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Acute Care Hospital

Union Hospital

Dover, Ohio · Tuscarawas County · Emergency services listed

Summary

Union Hospital is an acute care hospital in Dover, Ohio. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 84 services, specialties and programs. Medicare lists 496 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(330) 343‑3311 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
496Doctors and clinicians
84Services listed

Quick answers

Does Union Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Union Hospital. In a medical emergency, call 911.
Where is Union Hospital?
659 Boulevard, Dover, OH 44622, in Tuscarawas County, Ohio.
What is the phone number of Union Hospital?
(330) 343-3311, as listed by Medicare (CMS).
What is the Medicare star rating of Union Hospital?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[5][10][12][13][15][17]

Conditions treated[14][15]

Treatments[7][10][11][12][14]

  • Stress testing with nuclear imaging
  • Echocardiography
  • Adult and pediatric ECG
  • Cardioversion
  • Holter, event and continuous ECG monitoring
  • Telestroke stroke evaluation
  • 3D digital mammography
  • Breast ultrasound
  • Ultrasound-guided breast biopsy
  • Stereotactic breast biopsy
  • Low-dose CT lung screening
  • Bone densitometry
  • PET scanning
  • Nuclear medicine
  • Fluoroscopy

Procedures[5][11][17]

  • Surgery and endoscopy
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • Angiogram
  • Angioplasty
  • Atherectomy
  • IVC filter placement
  • Vascular embolization
  • Interventional radiology biopsy
  • Kyphoplasty
  • Nephrostomy tube placement
  • General surgery
  • Orthopaedic surgery
  • Eye surgery
  • Gynecologic surgery
  • Head and neck surgery
  • Oral and maxillofacial surgery
  • Podiatric surgery

Programs and centers[5][9][16]

  • Stroke Center
  • Inpatient Rehabilitation
  • Pulmonary Rehabilitation
  • Wound Healing Center
  • Infusion Center
  • Home Health Care
  • Diabetes Learning Center
  • Outpatient Diabetes Self-Management Training
  • M-Power Program (trauma-informed maternity care)
  • Childbirth Education Classes
  • Lactation Consultation
  • BLS and ACLS CPR classes

Emergency care (hospital website)[5][8][10][12]

Emergency roomYes
Open 24/7Yes
Stroke designationCertified Primary Stroke Center (The Joint Commission)

Visiting and practical information

VisitingOpen visitation 24/7, except in some ICU settings[6]
ParkingWeekdays until 4 p.m. visitors use visitor lots only; after 4 p.m. and weekends any lot[8]

Recognition[7][9][12]

  • Primary Stroke Center certified by The Joint Commission
  • Get With The Guidelines Stroke Gold Plus with Target: Stroke Honor Roll-Elite and Rural Stroke Award (AHA/ASA) 2026
  • DNV accreditation
  • Diabetes Learning Center accredited by the American Diabetes Association
  • Outpatient Diabetes Self-Management Training certified by the American Diabetes Association

Doctors and clinicians (496)

496 doctors and other clinicians list Union 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

Doctors with a page on this site (496)

And 472 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Union 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 hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1066%National average: 72%
Would definitely recommend the hospital63%National average: 71%
Nurses “always” communicated well80%National average: 80%
Doctors “always” communicated well79%National average: 80%
Staff “always” explained medicines before giving them61%National average: 62%
Were given information about recovery at home86%National average: 86%
Room and bathroom “always” clean75%National average: 74%
Area around the room “always” quiet at night41%National average: 60%
Completed surveys517Response rate: 23%

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)Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)Not reported to Medicare
Surgical site infections after colon surgery2.185No different from the national benchmark
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infectionsNot reported to Medicare
Clostridioides difficile (C. diff) intestinal infections0.309No different from 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 patientsToo few cases to report
Deaths within 30 days: heart failure patients12.2%
Deaths within 30 days: pneumonia patients15.8%
Deaths within 30 days: COPD patients8.9%
Deaths within 30 days: stroke patients13.9%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)1.02No different from the national rate
Complications after hip or knee replacementToo few cases to report

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 attackToo few cases to report
Readmitted within 30 days: heart failure20.2%
Readmitted within 30 days: pneumonia17.4%
Readmitted within 30 days: COPD21.2%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementToo few cases to report

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)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)216 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)58%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 OhioBest hospitals in Ohio

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 86 common services exactly as Union 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 →

