. Mott Children's Hospital (joint operating agreement)

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

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level II
Stroke designation	Joint Commission Certified Advanced Thrombectomy Capable Stroke Center

Recognition^[6]

The Joint Commission Certified Advanced Thrombectomy Capable Stroke Center

Doctors and clinicians (933)

933 doctors and other clinicians list Trinity Health Oakland 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 909 more: the button below opens the full list.

Other emergency rooms nearby

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

McLaren Oakland1.9 mi · Pontiac, MI · Acute Care Hospital
Beaumont Hospital Royal Oak7.9 mi · Royal Oak, MI · Acute Care Hospital
Ascension Providence Rochester Hospital7.9 mi · Rochester, MI · Acute Care Hospital
Henry Ford Health West Bloomfield Hospital8.5 mi · W Bloomfield, MI · Acute Care Hospital
Beaumont Hospital, Troy9.3 mi · Troy, MI · Acute Care Hospital

Other hospitals nearby

Pioneer Specialty Hospital1.9 mi · Pontiac, MI · Long-Term Acute Care Hospital
Pontiac General Hospital2.3 mi · Pontiac, MI · Psychiatric Hospital
Havenwyck Hospital3.4 mi · Auburn Hills, MI · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Oakland Manor Nursing and Rehabilitation Center LL2.2 mi · Pontiac, MI · 3 of 5 stars
Woodward Hills Health and Rehabilitation Center3.0 mi · Bloomfield Hills, MI · 3 of 5 stars
Pomeroy Living Rochester Skilled Rehabilitation3.7 mi · Rochester Hills, MI · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice of Southeastern Michigan, Inc2.7 mi · Southfield, MI · 3 of 5 stars
Residential Hospice5.0 mi · Troy, MI · 3 of 5 stars
Guardian Angel Home Care & Hospice of Rochester Hills5.4 mi · Rochester Hills, MI

All hospice providers in the state →

Home health agencies

Compassionate Home Health Services1.2 mi · Pontiac, MI
Prime Homecare Agency2.7 mi · Bloomfield Hills, MI · 4 of 5 stars
Residential Home Health5.0 mi · Troy, MI · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita North Oakland Dialysis1.2 mi · Pontiac, MI · 2 of 5 stars
Greenfield HS - Pontiac1.2 mi · Pontiac, MI · 2 of 5 stars
DaVita Orchard Square Dialysis2.7 mi · Bloomfield Hills, 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.

Bloomfield Hills Surgical Center2.7 mi · Bloomfield Hills, MI
Surgical Centers of Michigan, L.L.C.5.0 mi · Troy, MI
Unasource Surgery Center5.0 mi · Troy, 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

The Wellness Plan Medical Center - Pontiac1.3 mi · Pontiac, MI · Community health center
Orchard Lake Center1.8 mi · Pontiac, MI · Community health center
Family Medicine Center2.1 mi · Pontiac, MI · Community health center

Clinics and urgent care

Get Well Urgent Care Pontiac PLC1.2 mi · Pontiac, MI · Urgent care center
Nextera Healthcare PLLC1.2 mi · Pontiac, MI · Urgent care center
Common Ground2.7 mi · Bloomfield, MI · Urgent care center

Pharmacies

Bloomfield Pharmacy North PC1.2 mi · Pontiac, MI · Community/retail pharmacy
Healthline Pharmacy, LLC1.2 mi · Pontiac, MI · Community/retail pharmacy
Trinity Health-Michigan1.2 mi · Pontiac, MI · Community/retail pharmacy

Assisted living nearby

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

CCcare1.2 mi · Pontiac, MI
Comfort Group Home1.2 mi · Pontiac, MI
Koni's AFC Home I1.2 mi · Pontiac, MI
Koni's AFC Home II1.2 mi · Pontiac, 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 Oakland 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	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	1 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	66%National average: 72%
Would definitely recommend the hospital	66%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	71%National average: 80%
Staff “always” explained medicines before giving them	55%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	57%National average: 74%
Area around the room “always” quiet at night	52%National average: 60%
Completed surveys	658Response rate: 20%

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)	0.618No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.292Better than the national benchmark
Surgical site infections after colon surgery	1.319No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0.851No different from the national benchmark
MRSA bloodstream infections	0.731No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.53Better 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	9.4%
Deaths within 30 days: pneumonia patients	14.7%
Deaths within 30 days: COPD patients	7.8%
Deaths within 30 days: stroke patients	12%
Deaths within 30 days: coronary bypass surgery (CABG)	2.8%
Serious complications (patient safety indicator PSI-90)	1.06No different from the national rate
Complications after hip or knee replacement	6.7%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.1%
Readmitted within 30 days: heart failure	19.5%
Readmitted within 30 days: pneumonia	17.8%
Readmitted within 30 days: COPD	19.5%
Readmitted within 30 days: coronary bypass surgery	11.1%
Readmitted within 30 days: hip or knee replacement	7.4%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	200 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	67%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 Pontiac Best hospitals in Michigan

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 79 common services exactly as Trinity Health Oakland 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 →

$ 5 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient New Low Level	$249	Not listed in the file	$57.90 – $184.73
New patient office visit (about 30–44 minutes): 10 of 845 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $160.89 ACCLAIM — COFINITY: $151.89 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $116.80 AETNA DOMESTIC — AETNA: $151.48 AETNA MEDICARE TRANSPLANT — MEDICARE: $116.80 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $116.80 ALLEGEANT — COFINITY: $151.89 ALLIED BENEFIT SYSTEMS — COFINITY: $151.89 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $160.89 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $116.80
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New Moderate Level	$379	Not listed in the file	$84.99 – $303.20
New patient office visit (about 45–59 minutes): 10 of 742 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $139.57 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $101.32 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $101.32 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $84.99 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $84.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $103.39 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $84.99 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $101.32 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $84.99 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $101.32
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	$379	Not listed in the file	$94.06 – $278.95
New patient office visit (about 45–59 minutes): 10 of 742 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $176.37 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $176.37 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $176.37 AETNA MEDICARE TRANSPLANT — MEDICARE: $176.37 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $107.57 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $179.97 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $176.37 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $107.57 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $176.37 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $107.57
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	$379	Not listed in the file	$110.80 – $178.98
New patient office visit (about 45–59 minutes): rates for 8 insurance plans ASR HEALTH BENEFITS — HAP HMO/AHL: $178.98 BCCCP-MICHIGAN — BCCCP: $115 HAP — HAP HMO/AHL: $178.98 HAP — HAP HPI: $178.98 HEALTH PARTNERS — HAP HPI: $178.98 MEDICAID - NE — MEDICAID: $110.80 TUFTS HEALTH PLAN — HAP HPI: $178.98 VARIPRO — HAP HMO/AHL: $178.98
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$479	Not listed in the file	$115.66 – $271.73
New patient office visit (about 60–74 minutes): 10 of 677 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $226.08 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $164.12 AETNA MEDICARE TRANSPLANT — MEDICARE: $164.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $167.47 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $164.12 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $226.08 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $115.66 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $164.12 ALLY ALIGN CARE ADV — MEDICARE: $164.12 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $164.12
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient New High Level	$479	Not listed in the file	$126.74 – $374
New patient office visit (about 60–74 minutes): 10 of 677 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $325.74 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $236.46 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $236.46 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $142.07 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $142.07 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $142.07 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $236.46 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $142.07 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $236.46 AMERICAN HEALTH PLAN — MEDICARE: $236.46
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	$479	Not listed in the file	$115 – $226.59
New patient office visit (about 60–74 minutes): 10 of 73 insurance plan rates ASR HEALTH BENEFITS — HAP HMO/AHL: $221.77 BCBS GENERIC — BCBS TRUST TRAD: $226.59 BCCCP-MICHIGAN — BCCCP: $115 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRUST TRAD: $226.59 BLUE CROSS - AK (PREMERA) — BCBS TRUST TRAD: $226.59 BLUE CROSS - AL — BCBS TRUST TRAD: $226.59 BLUE CROSS - AR — BCBS TRUST TRAD: $226.59 BLUE CROSS - AZ — BCBS TRUST TRAD: $226.59 BLUE CROSS - CA (ANTHEM) — BCBS TRUST TRAD: $226.59 BLUE CROSS - CO (ANTHEM) — BCBS TRUST TRAD: $226.59
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$182	Not listed in the file	$48.76 – $125.89
Established patient office visit (about 20–29 minutes): 10 of 480 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $109.64 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $79.59 AETNA — AETNA: $103.22 AETNA DOMESTIC — AETNA: $103.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $79.59 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $79.59 AETNA MEDICARE TRANSPLANT — MEDICARE: $79.59 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $79.59 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $109.64 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $79.59
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$182	Not listed in the file	$57.36 – $148.10
Established patient office visit (about 20–29 minutes): 10 of 480 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $128.99 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $93.64 AETNA — AETNA: $121.44 AETNA DOMESTIC — AETNA: $121.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $93.64 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $93.64 AETNA MEDICARE TRANSPLANT — MEDICARE: $93.64 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $95.55 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $93.64 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $128.99
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Low Level	$182	Not listed in the file	$49.86 – $111.02
Established patient office visit (about 20–29 minutes): 10 of 365 insurance plan rates ACCESS HEALTH — COFINITY: $111.02 ACCLAIM — COFINITY: $111.02 ADMINISTRATIVE CONCEPTS — COFINITY: $111.02 AETNA MEDICAID — AETNA MEDICAID: $61.51 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $58.58 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $58.58 ALLEGEANT — COFINITY: $111.02 ALLIED BENEFIT SYSTEMS — COFINITY: $111.02 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $58.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $58.58
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Visit Office Outpatient Established Moderate Level	$263	Not listed in the file	$73.45 – $179.81
Established patient office visit (about 30–39 minutes): 10 of 481 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $156.61 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $113.69 AETNA — AETNA: $147.44 AETNA DOMESTIC — AETNA: $147.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $113.69 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $116.01 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $113.69 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $156.61 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $113.69 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $113.69
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	$263	Not listed in the file	$86.41 – $211.54
Established patient office visit (about 30–39 minutes): 10 of 481 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $133.75 AETNA — AETNA: $173.47 AETNA DOMESTIC — AETNA: $173.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $133.75 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $133.75 AETNA MEDICARE TRANSPLANT — MEDICARE: $133.75 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $136.48 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $133.75 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $184.25 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $133.75
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	$263	Not listed in the file	$74.79 – $160.43
Established patient office visit (about 30–39 minutes): 10 of 364 insurance plan rates ACCESS HEALTH — COFINITY: $160.43 ACCLAIM — COFINITY: $160.43 ADMINISTRATIVE CONCEPTS — COFINITY: $160.43 AETNA MEDICAID — AETNA MEDICAID: $86.55 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $82.43 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $82.43 ALLEGEANT — COFINITY: $160.43 ALLIED BENEFIT SYSTEMS — COFINITY: $160.43 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $82.43 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $82.43
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	$80	$52	$24 – $315.31
Preventive checkup, new patient, age 18–39: 10 of 247 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $54.40 ACCESS HEALTH — COFINITY PPO: $58.72 ACCLAIM — COFINITY PPO: $58.72 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $35.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $58.72 AETNA — AETNA DOMINOS PPO: $36.24 AETNA — AETNA PPO: $50.08 AETNA — AETNA PREFERRED: $24.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $30.40 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $68
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	$314	Not listed in the file	$68.62 – $235.50
Preventive checkup, new patient, age 18–39: 10 of 626 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $182.72 ADMINISTRATIVE CONCEPTS — COFINITY: $191.54 AETNA — AETNA: $172.03 AETNA DOMESTIC — AETNA: $172.03 AETNA MEDICAID — AETNA MEDICAID: $104.34 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $99.37 ALLIED BENEFIT SYSTEMS — COFINITY: $191.54 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $99.37 AMERIBEN — COFINITY: $191.54 AMERICAN FAMILY — COFINITY: $191.54
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	$80	$52	$24 – $365.41
Preventive checkup, new patient, age 40–64: 10 of 247 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $54.40 ACCESS HEALTH — COFINITY PPO: $58.72 ACCLAIM — COFINITY PPO: $58.72 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $35.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $58.72 AETNA — AETNA DOMINOS PPO: $36.24 AETNA — AETNA PPO: $50.08 AETNA — AETNA PREFERRED: $24.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $30.40 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $68
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	$362	Not listed in the file	$104.96 – $271.50
Preventive checkup, new patient, age 40–64: 10 of 626 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $211.33 ACCESS HEALTH — COFINITY: $220.82 ACCLAIM — COFINITY: $220.82 ADMINISTRATIVE CONCEPTS — COFINITY: $220.82 AETNA — AETNA: $198.96 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $153.41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $117.10 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $117.10 ALLEGEANT — COFINITY: $220.82 ALLIED BENEFIT SYSTEMS — COFINITY: $220.82
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 OB Triage	$1,099	$714.35	$149.49 – $1,099
Emergency room visit (moderate): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $747.32 ACCESS HEALTH — COFINITY PPO: $806.67 ACCLAIM — COFINITY PPO: $806.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $483.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $806.67 AETNA — AETNA DOMINOS PPO: $497.85 AETNA — AETNA PPO: $687.97 AETNA — AETNA PREFERRED: $342.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $266.56 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $272
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3 Sane_Safe	$1,099	$714.35	$149.49 – $1,099
Emergency room visit (moderate): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $747.32 ACCESS HEALTH — COFINITY PPO: $806.67 ACCLAIM — COFINITY PPO: $806.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $483.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $806.67 AETNA — AETNA DOMINOS PPO: $497.85 AETNA — AETNA PPO: $687.97 AETNA — AETNA PREFERRED: $342.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $266.56 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $272
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 3	$1,099	$714.35	$149.49 – $1,099
Emergency room visit (moderate): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $747.32 ACCESS HEALTH — COFINITY PPO: $806.67 ACCLAIM — COFINITY PPO: $806.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $483.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $806.67 AETNA — AETNA DOMINOS PPO: $497.85 AETNA — AETNA PPO: $687.97 AETNA — AETNA PREFERRED: $342.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $266.56 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $272
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Partial Trauma W/O Pre Notification Level 4	$10,621	$6,903.65	$228.50 – $10,621
Emergency room visit (moderately high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $7,222.28 ACCESS HEALTH — COFINITY PPO: $7,795.81 ACCLAIM — COFINITY PPO: $7,795.81 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $4,673.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $7,795.81 AETNA — AETNA DOMINOS PPO: $4,811.31 AETNA — AETNA PPO: $6,648.75 AETNA — AETNA PREFERRED: $3,313.75 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $407.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $415.76
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4	$1,958	$1,272.70	$228.50 – $1,958
Emergency room visit (moderately high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,331.44 ACCESS HEALTH — COFINITY PPO: $1,437.17 ACCLAIM — COFINITY PPO: $1,437.17 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $861.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,437.17 AETNA — AETNA DOMINOS PPO: $886.97 AETNA — AETNA PPO: $1,225.71 AETNA — AETNA PREFERRED: $610.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $407.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $415.76
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 4 Sane_Safe	$1,958	$1,272.70	$228.50 – $1,958
Emergency room visit (moderately high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,331.44 ACCESS HEALTH — COFINITY PPO: $1,437.17 ACCLAIM — COFINITY PPO: $1,437.17 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $861.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,437.17 AETNA — AETNA DOMINOS PPO: $886.97 AETNA — AETNA PPO: $1,225.71 AETNA — AETNA PREFERRED: $610.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $407.45 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $415.76
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5	$3,023	$1,964.95	$229 – $3,023
Emergency room visit (high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,055.64 ACCESS HEALTH — COFINITY PPO: $2,218.88 ACCLAIM — COFINITY PPO: $2,218.88 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,330.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,218.88 AETNA — AETNA DOMINOS PPO: $1,369.42 AETNA — AETNA PPO: $1,892.40 AETNA — AETNA PREFERRED: $943.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $581.52 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $593.39
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Trauma Evaluation W/O Pre Notification Level 5	$6,708	$4,360.20	$229 – $6,708
Emergency room visit (high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $4,561.44 ACCESS HEALTH — COFINITY PPO: $4,923.67 ACCLAIM — COFINITY PPO: $4,923.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,951.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4,923.67 AETNA — AETNA DOMINOS PPO: $3,038.72 AETNA — AETNA PPO: $4,199.21 AETNA — AETNA PREFERRED: $2,092.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $581.52 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $593.39
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED Type a Level 5 OB Triage	$3,023	$1,964.95	$229 – $3,023
Emergency room visit (high): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,055.64 ACCESS HEALTH — COFINITY PPO: $2,218.88 ACCLAIM — COFINITY PPO: $2,218.88 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,330.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,218.88 AETNA — AETNA DOMINOS PPO: $1,369.42 AETNA — AETNA PPO: $1,892.40 AETNA — AETNA PREFERRED: $943.18 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $581.52 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $593.39