$ 55 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD NEW ONLINE E&M LEVEL 3 $640 $416 $162.62 – $640
New patient office visit (about 30–44 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $147.69
  • Aetna — All Products First Health: $480
  • Aetna — Asa: $512
  • Aetna — Medicare Advantage: $70.77
  • Aetna — Qhp/Ifp: $640
  • AmeriHealth — Managed Medicaid: $46.44
  • Anthem — All Products Mid-Level Facility: $94.87
  • Anthem — All Products Mid-Level Non-Facility: $126.59
  • Anthem — Medicare Advantage: $70.77
  • Aultcare — Medicare Advantage: $74.31
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $640 $416 $162.62 – $640
New patient office visit (about 30–44 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $147.69
  • Aetna — All Products First Health: $480
  • Aetna — Asa: $512
  • Aetna — Medicare Advantage: $70.77
  • Aetna — Qhp/Ifp: $640
  • AmeriHealth — Managed Medicaid: $46.44
  • Anthem — All Products Mid-Level Facility: $94.87
  • Anthem — All Products Mid-Level Non-Facility: $126.59
  • Anthem — Medicare Advantage: $70.77
  • Aultcare — Medicare Advantage: $74.31
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEW PATIENT VISIT LEVEL 3 $25 $16.25 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $186.72
New patient office visit (about 30–44 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $147.69
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Medicare Advantage: $70.77
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $46.44
  • Anthem — All Products Mid-Level Facility: $94.87
  • Anthem — All Products Mid-Level Non-Facility: $126.59
  • Anthem — Medicare Advantage: $70.77
  • Aultcare — Medicare Advantage: $74.31
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD NEW ONLINE E&M LEVEL 4 $1,040 $676 $264.26 – $1,040
New patient office visit (about 45–59 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $225.33
  • Aetna — All Products First Health: $780
  • Aetna — Asa: $832
  • Aetna — Medicare Advantage: $115.62
  • Aetna — Qhp/Ifp: $1,040
  • AmeriHealth — Managed Medicaid: $75.19
  • Anthem — All Products Mid-Level Facility: $152.41
  • Anthem — All Products Mid-Level Non-Facility: $188.44
  • Anthem — Medicare Advantage: $115.62
  • Aultcare — Medicare Advantage: $121.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $1,040 $676 $264.26 – $1,040
New patient office visit (about 45–59 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $225.33
  • Aetna — All Products First Health: $780
  • Aetna — Asa: $832
  • Aetna — Medicare Advantage: $115.62
  • Aetna — Qhp/Ifp: $1,040
  • AmeriHealth — Managed Medicaid: $75.19
  • Anthem — All Products Mid-Level Facility: $152.41
  • Anthem — All Products Mid-Level Non-Facility: $188.44
  • Anthem — Medicare Advantage: $115.62
  • Aultcare — Medicare Advantage: $121.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEW PATIENT VISIT LEVEL 4 $25 $16.25 $6.35 – $25
New patient office visit (about 45–59 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $225.33
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Medicare Advantage: $115.62
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $75.19
  • Anthem — All Products Mid-Level Facility: $152.41
  • Anthem — All Products Mid-Level Non-Facility: $188.44
  • Anthem — Medicare Advantage: $115.62
  • Aultcare — Medicare Advantage: $121.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD NEW ONLINE E&M LEVEL 5 $1,400 $910 $355.74 – $1,400
New patient office visit (about 60–74 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $283.75
  • Aetna — All Products First Health: $1,050
  • Aetna — Asa: $1,120
  • Aetna — Medicare Advantage: $158.48
  • Aetna — Qhp/Ifp: $1,400
  • AmeriHealth — Managed Medicaid: $102.03
  • Anthem — All Products Mid-Level Facility: $206.82
  • Anthem — All Products Mid-Level Non-Facility: $248.97
  • Anthem — Medicare Advantage: $158.48
  • Aultcare — Medicare Advantage: $166.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $1,400 $910 $355.74 – $1,400
New patient office visit (about 60–74 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $283.75
  • Aetna — All Products First Health: $1,050
  • Aetna — Asa: $1,120
  • Aetna — Medicare Advantage: $158.48
  • Aetna — Qhp/Ifp: $1,400
  • AmeriHealth — Managed Medicaid: $102.03
  • Anthem — All Products Mid-Level Facility: $206.82
  • Anthem — All Products Mid-Level Non-Facility: $248.97
  • Anthem — Medicare Advantage: $158.48