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Basic Metabolic Panel (Calcium Total)	$105	$68.25	$4.63 – $105
Basic metabolic panel (blood test): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $71.40 ACCESS HEALTH — COFINITY PPO: $77.07 ACCLAIM — COFINITY PPO: $77.07 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $46.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $77.07 AETNA — AETNA DOMINOS PPO: $47.57 AETNA — AETNA PPO: $12.54 AETNA — AETNA PREFERRED: $32.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.29 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Comprehensive Metabolic Panel	$127	$82.55	$5.77 – $127
Comprehensive metabolic panel (blood test): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $86.36 ACCESS HEALTH — COFINITY PPO: $93.22 ACCLAIM — COFINITY PPO: $93.22 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $55.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $93.22 AETNA — AETNA DOMINOS PPO: $57.53 AETNA — AETNA PPO: $15.65 AETNA — AETNA PREFERRED: $39.62 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10.35 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $10.56
Obstetric blood test panel CPT 80055 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Obstetric Panel	$269	$174.85	$26.14 – $269
Obstetric blood test panel: 10 of 255 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $182.92 ACCESS HEALTH — COFINITY PPO: $197.45 ACCLAIM — COFINITY PPO: $197.45 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $118.36 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $197.45 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: $197.45 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $118.36
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Labcorp 884247 Lipid Panel	$37.75	$24.54	$7.32 – $42.35
Cholesterol panel (lipid panel): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $25.67 ACCESS HEALTH — COFINITY PPO: $27.71 ACCLAIM — COFINITY PPO: $27.71 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $16.61 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $27.71 AETNA — AETNA DOMINOS PPO: $17.10 AETNA — AETNA PPO: $19.84 AETNA — AETNA PREFERRED: $11.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde Lipid Panel	$5	$3.25	$1.52 – $42.35
Cholesterol panel (lipid panel): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.40 ACCESS HEALTH — COFINITY PPO: $3.67 ACCLAIM — COFINITY PPO: $3.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.67 AETNA — AETNA DOMINOS PPO: $2.27 AETNA — AETNA PPO: $19.84 AETNA — AETNA PREFERRED: $1.56 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Lipid Panel	$112	$72.80	$7.32 – $112
Cholesterol panel (lipid panel): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $76.16 ACCESS HEALTH — COFINITY PPO: $82.21 ACCLAIM — COFINITY PPO: $82.21 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $49.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $82.21 AETNA — AETNA DOMINOS PPO: $50.74 AETNA — AETNA PPO: $19.84 AETNA — AETNA PREFERRED: $34.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $13.12 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $13.39
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Renal Function Panel	$96	$62.40	$4.75 – $96
Kidney function panel: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $65.28 ACCESS HEALTH — COFINITY PPO: $70.46 ACCLAIM — COFINITY PPO: $70.46 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $42.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $70.46 AETNA — AETNA DOMINOS PPO: $43.49 AETNA — AETNA PPO: $12.87 AETNA — AETNA PREFERRED: $29.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.51 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.68
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Hepatic Function Panel	$98	$63.70	$4.47 – $98
Liver function panel: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $66.64 ACCESS HEALTH — COFINITY PPO: $71.93 ACCLAIM — COFINITY PPO: $71.93 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $43.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $71.93 AETNA — AETNA DOMINOS PPO: $44.39 AETNA — AETNA PPO: $12.11 AETNA — AETNA PREFERRED: $30.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $8.01 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $8.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	$52	$33.80	$1.73 – $52
Urine test (automated, with microscope): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $35.36 ACCESS HEALTH — COFINITY PPO: $38.17 ACCLAIM — COFINITY PPO: $38.17 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $22.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $38.17 AETNA — AETNA DOMINOS PPO: $23.56 AETNA — AETNA PPO: $4.70 AETNA — AETNA PREFERRED: $16.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Urinalysis With Microscopy Automated	Not listed in the file	$383.50	$1.73 – $10.48
Urine test (automated, with microscope): 10 of 104 insurance plan rates AETNA — AETNA PPO: $4.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.11 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.17 ASR HEALTH BENEFITS — HAP AHLIC: $10.48 BCBS GENERIC — BCBS TRAD / TRUST: $3.32 BCN DOMESTIC — BCN HMO: $3.32 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3.32 BLUE CARE NETWORK — BCN HMO: $3.32 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3.11 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3.32
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Nonautomated	$12	$7.80	$1.90 – $12
Urine test (manual, without microscope): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $8.16 ACCESS HEALTH — COFINITY PPO: $8.81 ACCLAIM — COFINITY PPO: $8.81 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $5.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $8.81 AETNA — AETNA DOMINOS PPO: $5.44 AETNA — AETNA PPO: $5.16 AETNA — AETNA PREFERRED: $3.74 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3.41 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	$9	$9	$1.80 – $9
Urine test (automated, without microscope): 10 of 752 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $6.30 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $2.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $2.21 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1.87 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1.87 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLY ALIGN CARE ADV — MEDICARE: $2.21 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $2.21
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Urinalysis Without Microscopy Automated	$29	$18.85	$1.23 – $29
Urine test (automated, without microscope): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $19.72 ACCESS HEALTH — COFINITY PPO: $21.29 ACCLAIM — COFINITY PPO: $21.29 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $12.76 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $21.29 AETNA — AETNA DOMINOS PPO: $13.14 AETNA — AETNA PPO: $3.34 AETNA — AETNA PREFERRED: $9.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Urinalysis Without Microscopy Automated	Not listed in the file	$7.49	$1.80 – $7.49
Urine test (automated, without microscope): 10 of 752 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $2.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $2.21 AETNA MEDICARE TRANSPLANT — MEDICARE: $2.21 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1.87 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $5.24 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $2.21 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $1.87 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $2.21 AMERIHEALTH MEDICARE — MEDICARE: $2.21 ASCENSION ST. VINCENT PUBLIC SAFETY MEDICAL — MEDICAID: $1.87
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Prostate Specific Antigen Total	$94	$61.10	$10.05 – $94
PSA (prostate specific antigen) blood test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $63.92 ACCESS HEALTH — COFINITY PPO: $69 ACCLAIM — COFINITY PPO: $69 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $41.36 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $69 AETNA — AETNA DOMINOS PPO: $42.58 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $29.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde Prostate Specific Antigen Total Ultrasensitive	$24.95	$16.22	$7.57 – $61.01
PSA (prostate specific antigen) blood test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $16.97 ACCESS HEALTH — COFINITY PPO: $18.31 ACCLAIM — COFINITY PPO: $18.31 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $10.98 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $18.31 AETNA — AETNA DOMINOS PPO: $11.30 AETNA — AETNA PPO: $27.25 AETNA — AETNA PREFERRED: $7.78 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $18.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3400781 Thyroid Stimulating Hormone	$4.83	$3.14	$1.47 – $55.70
Thyroid stimulating hormone (TSH) test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.28 ACCESS HEALTH — COFINITY PPO: $3.55 ACCLAIM — COFINITY PPO: $3.55 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.13 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.55 AETNA — AETNA DOMINOS PPO: $2.19 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $1.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3400781 Thyroid Stimulating Hormone Hama Treated	$4.83	$3.14	$1.47 – $55.70
Thyroid stimulating hormone (TSH) test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3.28 ACCESS HEALTH — COFINITY PPO: $3.55 ACCLAIM — COFINITY PPO: $3.55 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.13 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3.55 AETNA — AETNA DOMINOS PPO: $2.19 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $1.51 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thyroid Stimulating Hormone	$99	$64.35	$9.18 – $99
Thyroid stimulating hormone (TSH) test: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $67.32 ACCESS HEALTH — COFINITY PPO: $72.67 ACCLAIM — COFINITY PPO: $72.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $43.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $72.67 AETNA — AETNA DOMINOS PPO: $44.85 AETNA — AETNA PPO: $24.90 AETNA — AETNA PREFERRED: $30.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $16.46 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $16.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated/Differential Wbc Automated	$75	$48.75	$4.25 – $75
Complete blood count (CBC) with differential: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $51 ACCESS HEALTH — COFINITY PPO: $55.05 ACCLAIM — COFINITY PPO: $55.05 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $33 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $55.05 AETNA — AETNA DOMINOS PPO: $33.98 AETNA — AETNA PPO: $11.51 AETNA — AETNA PREFERRED: $23.40 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7.61 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7.77
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cbc Automated	$52	$33.80	$3.54 – $52
Complete blood count (CBC), automated: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $35.36 ACCESS HEALTH — COFINITY PPO: $38.17 ACCLAIM — COFINITY PPO: $38.17 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $22.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $38.17 AETNA — AETNA DOMINOS PPO: $23.56 AETNA — AETNA PPO: $9.59 AETNA — AETNA PREFERRED: $16.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Cbc Automated	Not listed in the file	$338.65	$3.54 – $15.41
Complete blood count (CBC), automated: 10 of 104 insurance plan rates AETNA — AETNA PPO: $9.59 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $6.34 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.47 ASR HEALTH BENEFITS — HAP AHLIC: $15.41 BCBS GENERIC — BCBS TRAD / TRUST: $6.76 BCN DOMESTIC — BCN HMO: $6.76 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $6.76 BLUE CARE NETWORK — BCN HMO: $6.76 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $6.34 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $6.76
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 – $13.52
Blood clotting time test (prothrombin time, PT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $9.19 ACCESS HEALTH — COFINITY PPO: $9.92 ACCLAIM — COFINITY PPO: $9.92 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $5.95 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $9.92 AETNA — AETNA DOMINOS PPO: $6.12 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $4.22 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3514930 Prothrombin Time	$6.67	$4.34	$2.02 – $13.02
Blood clotting time test (prothrombin time, PT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $4.54 ACCESS HEALTH — COFINITY PPO: $4.90 ACCLAIM — COFINITY PPO: $4.90 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2.93 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4.90 AETNA — AETNA DOMINOS PPO: $3.02 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $2.08 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POCT Prothrombin Time	$43	$27.95	$2.35 – $43
Blood clotting time test (prothrombin time, PT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $29.24 ACCESS HEALTH — COFINITY PPO: $31.56 ACCLAIM — COFINITY PPO: $31.56 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $18.92 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $31.56 AETNA — AETNA DOMINOS PPO: $19.48 AETNA — AETNA PPO: $6.36 AETNA — AETNA PREFERRED: $13.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.20 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3500044 Thromboplastin Time Partial (Ptt)	$20.63	$13.41	$3.29 – $20.63
Blood clotting test (partial thromboplastin time, PTT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $14.03 ACCESS HEALTH — COFINITY PPO: $15.14 ACCLAIM — COFINITY PPO: $15.14 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $9.08 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $15.14 AETNA — AETNA DOMINOS PPO: $9.35 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $6.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Warde 3502730 Thromboplastin Time Partial (Ptt)	$26.13	$16.98	$3.29 – $26.13
Blood clotting test (partial thromboplastin time, PTT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $17.77 ACCESS HEALTH — COFINITY PPO: $19.18 ACCLAIM — COFINITY PPO: $19.18 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $11.50 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $19.18 AETNA — AETNA DOMINOS PPO: $11.84 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $8.15 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Thromboplastin Time Partial (Ptt)	$70	$45.50	$3.29 – $70
Blood clotting test (partial thromboplastin time, PTT): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $47.60 ACCESS HEALTH — COFINITY PPO: $51.38 ACCLAIM — COFINITY PPO: $51.38 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $30.80 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $51.38 AETNA — AETNA DOMINOS PPO: $31.71 AETNA — AETNA PPO: $8.91 AETNA — AETNA PREFERRED: $21.84 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5.89 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	$2,708	$1,760.20	$57.25 – $2,708
CT scan of the head or brain, without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,841.44 ACCESS HEALTH — COFINITY PPO: $1,987.67 ACCLAIM — COFINITY PPO: $1,987.67 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,191.52 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,987.67 AETNA — AETNA DOMINOS PPO: $1,226.72 AETNA — AETNA PPO: $83.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 ALLEGEANT — COFINITY PPO: $1,987.67
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Head/Brain W/O Contrast	Not listed in the file	$1,760.20	$57.25 – $923.04
CT scan of the head or brain, without contrast: 10 of 104 insurance plan rates AETNA — AETNA PPO: $83.95 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 ASR HEALTH BENEFITS — HAP AHLIC: $277.91 BCBS GENERIC — BCBS TRAD / TRUST: $109.18 BCN DOMESTIC — BCN HMO: $109.18 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $109.18 BLUE CARE NETWORK — BCN HMO: $109.18 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $102.09 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $109.18
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: HC CT Head/Brain W/O Contrast\|REDUCED SERVICES	$2,708	$1,760.20	$57.25 – $2,708
CT scan of the head or brain, without contrast: 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $102.09 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $102.09 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $58.40 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $110.25 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $240.33 HAP MEDICAID — HAP CARESOURCE MEDICAID: $58.40 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $102.09 HEALTH COST SOLUTIONS — WELLPATH: $161.46
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Brain W/O & W/Contrast	$7,842	$5,097.30	$191.05 – $7,842
MRI of the brain, before and after contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $5,332.56 ACCESS HEALTH — COFINITY PPO: $5,756.03 ACCLAIM — COFINITY PPO: $5,756.03 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $3,450.48 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $5,756.03 AETNA — AETNA DOMINOS PPO: $3,552.43 AETNA — AETNA PPO: $269.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $340.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $347.62 ALLEGEANT — COFINITY PPO: $5,756.03
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Chest 2 Views	$366	$237.90	$31.69 – $366
Chest X-ray, 2 views: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $248.88 ACCESS HEALTH — COFINITY PPO: $268.64 ACCLAIM — COFINITY PPO: $268.64 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $161.04 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $268.64 AETNA — AETNA DOMINOS PPO: $165.80 AETNA — AETNA PPO: $81.12 AETNA — AETNA PREFERRED: $114.19 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $84.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $86.71
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Chest 2 Views	Not listed in the file	$237.90	$31.69 – $200.06
Chest X-ray, 2 views: 10 of 104 insurance plan rates AETNA — AETNA PPO: $81.12 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $84.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $86.71 ASR HEALTH BENEFITS — HAP AHLIC: $36.78 BCBS GENERIC — BCBS TRAD / TRUST: $51.95 BCN DOMESTIC — BCN HMO: $51.95 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $51.95 BLUE CARE NETWORK — BCN HMO: $51.95 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $84.98 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $51.95
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	$3.30 – $23
Chest X-ray, 2 views: 10 of 844 insurance plan rates ACCLAIM — COFINITY: $13.34 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $4.98 AETNA DOMESTIC — AETNA: $7.99 AETNA MEDICAID — MEDICAID: $3.30 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $4.98 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $3.30 ALLEGEANT — COFINITY: $13.34 ALLIED BENEFIT SYSTEMS — COFINITY: $13.34 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $6.86 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $3.30
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	$474	$308.10	$53.42 – $474
X-ray of the lower spine, at least 4 views: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $322.32 ACCESS HEALTH — COFINITY PPO: $347.92 ACCLAIM — COFINITY PPO: $347.92 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $208.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $347.92 AETNA — AETNA DOMINOS PPO: $214.72 AETNA — AETNA PPO: $135.44 AETNA — AETNA PREFERRED: $147.89 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Xr Lumbosacral Spine >= 4 Views	Not listed in the file	$308.10	$53.42 – $240.33
X-ray of the lower spine, at least 4 views: 10 of 104 insurance plan rates AETNA — AETNA PPO: $135.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 ASR HEALTH BENEFITS — HAP AHLIC: $69.70 BCBS GENERIC — BCBS TRAD / TRUST: $87.58 BCN DOMESTIC — BCN HMO: $87.58 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $87.58 BLUE CARE NETWORK — BCN HMO: $87.58 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $102.09 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $87.58
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	$474	$308.10	$53.42 – $474
X-ray of the lower spine, at least 4 views: 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $102.09 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $102.09 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $58.40 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $110.25 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $240.33 HAP MEDICAID — HAP CARESOURCE MEDICAID: $58.40 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $102.09 HEALTH COST SOLUTIONS — WELLPATH: $161.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lumbar Spine W/O Contrast	$4,569	$2,969.85	$130.66 – $4,569
MRI of the lower back (lumbar spine), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,106.92 ACCESS HEALTH — COFINITY PPO: $3,353.65 ACCLAIM — COFINITY PPO: $3,353.65 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,010.36 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,353.65 AETNA — AETNA DOMINOS PPO: $2,069.76 AETNA — AETNA PPO: $155.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.74 ALLEGEANT — COFINITY PPO: $3,353.65
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: HC MRI Lumbar Spine W/O Contrast\|REDUCED SERVICES	$4,569	$2,969.85	$130.66 – $4,569
MRI of the lower back (lumbar spine), without contrast: 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.74 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $232.99 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $232.99 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $133.27 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $251.63 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $548.51 HAP MEDICAID — HAP CARESOURCE MEDICAID: $133.27 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $232.99 HEALTH COST SOLUTIONS — WELLPATH: $368.50
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Pelvis W/Contrast	$2,349	$1,526.85	$96.05 – $2,349
CT scan of the pelvis, with contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,597.32 ACCESS HEALTH — COFINITY PPO: $1,724.17 ACCLAIM — COFINITY PPO: $1,724.17 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,033.56 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,724.17 AETNA — AETNA DOMINOS PPO: $1,064.10 AETNA — AETNA PPO: $213.65 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $171.27 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $174.77 ALLEGEANT — COFINITY PPO: $1,724.17
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Bl	$5,777	$3,755.05	$130.66 – $5,777
MRI of a leg joint (such as the knee), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,928.36 ACCESS HEALTH — COFINITY PPO: $4,240.32 ACCLAIM — COFINITY PPO: $4,240.32 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,541.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4,240.32 AETNA — AETNA DOMINOS PPO: $2,616.98 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.74 ALLEGEANT — COFINITY PPO: $4,240.32
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Rt	$3,851	$2,503.15	$130.66 – $3,851
MRI of a leg joint (such as the knee), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,618.68 ACCESS HEALTH — COFINITY PPO: $2,826.63 ACCLAIM — COFINITY PPO: $2,826.63 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,694.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,826.63 AETNA — AETNA DOMINOS PPO: $1,744.50 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.74 ALLEGEANT — COFINITY PPO: $2,826.63
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI Lower Extremity Joint W/O Contrast Lt	$3,851	$2,503.15	$130.66 – $3,851
MRI of a leg joint (such as the knee), without contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,618.68 ACCESS HEALTH — COFINITY PPO: $2,826.63 ACCLAIM — COFINITY PPO: $2,826.63 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,694.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,826.63 AETNA — AETNA DOMINOS PPO: $1,744.50 AETNA — AETNA PPO: $176.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $232.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $237.74 ALLEGEANT — COFINITY PPO: $2,826.63
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	$6,169	$4,009.85	$191.05 – $6,169
CT scan of the abdomen and pelvis, with contrast: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $4,194.92 ACCESS HEALTH — COFINITY PPO: $4,528.05 ACCLAIM — COFINITY PPO: $4,528.05 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,714.36 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $4,528.05 AETNA — AETNA DOMINOS PPO: $2,794.56 AETNA — AETNA PPO: $278.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $340.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $347.62 ALLEGEANT — COFINITY PPO: $4,528.05
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT Abdomen & Pelvis W/Contrast	Not listed in the file	$4,376.12	$191.05 – $802
CT scan of the abdomen and pelvis, with contrast: 10 of 104 insurance plan rates AETNA — AETNA PPO: $278.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $340.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $347.62 ASR HEALTH BENEFITS — HAP AHLIC: $524.37 BCBS GENERIC — BCBS TRAD / TRUST: $352.05 BCN DOMESTIC — BCN HMO: $352.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $352.05 BLUE CARE NETWORK — BCN HMO: $352.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $340.67 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $352.05
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Abdomen Complete	$1,336	$868.40	$57.25 – $1,336
Ultrasound of the abdomen, complete: 10 of 256 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $908.48 ACCESS HEALTH — COFINITY PPO: $980.62 ACCLAIM — COFINITY PPO: $980.62 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $587.84 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $980.62 AETNA — AETNA DOMINOS PPO: $605.21 AETNA — AETNA PPO: $87.86 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 ALLEGEANT — COFINITY PPO: $980.62
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation	$905	$588.25	$57.25 – $905
Pregnancy ultrasound (after the first trimester): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $615.40 ACCESS HEALTH — COFINITY PPO: $664.27 ACCLAIM — COFINITY PPO: $664.27 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $398.20 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $664.27 AETNA — AETNA DOMINOS PPO: $409.97 AETNA — AETNA PPO: $309.04 AETNA — AETNA PREFERRED: $282.36 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17
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	$315	Not listed in the file	$30.03 – $315
Pregnancy ultrasound (after the first trimester): 10 of 845 insurance plan rates ACCLAIM — COFINITY: $192.15 AETNA DOMESTIC — AETNA: $169.91 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $85.63 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $85.63 ALLEGEANT — COFINITY: $192.15 ALLIED BENEFIT SYSTEMS — COFINITY: $192.15 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $180.47 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $85.63 AMERICAN FAMILY — COFINITY: $192.15 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $192.15
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	$106	Not listed in the file	$30.03 – $315
Pregnancy ultrasound (after the first trimester): 10 of 845 insurance plan rates ACCLAIM — COFINITY: $64.66 AETNA DOMESTIC — AETNA: $60.32 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $30.03 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $30.03 ALLEGEANT — COFINITY: $64.66 ALLIED BENEFIT SYSTEMS — COFINITY: $64.66 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $64.07 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $30.03 AMERICAN FAMILY — COFINITY: $64.66 AMERICAN HEALTHCARE ALLIANCE — COFINITY: $64.66
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	$1,113	$723.45	$57.25 – $1,113
Transvaginal ultrasound: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $756.84 ACCESS HEALTH — COFINITY PPO: $816.94 ACCLAIM — COFINITY PPO: $816.94 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $489.72 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $816.94 AETNA — AETNA DOMINOS PPO: $504.19 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $347.26 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US Transvaginal Non Obstetric	Not listed in the file	$1,508.65	$57.25 – $303.05
Transvaginal ultrasound: 10 of 104 insurance plan rates AETNA — AETNA PPO: $303.05 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $102.09 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $104.17 ASR HEALTH BENEFITS — HAP AHLIC: $185.03 BCBS GENERIC — BCBS TRAD / TRUST: $189.24 BCN DOMESTIC — BCN HMO: $189.24 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $189.24 BLUE CARE NETWORK — BCN HMO: $189.24 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $102.09 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $189.24
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Doctor (professional) fee · modifier 26 In the file: PR US Transvaginal Non Obstetric\|PROFESSIONAL COMPONENT	$72	Not listed in the file	$20.87 – $72
Transvaginal ultrasound: 10 of 842 insurance plan rates AETNA DOMESTIC — AETNA: $51.02 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $32.35 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $20.87 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $33.01 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $20.87 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $32.35 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $32.35 AMERICAN HEALTH PLAN — MEDICARE: $32.35 AMISH MENNONITE — MEDICAID: $20.87 ANDRIE INC — WORKERS COMP: $48.33
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Rt	$562	$365.30	$45.59 – $562
Diagnostic mammogram, one breast: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $382.16 ACCESS HEALTH — COFINITY PPO: $412.51 ACCLAIM — COFINITY PPO: $412.51 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $247.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $412.51 AETNA — AETNA DOMINOS PPO: $254.59 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $175.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.73 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $83.40
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Unilateral Lt	$562	$365.30	$45.59 – $562
Diagnostic mammogram, one breast: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $382.16 ACCESS HEALTH — COFINITY PPO: $412.51 ACCLAIM — COFINITY PPO: $412.51 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $247.28 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $412.51 AETNA — AETNA DOMINOS PPO: $254.59 AETNA — AETNA PPO: $303.05 AETNA — AETNA PREFERRED: $175.34 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $81.73 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $83.40
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Diagnostic Bilateral	$843	$547.95	$58.59 – $843
Diagnostic mammogram, both breasts: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $573.24 ACCESS HEALTH — COFINITY PPO: $618.76 ACCLAIM — COFINITY PPO: $618.76 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $370.92 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $618.76 AETNA — AETNA DOMINOS PPO: $381.88 AETNA — AETNA PPO: $386.26 AETNA — AETNA PREFERRED: $263.02 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $105.03 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $107.17
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bilateral	$582	$378.30	$48.24 – $582
Screening mammogram, both breasts: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $395.76 ACCESS HEALTH — COFINITY PPO: $427.19 ACCLAIM — COFINITY PPO: $427.19 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $256.08 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $427.19 AETNA — AETNA DOMINOS PPO: $263.65 AETNA — AETNA PPO: $320.36 AETNA — AETNA PREFERRED: $181.58 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $86.47 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $88.23
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$402	$261.30	$48.24 – $402
Screening mammogram, both breasts: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $273.36 ACCESS HEALTH — COFINITY PPO: $295.07 ACCLAIM — COFINITY PPO: $295.07 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $176.88 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $295.07 AETNA — AETNA DOMINOS PPO: $182.11 AETNA — AETNA PPO: $320.36 AETNA — AETNA PREFERRED: $125.42 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $86.47 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $88.23

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Cath Lt Heart/Lv Gram	$9,876	$6,419.40	$1,393.67 – $9,876
Left heart catheterization (diagnostic): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $6,715.68 ACCESS HEALTH — COFINITY PPO: $7,248.98 ACCLAIM — COFINITY PPO: $7,248.98 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $4,345.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $7,248.98 AETNA — AETNA DOMINOS PPO: $4,473.83 AETNA — AETNA PPO: $6,182.38 AETNA — AETNA PREFERRED: $3,081.31 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,165.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,230.27
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Comprehensive Rt Atrial/Ventricular Pacing/Record W/O Arrhythmia	$14,876	$9,669.40	$771.45 – $17,930.12
Heart rhythm study (electrophysiology evaluation): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $10,115.68 ACCESS HEALTH — COFINITY PPO: $10,918.98 ACCLAIM — COFINITY PPO: $10,918.98 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $6,545.44 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $10,918.98 AETNA — AETNA DOMINOS PPO: $6,738.83 AETNA — AETNA PPO: $9,312.38 AETNA — AETNA PREFERRED: $4,641.31 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7,616.18 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7,771.62
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Evaluation Electrophysiologic Comprehensive Transeptal Atrial Fibrillation	$38,048	$24,731.20	$513.07 – $60,086.57
Heart rhythm study with ablation for atrial fibrillation: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $25,872.64 ACCESS HEALTH — COFINITY PPO: $27,927.23 ACCLAIM — COFINITY PPO: $27,927.23 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $16,741.12 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $27,927.23 AETNA — AETNA DOMINOS PPO: $17,235.74 AETNA — AETNA PPO: $23,818.05 AETNA — AETNA PREFERRED: $11,870.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $25,522.99 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $26,043.87
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years	$4,995	$3,246.75	$470.25 – $4,995
Sleep study (overnight, in a sleep lab): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,396.60 ACCESS HEALTH — COFINITY PPO: $3,666.33 ACCLAIM — COFINITY PPO: $3,666.33 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $2,197.80 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,666.33 AETNA — AETNA DOMINOS PPO: $2,262.74 AETNA — AETNA PPO: $3,126.87 AETNA — AETNA PREFERRED: $1,558.44 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $838.54 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $855.65
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee · modifier 52 In the file: HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years\|REDUCED SERVICES	$4,995	$3,246.75	$470.25 – $4,995
Sleep study (overnight, in a sleep lab): 10 of 21 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $838.54 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $855.65 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $838.54 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $838.54 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $479.66 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $905.62 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $1,974.10 HAP MEDICAID — HAP CARESOURCE MEDICAID: $479.66 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $838.54 HEALTH COST SOLUTIONS — WELLPATH: $1,326.26