  • Aultcare — Medicare Advantage: $166.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEW PATIENT VISIT LEVEL 5 $25 $16.25 $6.35 – $25
New patient office visit (about 60–74 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $283.75
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Medicare Advantage: $158.48
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $102.03
  • Anthem — All Products Mid-Level Facility: $206.82
  • Anthem — All Products Mid-Level Non-Facility: $248.97
  • Anthem — Medicare Advantage: $158.48
  • Aultcare — Medicare Advantage: $166.40
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD EST ONLINE E&M LEVEL 3 $520 $338 $132.13 – $520
Established patient office visit (about 20–29 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $101.07
  • Aetna — All Products First Health: $390
  • Aetna — Asa: $416
  • Aetna — Medicare Advantage: $56.80
  • Aetna — Qhp/Ifp: $520
  • AmeriHealth — Managed Medicaid: $37.11
  • Anthem — All Products Mid-Level Facility: $75.39
  • Anthem — All Products Mid-Level Non-Facility: $101.69
  • Anthem — Medicare Advantage: $56.80
  • Aultcare — Medicare Advantage: $59.64
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN $520 $338 $132.13 – $520
Established patient office visit (about 20–29 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $101.07
  • Aetna — All Products First Health: $390
  • Aetna — Asa: $416
  • Aetna — Medicare Advantage: $56.80
  • Aetna — Qhp/Ifp: $520
  • AmeriHealth — Managed Medicaid: $37.11
  • Anthem — All Products Mid-Level Facility: $75.39
  • Anthem — All Products Mid-Level Non-Facility: $101.69
  • Anthem — Medicare Advantage: $56.80
  • Aultcare — Medicare Advantage: $59.64
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EST PATIENT VISIT LEVEL 3 $25 $16.25 $6.35 – $25
Established patient office visit (about 20–29 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $101.07
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Medicare Advantage: $56.80
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $37.11
  • Anthem — All Products Mid-Level Facility: $75.39
  • Anthem — All Products Mid-Level Non-Facility: $101.69
  • Anthem — Medicare Advantage: $56.80
  • Aultcare — Medicare Advantage: $59.64
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OD EST ONLINE E&M LEVEL 4 $768 $499.20 $195.15 – $768
Established patient office visit (about 30–39 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $148.30
  • Aetna — All Products First Health: $576
  • Aetna — Asa: $614.40
  • Aetna — Medicare Advantage: $83.59
  • Aetna — Qhp/Ifp: $768
  • AmeriHealth — Managed Medicaid: $54.44
  • Anthem — All Products Mid-Level Facility: $111.30
  • Anthem — All Products Mid-Level Non-Facility: $144.09
  • Anthem — Medicare Advantage: $83.59
  • Aultcare — Medicare Advantage: $87.77
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN $768 $499.20 $195.15 – $768
Established patient office visit (about 30–39 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $148.30
  • Aetna — All Products First Health: $576
  • Aetna — Asa: $614.40
  • Aetna — Medicare Advantage: $83.59
  • Aetna — Qhp/Ifp: $768
  • AmeriHealth — Managed Medicaid: $54.44
  • Anthem — All Products Mid-Level Facility: $111.30
  • Anthem — All Products Mid-Level Non-Facility: $144.09
  • Anthem — Medicare Advantage: $83.59
  • Aultcare — Medicare Advantage: $87.77
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EST PATIENT VISIT LEVEL 4 $25 $16.25 $6.35 – $25
Established patient office visit (about 30–39 minutes): 10 of 52 insurance plan rates
  • Aetna — Acop: $148.30
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Medicare Advantage: $83.59
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $54.44
  • Anthem — All Products Mid-Level Facility: $111.30
  • Anthem — All Products Mid-Level Non-Facility: $144.09
  • Anthem — Medicare Advantage: $83.59
  • Aultcare — Medicare Advantage: $87.77
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $720 $468 $182.95 – $720
Office consultation with a specialist (moderate): 10 of 40 insurance plan rates
  • Aetna — Acop: $167.99
  • Aetna — All Products First Health: $540
  • Aetna — Asa: $576
  • Aetna — Qhp/Ifp: $720
  • AmeriHealth — Managed Medicaid: $52.54
  • Anthem — All Products Mid-Level Facility: $101.34
  • Anthem — All Products Mid-Level Non-Facility: $128.37
  • Aultcare — PPO/HMO: $311.76
  • Buckeye — Managed Medicaid: $47.76
  • Caresource — Managed Medicaid: $50.15