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$220	$143	$15.83 – $198
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $149.60 ACCESS HEALTH — COFINITY PPO: $161.48 ACCLAIM — COFINITY PPO: $161.48 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $96.80 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $161.48 AETNA — AETNA DOMINOS PPO: $99.66 AETNA — AETNA PPO: $137.72 AETNA — AETNA PREFERRED: $68.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28.37 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$220	$143	$44.87 – $220
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $149.60 ACCESS HEALTH — COFINITY PPO: $161.48 ACCLAIM — COFINITY PPO: $161.48 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $96.80 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $161.48 AETNA — AETNA DOMINOS PPO: $99.66 AETNA — AETNA PPO: $137.72 AETNA — AETNA PREFERRED: $68.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28.37 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.95
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee · modifier CO In the file: HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes\|CO	$220	$143	$15.83 – $198
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $28.37 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $28.95 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $28.37 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $28.37 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $30.64 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $65.14 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $28.37 HEALTH COST SOLUTIONS — WELLPATH: $44.87 HOSPICE ADVANTAGE — HOSPICE ADVANTAGE: $28.95 LONGEVITY IPA OF MICHIGAN LLC HEALTH PLAN ISNP — LONGEVITY IPA MEDICARE ADVANTAGE: $32.63
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	$334	$217.10	$53.01 – $334
Physical therapy evaluation (low complexity): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $227.12 ACCESS HEALTH — COFINITY PPO: $245.16 ACCLAIM — COFINITY PPO: $245.16 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $146.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $245.16 AETNA — AETNA DOMINOS PPO: $151.30 AETNA — AETNA PPO: $209.08 AETNA — AETNA PREFERRED: $104.21 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Pt Evaluation Low Complexity Patient/Family	Not listed in the file	$2,032.55	$53.01 – $218.16
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96 ASR HEALTH BENEFITS — HAP AHLIC: $195.32 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $95.02 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $95.02 BLUE CROSS COMPLETE - MI — BLUE CROSS COMPLETE MEDICAID: $53.01 CARESOURCE — HAP HMO: $195.32 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $102.62 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $218.16 HAP — HAP AHLIC: $195.32
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation Moderate Complexity Patient/Family	$378	$245.70	$53.01 – $378
Physical therapy evaluation (moderate complexity): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $257.04 ACCESS HEALTH — COFINITY PPO: $277.45 ACCLAIM — COFINITY PPO: $277.45 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $166.32 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $277.45 AETNA — AETNA DOMINOS PPO: $171.23 AETNA — AETNA PPO: $236.63 AETNA — AETNA PREFERRED: $117.94 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee · modifier CQ In the file: HC Pt Evaluation Moderate Complexity Patient/Family\|CQ	$378	$245.70	$53.01 – $378
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $95.02 BLUE CROSS - MI MEDICARE ADVANTAGE — BCBS MEDICARE ADVANTAGE: $95.02 CCA - ZING HEALTH — RELIANCE HMO MEDICARE ADVANTAGE: $102.62 EMPLOYEE BENEFIT LOGISTIC — EMPLOYEE BENEFIT LOGISTIC: $218.16 HAP MEDICARE ADVANTAGE — HAP MEDICARE ADVANTAGE: $95.02 HEALTH COST SOLUTIONS — WELLPATH: $150.29 HOSPICE ADVANTAGE — HOSPICE ADVANTAGE: $96.96 LONGEVITY IPA OF MICHIGAN LLC HEALTH PLAN ISNP — LONGEVITY IPA MEDICARE ADVANTAGE: $109.27
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Pt Evaluation High Complexity Patient/Family	$384	$249.60	$53.01 – $384
Physical therapy evaluation (high complexity): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $261.12 ACCESS HEALTH — COFINITY PPO: $281.86 ACCLAIM — COFINITY PPO: $281.86 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $168.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $281.86 AETNA — AETNA DOMINOS PPO: $173.95 AETNA — AETNA PPO: $240.38 AETNA — AETNA PREFERRED: $119.81 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $95.02 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $96.96
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 30 Minutes	$218	$141.70	$50.12 – $218
Psychotherapy, 30 minutes: 10 of 236 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $148.24 ACCESS HEALTH — COFINITY PPO: $160.01 ACCLAIM — COFINITY PPO: $160.01 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $95.92 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $160.01 AETNA — AETNA DOMINOS PPO: $98.75 AETNA — AETNA PPO: $136.47 AETNA — AETNA PREFERRED: $68.02 ALLEGEANT — COFINITY PPO: $160.01 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $95.92
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 45 Minutes	$236	$153.40	$54.26 – $236
Psychotherapy, 45 minutes: 10 of 236 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $160.48 ACCESS HEALTH — COFINITY PPO: $173.22 ACCLAIM — COFINITY PPO: $173.22 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $103.84 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $173.22 AETNA — AETNA DOMINOS PPO: $106.91 AETNA — AETNA PPO: $147.74 AETNA — AETNA PREFERRED: $73.63 ALLEGEANT — COFINITY PPO: $173.22 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $103.84
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Patient Individual Therapy 60 Minutes	$284	$184.60	$65.29 – $348.60
Psychotherapy, 60 minutes: 10 of 236 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $193.12 ACCESS HEALTH — COFINITY PPO: $208.46 ACCLAIM — COFINITY PPO: $208.46 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $124.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $208.46 AETNA — AETNA DOMINOS PPO: $128.65 AETNA — AETNA PPO: $177.78 AETNA — AETNA PREFERRED: $88.61 ALLEGEANT — COFINITY PPO: $208.46 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $124.96
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Family W/O Patient 50 Minutes	$271	$176.15	$62.30 – $326.75
Family psychotherapy, without the patient: 10 of 236 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $184.28 ACCESS HEALTH — COFINITY PPO: $198.91 ACCLAIM — COFINITY PPO: $198.91 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $119.24 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $198.91 AETNA — AETNA DOMINOS PPO: $122.76 AETNA — AETNA PPO: $169.65 AETNA — AETNA PREFERRED: $84.55 ALLEGEANT — COFINITY PPO: $198.91 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $119.24
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Family W/Patient 50 Minutes	$203	$131.95	$46.67 – $326.75
Family psychotherapy, with the patient: 10 of 236 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $138.04 ACCESS HEALTH — COFINITY PPO: $149 ACCLAIM — COFINITY PPO: $149 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $89.32 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $149 AETNA — AETNA DOMINOS PPO: $91.96 AETNA — AETNA PPO: $127.08 AETNA — AETNA PREFERRED: $63.34 ALLEGEANT — COFINITY PPO: $149 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $89.32
Group psychotherapy CPT 90853 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Psychotherapy Group Therapy	$185	$120.25	$42.53 – $195
Group psychotherapy: 10 of 236 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $125.80 ACCESS HEALTH — COFINITY PPO: $135.79 ACCLAIM — COFINITY PPO: $135.79 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $81.40 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $135.79 AETNA — AETNA DOMINOS PPO: $83.81 AETNA — AETNA PPO: $115.81 AETNA — AETNA PREFERRED: $57.72 ALLEGEANT — COFINITY PPO: $135.79 ALLIED BENEFIT SYSTEMS — COFINITY ADVANTAGE BUSINESS: $81.40

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Rt	$4,416	$2,870.40	$1,027.63 – $9,000.93
Removal of breast growth (open surgery): 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $3,002.88 ACCESS HEALTH — COFINITY PPO: $3,241.34 ACCLAIM — COFINITY PPO: $3,241.34 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,943.04 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,241.34 AETNA — AETNA DOMINOS PPO: $2,000.45 AETNA — AETNA PPO: $2,764.42 AETNA — AETNA PREFERRED: $1,377.79 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,823.33 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,901.35
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$854	Not listed in the file	$135.90 – $631.07
Removal of breast growth (open surgery): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $293.78 ACCLAIM — COFINITY: $495.32 AETNA MEDICAID — MEDICAID: $135.90 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $213.26 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $213.26 ALLEGEANT — COFINITY: $495.32 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $293.78 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $135.90 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $213.26 ALLY ALIGN CARE ADV — MEDICARE: $213.26
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion	$930	Not listed in the file	$135.90 – $631.07
Removal of breast growth (open surgery): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $293.78 ADMINISTRATIVE CONCEPTS — COFINITY: $539.40 AETNA — AETNA: $328.98 AETNA MEDICAID — MEDICAID: $135.90 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $213.26 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $135.90 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $135.90 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $217.61 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $135.90 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $135.90
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	$38,743.26	$2,767.78 – $29,513.98
Total hip replacement: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,536.66 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $12,792.51 ASR HEALTH BENEFITS — HAP AHLIC: $3,729.95 BCBS GENERIC — BCBS TRAD / TRUST: $18,811.24 BCN DOMESTIC — BCN HMO: $18,811.24 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $18,811.24 BLUE CARE NETWORK — BCN HMO: $18,811.24 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $12,536.66 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $18,811.24 BLUE CROSS - AL — BCBS TRAD / TRUST: $18,811.24
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH)\|BILATERAL PROCEDURE	Not listed in the file	$43,380.15	$2,767.78 – $29,513.98
Total hip replacement: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,536.66 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $12,792.51 ASR HEALTH BENEFITS — HAP AHLIC: $3,729.95 BCBS GENERIC — BCBS TRAD / TRUST: $23,514.05 BCN DOMESTIC — BCN HMO: $23,514.05 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $23,514.05 BLUE CARE NETWORK — BCN HMO: $23,514.05 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $12,536.66 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $23,514.05 BLUE CROSS - AL — BCBS TRAD / TRUST: $23,514.05
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	$34,004.94	$2,764.23 – $29,513.98
Total knee replacement: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,536.66 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $12,792.51 ASR HEALTH BENEFITS — HAP AHLIC: $3,983.83 BCBS GENERIC — BCBS TRAD / TRUST: $18,343.88 BCN DOMESTIC — BCN HMO: $18,343.88 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $18,343.88 BLUE CARE NETWORK — BCN HMO: $18,343.88 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $12,536.66 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $18,343.88 BLUE CROSS - AL — BCBS TRAD / TRUST: $18,343.88
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	$33,144.29	$2,764.23 – $29,513.98
Total knee replacement: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $12,536.66 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $12,792.51 ASR HEALTH BENEFITS — HAP AHLIC: $3,983.83 BCBS GENERIC — BCBS TRAD / TRUST: $22,929.85 BCN DOMESTIC — BCN HMO: $22,929.85 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $22,929.85 BLUE CARE NETWORK — BCN HMO: $22,929.85 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $12,536.66 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $22,929.85 BLUE CROSS - AL — BCBS TRAD / TRUST: $22,929.85
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	$33,992.48	$321.21 – $16,680.83
Shoulder arthroscopy: shaving of shoulder bone: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $7,085.52 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $7,230.12 ASR HEALTH BENEFITS — HAP AHLIC: $464.01 BCBS GENERIC — BCBS TRAD / TRUST: $3,327.47 BCN DOMESTIC — BCN HMO: $3,327.47 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,327.47 BLUE CARE NETWORK — BCN HMO: $3,327.47 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $7,085.52 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,327.47 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,327.47
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	$20,629.15	$1,117.04 – $7,521.78
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,195.03 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,260.23 ASR HEALTH BENEFITS — HAP AHLIC: $1,402.82 BCBS GENERIC — BCBS TRAD / TRUST: $3,333.54 BCN DOMESTIC — BCN HMO: $3,333.54 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,333.54 BLUE CARE NETWORK — BCN HMO: $3,333.54 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,195.03 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,333.54 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,333.54
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	$16,421.87	$625.04 – $13,608.70
Removal of tonsils and adenoids (under age 12): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,780.57 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $5,898.54 ASR HEALTH BENEFITS — HAP AHLIC: $747.82 BCBS GENERIC — BCBS TRAD / TRUST: $2,923.16 BCN DOMESTIC — BCN HMO: $2,923.16 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $2,923.16 BLUE CARE NETWORK — BCN HMO: $2,923.16 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $5,780.57 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $2,923.16 BLUE CROSS - AL — BCBS TRAD / TRUST: $2,923.16
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	$38.88 – $246.61
Upper GI endoscopy (diagnostic): 10 of 842 insurance plan rates ACCLAIM — COFINITY: $154.86 AETNA DOMESTIC — AETNA: $180.54 AETNA MEDICAID — MEDICAID: $38.88 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $56.28 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $57.43 ALLEGEANT — COFINITY: $154.86 ALLIED BENEFIT SYSTEMS — COFINITY: $154.86 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $77.53 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $38.88 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $56.28
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing	$354	Not listed in the file	$38.88 – $246.61
Upper GI endoscopy (diagnostic): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $77.53 ACCLAIM — COFINITY: $205.32 ADMINISTRATIVE CONCEPTS — COFINITY: $205.32 AETNA — AETNA: $180.54 AETNA DOMESTIC — AETNA: $180.54 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $56.28 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $56.28 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $38.88 ALLEGEANT — COFINITY: $205.32 ALLIED BENEFIT SYSTEMS — COFINITY: $205.32
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	$5,589.54	$496.67 – $2,085.01
Upper GI endoscopy (diagnostic): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $885.65 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $903.72 ASR HEALTH BENEFITS — HAP AHLIC: $752.55 BCBS GENERIC — BCBS TRAD / TRUST: $722.07 BCN DOMESTIC — BCN HMO: $722.07 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $722.07 BLUE CARE NETWORK — BCN HMO: $722.07 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $885.65 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $722.07 BLUE CROSS - AL — BCBS TRAD / TRUST: $722.07
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	$43.67 – $283.36
Upper GI endoscopy with biopsy: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $86.73 ACCLAIM — COFINITY: $174.58 ADMINISTRATIVE CONCEPTS — COFINITY: $174.58 AETNA — AETNA: $158.67 AETNA DOMESTIC — AETNA: $158.67 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $62.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $43.67 ALLEGEANT — COFINITY: $174.58 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $43.67 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $62.96
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Egd Flexible Transoral W/ Biopsy Single/Multiple	$282	Not listed in the file	$43.67 – $282
Upper GI endoscopy with biopsy: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $86.73 ADMINISTRATIVE CONCEPTS — COFINITY: $163.56 AETNA — AETNA: $158.67 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $62.96 AETNA MEDICARE TRANSPLANT — MEDICARE: $62.96 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $43.67 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $62.96 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $43.67 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $62.96 ALLY ALIGN CARE ADV — MEDICARE: $62.96
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH)	Not listed in the file	$6,041.23	$124.13 – $2,085.01
Upper GI endoscopy with biopsy: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $885.65 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $903.72 ASR HEALTH BENEFITS — HAP AHLIC: $868.16 BCBS GENERIC — BCBS TRAD / TRUST: $876.30 BCN DOMESTIC — BCN HMO: $876.30 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $876.30 BLUE CARE NETWORK — BCN HMO: $876.30 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $885.65 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $876.30 BLUE CROSS - AL — BCBS TRAD / TRUST: $876.30
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing	$369	Not listed in the file	$58.36 – $323.83
Colonoscopy (diagnostic): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $116.43 ACCLAIM — COFINITY: $214.02 AETNA DOMESTIC — AETNA: $200.06 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $58.36 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $86.25 ALLEGEANT — COFINITY: $214.02 ALLIED BENEFIT SYSTEMS — COFINITY: $214.02 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $116.43 AMERIBEN — COFINITY: $214.02 AMERICAN FAMILY — COFINITY: $214.02
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH)	Not listed in the file	$4,125.13	$111.71 – $2,137.82
Colonoscopy (diagnostic): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $908.08 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $926.61 ASR HEALTH BENEFITS — HAP AHLIC: $1,001.05 BCBS GENERIC — BCBS TRAD / TRUST: $817.88 BCN DOMESTIC — BCN HMO: $817.88 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $817.88 BLUE CARE NETWORK — BCN HMO: $817.88 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $908.08 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $817.88 BLUE CROSS - AL — BCBS TRAD / TRUST: $817.88
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	$58.36 – $323.83
Colonoscopy (diagnostic): 10 of 842 insurance plan rates ACCLAIM — COFINITY: $214.02 ADMINISTRATIVE CONCEPTS — COFINITY: $214.02 AETNA — AETNA: $200.06 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.52 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $58.36 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $86.25 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.52 ALLEGEANT — COFINITY: $214.02 ALLIED BENEFIT SYSTEMS — COFINITY: $214.02 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $116.43
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Biopsy Single/Multiple	$403	Not listed in the file	$63.48 – $386.49
Colonoscopy with biopsy: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $125.31 ADMINISTRATIVE CONCEPTS — COFINITY: $233.74 AETNA — AETNA: $239.33 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $90.97 AETNA MEDICARE TRANSPLANT — MEDICARE: $90.97 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $90.97 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $63.48 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $90.97 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $63.48 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $90.97
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH)	Not listed in the file	$5,193.08	$111.71 – $2,750.88
Colonoscopy with biopsy: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,168.49 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,192.34 ASR HEALTH BENEFITS — HAP AHLIC: $1,192.66 BCBS GENERIC — BCBS TRAD / TRUST: $897.33 BCN DOMESTIC — BCN HMO: $897.33 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $897.33 BLUE CARE NETWORK — BCN HMO: $897.33 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,168.49 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $897.33 BLUE CROSS - AL — BCBS TRAD / TRUST: $897.33
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	$63.48 – $386.49
Colonoscopy with biopsy: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $125.31 ADMINISTRATIVE CONCEPTS — COFINITY: $233.74 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $90.97 AETNA — AETNA: $239.33 AETNA DOMESTIC — AETNA: $239.33 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $90.97 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $90.97 AETNA MEDICARE TRANSPLANT — MEDICARE: $90.97 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $63.48 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $92.82
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	$79.98 – $435.19
Colonoscopy with removal of polyps (snare): 10 of 842 insurance plan rates ACCLAIM — COFINITY: $319.58 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $114.24 AETNA DOMESTIC — AETNA: $284.43 AETNA MEDICAID — MEDICAID: $79.98 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $114.24 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $79.98 ALLEGEANT — COFINITY: $319.58 ALLIED BENEFIT SYSTEMS — COFINITY: $319.58 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $157.37 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $79.98
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech	$506	Not listed in the file	$79.98 – $435.19
Colonoscopy with removal of polyps (snare): 10 of 842 insurance plan rates ACCLAIM — COFINITY: $293.48 ADMINISTRATIVE CONCEPTS — COFINITY: $293.48 AETNA — AETNA: $284.43 AETNA DOMESTIC — AETNA: $284.43 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $114.24 AETNA MEDICARE TRANSPLANT — MEDICARE: $114.24 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $79.98 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $79.98 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $114.24 ALLEGEANT — COFINITY: $293.48
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH)	Not listed in the file	$5,381.51	$111.71 – $2,750.88
Colonoscopy with removal of polyps (snare): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,168.49 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,192.34 ASR HEALTH BENEFITS — HAP AHLIC: $1,345.05 BCBS GENERIC — BCBS TRAD / TRUST: $897.33 BCN DOMESTIC — BCN HMO: $897.33 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $897.33 BLUE CARE NETWORK — BCN HMO: $897.33 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,168.49 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $897.33 BLUE CROSS - AL — BCBS TRAD / TRUST: $897.33
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Colonscopy Colorectal Cancer Screening Non High Risk Patient	$769	Not listed in the file	$58.47 – $446.02
Screening colonoscopy (not high risk): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $116.82 ADMINISTRATIVE CONCEPTS — COFINITY: $446.02 AETNA — AETNA: $143.69 AETNA MEDICAID — MEDICAID: $58.47 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $84.80 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.80 ALLIED BENEFIT SYSTEMS — COFINITY: $446.02 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $116.82 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $58.47 ALLY ALIGN CARE ADV — MEDICARE: $84.80
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Colonoscopy Colorectal Cancer Screening Non High Risk Patient (Restricted Method II CAH)	Not listed in the file	$4,034.13	$111.71 – $2,137.82
Screening colonoscopy (not high risk): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $908.08 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $926.61 ASR HEALTH BENEFITS — HAP AHLIC: $1,001.05 BCBS GENERIC — BCBS TRAD / TRUST: $817.88 BCN DOMESTIC — BCN HMO: $817.88 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $817.88 BLUE CARE NETWORK — BCN HMO: $817.88 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $908.08 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $817.88 BLUE CROSS - AL — BCBS TRAD / TRUST: $817.88
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	$58.47 – $446.02
Screening colonoscopy (not high risk): 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $116.82 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $84.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $84.80 AETNA MEDICARE TRANSPLANT — MEDICARE: $84.80 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $58.47 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $84.80 ALLIED BENEFIT SYSTEMS — COFINITY: $446.02 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $84.80 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $58.47 AMERIBEN — COFINITY: $446.02
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,451	Not listed in the file	$12.26 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $993.98
Gallbladder removal by laparoscope: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $462.72 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $335.90 AETNA DOMESTIC — AETNA: $574.75 AETNA MEDICAID — MEDICAID: $213.64 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $335.90 AETNA MEDICARE TRANSPLANT — MEDICARE: $335.90 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $213.64 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $342.75 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $462.72 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $213.64
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Laparoscopy Surgical Cholecystectomy	$1,541	Not listed in the file	$213.64 – $993.98
Gallbladder removal by laparoscope: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $462.72 ACCLAIM — COFINITY: $893.78 ADMINISTRATIVE CONCEPTS — COFINITY: $893.78 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $335.90 AETNA — AETNA: $574.75 AETNA MEDICAID — MEDICAID: $213.64 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $335.90 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $213.64 ALLEGEANT — COFINITY: $893.78 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $462.72
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	$24,865.98	$1,438.76 – $13,897.66
Gallbladder removal by laparoscope: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $5,903.31 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $6,023.79 ASR HEALTH BENEFITS — HAP AHLIC: $1,936.15 BCBS GENERIC — BCBS TRAD / TRUST: $5,257.02 BCN DOMESTIC — BCN HMO: $5,257.02 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $5,257.02 BLUE CARE NETWORK — BCN HMO: $5,257.02 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $5,903.31 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $5,257.02 BLUE CROSS - AL — BCBS TRAD / TRUST: $5,257.02
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,157	Not listed in the file	$9.77 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $794.77
Groin (inguinal) hernia repair, age 5 or older: 10 of 842 insurance plan rates AETNA DOMESTIC — AETNA: $381.92 AETNA MEDICAID — MEDICAID: $169.76 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $268.58 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $169.76 ALLIED BENEFIT SYSTEMS — COFINITY: $671.06 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $369.98 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $169.76 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $268.58 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $169.76 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $268.58
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Repr Init Ing Hernia 5y or Older Reducible	$1,199	Not listed in the file	$169.76 – $794.77
Groin (inguinal) hernia repair, age 5 or older: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $369.98 ACCLAIM — COFINITY: $695.42 ADMINISTRATIVE CONCEPTS — COFINITY: $695.42 AETNA — AETNA: $381.92 AETNA MEDICAID — MEDICAID: $169.76 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $268.58 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $169.76 ALLEGEANT — COFINITY: $695.42 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $169.76 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $268.58
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	$18,167.01	$1,139.81 – $13,955.98
Groin (inguinal) hernia repair, age 5 or older: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,496.17 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,567.53 ASR HEALTH BENEFITS — HAP AHLIC: $1,338.70 BCBS GENERIC — BCBS TRAD / TRUST: $3,975.31 BCN DOMESTIC — BCN HMO: $3,975.31 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $3,975.31 BLUE CARE NETWORK — BCN HMO: $3,975.31 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $3,496.17 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $3,975.31 BLUE CROSS - AL — BCBS TRAD / TRUST: $3,975.31
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	$2,159	$1,403.35	$472.42 – $2,159
Prostate biopsy: 10 of 249 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,468.12 ACCESS HEALTH — COFINITY PPO: $1,584.71 ACCLAIM — COFINITY PPO: $1,584.71 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $949.96 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,584.71 AETNA — AETNA DOMINOS PPO: $978.03 AETNA — AETNA PPO: $1,351.53 AETNA — AETNA PREFERRED: $673.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $820.42 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,835.15
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach	Not listed in the file	$18,040.53	$350.01 – $1,617.64
Prostate biopsy: 10 of 85 insurance plan rates ASR HEALTH BENEFITS — HAP AHLIC: $553.28 BCBS GENERIC — BCBS TRAD / TRUST: $1,617.64 BCN DOMESTIC — BCN HMO: $1,617.64 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,617.64 BLUE CARE NETWORK — BCN HMO: $1,617.64 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $350.01 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,617.64 BLUE CROSS - AL — BCBS TRAD / TRUST: $1,617.64 BLUE CROSS - AR — BCBS TRAD / TRUST: $1,617.64 BLUE CROSS - AZ — BCBS TRAD / TRUST: $1,617.64
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	$50,137.69	$1,241.17 – $24,436.21
Prostate removal by laparoscope (radical prostatectomy): 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $10,379.78 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $10,591.61 ASR HEALTH BENEFITS — HAP AHLIC: $4,384.54 BCBS GENERIC — BCBS TRAD / TRUST: $14,605 BCN DOMESTIC — BCN HMO: $14,605 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $14,605 BLUE CARE NETWORK — BCN HMO: $14,605 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $10,379.78 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $14,605 BLUE CROSS - AL — BCBS TRAD / TRUST: $14,605
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	$4,322	$2,809.30	$968.54 – $7,441.61
Hysteroscopy with biopsy of the uterus lining: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,938.96 ACCESS HEALTH — COFINITY PPO: $3,172.35 ACCLAIM — COFINITY PPO: $3,172.35 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,901.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $3,172.35 AETNA — AETNA DOMINOS PPO: $1,957.87 AETNA — AETNA PPO: $2,705.57 AETNA — AETNA PREFERRED: $1,348.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $3,160.98 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $3,225.49
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$684	Not listed in the file	$73.91 – $396.72
Hysteroscopy with biopsy of the uterus lining: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $148.07 ACCLAIM — COFINITY: $396.72 ADMINISTRATIVE CONCEPTS — COFINITY: $396.72 AETNA — AETNA: $230.28 AETNA DOMESTIC — AETNA: $230.28 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.49 AETNA MEDICARE TRANSPLANT — MEDICARE: $107.49 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $73.91 ALLEGEANT — COFINITY: $396.72 ALLIED BENEFIT SYSTEMS — COFINITY: $396.72
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PR Hysteroscopy W/Biopsy Endometrium and/or Polypectomy W/O and/or W/D&C	$498	Not listed in the file	$6.37 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $332.11
Hysteroscopy with biopsy of the uterus lining: 10 of 842 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $148.07 ACCLAIM — COFINITY: $288.84 ADMINISTRATIVE CONCEPTS — COFINITY: $288.84 AETNA — AETNA: $230.28 AETNA DOMESTIC — AETNA: $230.28 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $107.49 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $73.91 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $73.91 ALLEGEANT — COFINITY: $288.84 ALLIED BENEFIT SYSTEMS — COFINITY: $288.84
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance	$1,717	$1,116.05	$353.38 – $1,717
Spinal injection, lower back (epidural), with imaging guidance: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $1,167.56 ACCESS HEALTH — COFINITY PPO: $1,260.28 ACCLAIM — COFINITY PPO: $1,260.28 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $755.48 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $1,260.28 AETNA — AETNA DOMINOS PPO: $777.80 AETNA — AETNA PPO: $1,074.84 AETNA — AETNA PREFERRED: $535.70 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $689.28 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $703.34
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl	$3,822	$2,484.30	$484.35 – $3,822
Nerve root injection, lower back, with imaging guidance: 10 of 257 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $2,598.96 ACCESS HEALTH — COFINITY PPO: $2,805.35 ACCLAIM — COFINITY PPO: $2,805.35 ACS BENEFIT SERVICES — COFINITY ADVANTAGE BUSINESS: $1,681.68 ADMINISTRATIVE CONCEPTS — COFINITY PPO: $2,805.35 AETNA — AETNA DOMINOS PPO: $1,731.37 AETNA — AETNA PPO: $2,392.57 AETNA — AETNA PREFERRED: $1,192.46 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $863.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $881.29
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · Hospital (facility) fee · modifier 50 In the file: HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl\|BILATERAL PROCEDURE	$3,822	$2,484.30	$484.35 – $3,822
Nerve root injection, lower back, with imaging guidance: 10 of 94 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $863.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $881.29 BCBS GENERIC — BCBS TRAD / TRUST: $1,086.26 BCN DOMESTIC — BCN HMO: $1,086.26 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $1,086.26 BLUE CARE NETWORK — BCN HMO: $1,086.26 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $863.67 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $1,086.26 BLUE CROSS - AL — BCBS TRAD / TRUST: $1,086.26 BLUE CROSS - AR — BCBS TRAD / TRUST: $1,086.26
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Neuroplasty/Transposition Median Nerve at Carpal Tunnel	$918	Not listed in the file	$122.01 – $634.94
Carpal tunnel release: 10 of 842 insurance plan rates ACCLAIM — COFINITY: $532.44 AETNA — AETNA: $341.59 AETNA MEDICAID — MEDICAID: $143.67 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $214.57 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $143.67 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $143.67 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $218.95 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $214.57 ALLEGEANT — COFINITY: $532.44 ALLWELL PA HEALTH & WELLNESS MEDICAID ADVANTAGE — MEDICAID: $143.67
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 – $634.94
Carpal tunnel release: 10 of 842 insurance plan rates ACCLAIM — COFINITY: $577.10 ADMINISTRATIVE CONCEPTS — COFINITY: $577.10 AETNA — AETNA: $341.59 AETNA DOMESTIC — AETNA: $341.59 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $214.57 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $214.57 ALLIED BENEFIT SYSTEMS — COFINITY: $577.10 ALLY ALIGN CARE ADV — MEDICARE: $214.57 AMERICAN FAMILY — COFINITY: $577.10 AMERICAN HEALTH PLAN — MEDICARE: $214.57
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	$14,163.17	$975.18 – $4,488.99
Carpal tunnel release: 10 of 100 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,906.79 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $1,945.70 ASR HEALTH BENEFITS — HAP AHLIC: $1,085.84 BCBS GENERIC — BCBS TRAD / TRUST: $2,083 BCN DOMESTIC — BCN HMO: $2,083 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $2,083 BLUE CARE NETWORK — BCN HMO: $2,083 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $1,906.79 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $2,083 BLUE CROSS - AL — BCBS TRAD / TRUST: $2,083

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care	$4,354	Not listed in the file	$850.07 – $3,528.56
Vaginal delivery, with care before and after: 10 of 842 insurance plan rates ACCLAIM — COFINITY: $2,525.32 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,192.41 AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,192.41 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1,110.37 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,110.37 ALLEGEANT — COFINITY: $2,525.32 ALLIED BENEFIT SYSTEMS — COFINITY: $2,525.32 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,642.61 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $1,192.41
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	$850.07 – $3,528.56
Vaginal delivery, with care before and after: 10 of 842 insurance plan rates ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $1,192.41 AETNA MEDICAID — MEDICAID: $1,110.37 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $1,192.41 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,110.37 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,216.75 ALIGNMENT HEALTH PLAN MEDICARE ADVANTAGE — MEDICARE: $1,192.41 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,110.37 ALLWELL MEDICARE ADVANTAGE — MEDICARE: $1,192.41 ALLY ALIGN CARE ADV — MEDICARE: $1,192.41 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $1,192.41
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · Doctor (professional) fee In the file: PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care	$4,753	Not listed in the file	$962.89 – $3,984.82
Cesarean delivery (C-section), with care before and after: 10 of 842 insurance plan rates ACCLAIM — COFINITY: $2,756.74 AETNA MEDICAID — MEDICAID: $1,237.88 ALBANY COUNTY CORRECTIONAL FACILITY — MEDICAID: $1,237.88 ALIGN SENIOR CARE — ALIGN SENIOR CARE: $1,374.08 ALLEGEANT — COFINITY: $2,756.74 ALLIED BENEFIT SYSTEMS — COFINITY: $2,756.74 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,855 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,237.88 ALLWELL PA HEALTH & WELLNESS MEDICARE ADVANTAGE — MEDICARE: $1,346.60 AMERICAN FAMILY — COFINITY: $2,756.74
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	$962.89 – $3,984.82
Cesarean delivery (C-section), with care before and after: 10 of 842 insurance plan rates AETNA DOMESTIC — AETNA: $1,842.82 AETNA MEDICAID — MEDICAID: $1,237.88 AETNA MEDICARE ASSURE PREMIER HMO D-SNP — MEDICARE: $1,346.60 AFFINITY HEALTH PLAN MEDICAID ADVANTAGE — MEDICAID: $1,237.88 ALLIED BENEFIT SYSTEMS — COFINITY: $3,398.80 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $1,855 ALLWELL MEDICAID ADVANTAGE — MEDICAID: $1,237.88 AMERICAN FAMILY — COFINITY: $3,398.80 AMERICAN HEALTH ADVANTAGE OF IDAHO — MEDICARE: $1,346.60 AMERICAN POSTAL WORKERS SECONDARY — PRIORITY HEALTH CIGNA: $1,795.03
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 844 insurance plan rates 1199 NATIONAL BENEFIT FUND — MULTIPLAN: $296.80 ACCLAIM — COFINITY: $543.81 ADMINISTRATIVE CONCEPTS — COFINITY: $543.81 ADVANTRA FREEDOM MEDICARE ADVANTAGE — MEDICARE: $215.46 AETNA — AETNA: $294.85 AETNA MEDICAID — MEDICAID: $198.06 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $215.46 ALLEGEANT — COFINITY: $543.81 ALLIED BENEFIT SYSTEMS — COFINITY: $543.81 ALLIED NATIONAL GLOBAL CARE — MULTIPLAN: $296.80

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	$177,244.52	$229 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $203,700.02
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 89 insurance plan rates AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $69,974.70 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $71,402.75 BCBS GENERIC — BCBS TRAD / TRUST: $203,700.02 BCN DOMESTIC — BCN HMO: $203,700.02 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $203,700.02 BLUE CARE NETWORK — BCN HMO: $203,700.02 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $69,974.70 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $203,700.02 BLUE CROSS - AL — BCBS TRAD / TRUST: $203,700.02 BLUE CROSS - AR — BCBS TRAD / TRUST: $203,700.02
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	$38,756.69	$1,057.49 – $37,083.08
Hip or knee replacement (major joint of the leg), without major complications: 10 of 100 insurance plan rates AETNA — AETNA PPO: $28,767.61 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $14,142.94 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $14,431.57 ASR HEALTH BENEFITS — HAP AHLIC: $31,562.59 BCBS GENERIC — BCBS TRAD / TRUST: $37,083.08 BCN DOMESTIC — BCN HMO: $37,083.08 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $37,083.08 BLUE CARE NETWORK — BCN HMO: $37,083.08 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $14,142.94 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $37,083.08
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	$61,682.89	$1,057.49 – $2,000
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans HOSPICE ADVANTAGE — HOSPICE ADVANTAGE: $1,057.49 VITALCORE — VITALCORE PHYSICIANS GROUP: $2,000
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	$34,636.19	$1,057.49 – $23,363.41
Uterus and ovary surgery (not for cancer), without complications: 10 of 100 insurance plan rates AETNA — AETNA PPO: $18,503.80 AETNA MEDICARE ADVANTAGE — AETNA MEDICARE ADVANTAGE: $9,250.66 ALIGN SENIOR CARE — ALIGN SENIOR CARE MEDICARE ADVANTAGE: $9,439.45 ASR HEALTH BENEFITS — HAP AHLIC: $20,301.57 BCBS GENERIC — BCBS TRAD / TRUST: $23,363.41 BCN DOMESTIC — BCN HMO: $23,363.41 BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS — BCBS TRAD / TRUST: $23,363.41 BLUE CARE NETWORK — BCN HMO: $23,363.41 BLUE CARE NETWORK ADVANTAGE — BCN MEDICARE ADVANTAGE: $9,250.66 BLUE CROSS - AK (PREMERA) — BCBS TRAD / TRUST: $23,363.41

Source: Trinity Health Oakland 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	44405 Woodward Ave, Pontiac, MI 48341
County	Oakland County
State	Michigan
Phone	(248) 858‑3000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	230029
Name in Medicare records	TRINITY HEALTH OAKLAND HOSPITAL
Profile level	Medicare data + hospital website
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 Oakland Hospital — trinityhealthmichigan.org
Pediatric Specialty Clinics | Trinity Health Michigan — trinityhealthmichigan.org
Awards and Recognition | Trinity Health Michigan — trinityhealthmichigan.org
Supportive Cancer Care and Services | Trinity Health Michigan — trinityhealthmichigan.org
Maternity Care | Trinity Health Michigan — trinityhealthmichigan.org

Trinity Health Oakland Hospital

Summary

Profile from official sources

At a glance