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $720 $468 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $282.28
Office consultation with a specialist (moderate): 10 of 40 insurance plan rates
  • Aetna — Acop: $167.99
  • Aetna — All Products First Health: $540
  • Aetna — Asa: $576
  • Aetna — Qhp/Ifp: $720
  • AmeriHealth — Managed Medicaid: $52.54
  • Anthem — All Products Mid-Level Facility: $101.34
  • Anthem — All Products Mid-Level Non-Facility: $128.37
  • Aultcare — PPO/HMO: $311.76
  • Buckeye — Managed Medicaid: $47.76
  • Caresource — Managed Medicaid: $50.15
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est low 30 Not listed in the file Not listed in the file $73.77 – $81.15
Office consultation with a specialist (moderate): rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $81.15
  • ANTHEM — Managed Medicaid: $77.46
  • Buckeye — Managed Medicaid: $73.77
  • CARESOURCE — Managed Medicaid: $78.93
  • MOLINA — Managed Medicaid: $77.46
  • UNITED — Managed Medicaid: $78.93
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $1,076 $699.40 $273.41 – $1,076
Office consultation with a specialist (moderate to high): 10 of 40 insurance plan rates
  • Aetna — Acop: $252.18
  • Aetna — All Products First Health: $807
  • Aetna — Asa: $860.80
  • Aetna — Qhp/Ifp: $1,076
  • AmeriHealth — Managed Medicaid: $83.94
  • Anthem — All Products Mid-Level Facility: $154.51
  • Anthem — All Products Mid-Level Non-Facility: $184.07
  • Aultcare — PPO/HMO: $465.91
  • Buckeye — Managed Medicaid: $76.31
  • Caresource — Managed Medicaid: $80.13
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $1,076 $699.40 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $282.28
Office consultation with a specialist (moderate to high): 10 of 40 insurance plan rates
  • Aetna — Acop: $252.18
  • Aetna — All Products First Health: $807
  • Aetna — Asa: $860.80
  • Aetna — Qhp/Ifp: $1,076
  • AmeriHealth — Managed Medicaid: $83.94
  • Anthem — All Products Mid-Level Facility: $154.51
  • Anthem — All Products Mid-Level Non-Facility: $184.07
  • Aultcare — PPO/HMO: $465.91
  • Buckeye — Managed Medicaid: $76.31
  • Caresource — Managed Medicaid: $80.13
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Off/op cnsltj new/est mod 40 Not listed in the file Not listed in the file $73.77 – $81.15
Office consultation with a specialist (moderate to high): rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $81.15
  • ANTHEM — Managed Medicaid: $77.46
  • Buckeye — Managed Medicaid: $73.77
  • CARESOURCE — Managed Medicaid: $78.93
  • MOLINA — Managed Medicaid: $77.46
  • UNITED — Managed Medicaid: $78.93
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $184 $119.60 $40.11 – $184
Preventive checkup, new patient, age 18–39: 10 of 42 insurance plan rates
  • AETNA — Acop: $69.18
  • AETNA — ALL PRODUCTS: $138
  • AETNA — Asa_Whirlpool_Peia: $83.54
  • AETNA — MEDICARE ADVANTAGE: $40.11
  • AETNA — Qhp/Ipf: $184
  • AMERIHEALTH — Managed Medicaid: $81.15
  • Amish Community Aid Plan — ALL PRODUCTS: $82.80
  • ANTHEM — HPN: $70.03
  • ANTHEM — Managed Medicaid: $77.46
  • ANTHEM — PPO/HMO: $82.40
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WELLNESS EXAM NEW 18-39 YRS $768 $499.20 $195.15 – $768
Preventive checkup, new patient, age 18–39: 10 of 39 insurance plan rates
  • Aetna — Acop: $180.64
  • Aetna — All Products First Health: $576
  • Aetna — Asa: $614.40
  • Aetna — Qhp/Ifp: $768
  • AmeriHealth — Managed Medicaid: $53.87
  • Anthem — All Products Mid-Level Facility: $107.58
  • Anthem — All Products Mid-Level Non-Facility: $145.42
  • Aultcare — PPO/HMO: $332.54
  • Buckeye — Managed Medicaid: $48.97
  • Caresource — Managed Medicaid: $51.42
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39 $25 $16.25 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $282.28
Preventive checkup, new patient, age 18–39: 10 of 39 insurance plan rates
  • Aetna — Acop: $180.64
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $53.87
  • Anthem — All Products Mid-Level Facility: $107.58
  • Anthem — All Products Mid-Level Non-Facility: $145.42
  • Aultcare — PPO/HMO: $10.83
  • Buckeye — Managed Medicaid: $48.97
  • Caresource — Managed Medicaid: $51.42
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $254 $165.10 $55.37 – $254
Preventive checkup, new patient, age 40–64: 10 of 42 insurance plan rates
  • AETNA — Acop: $95.50
  • AETNA — ALL PRODUCTS: $190.50
  • AETNA — Asa_Whirlpool_Peia: $115.32
  • AETNA — MEDICARE ADVANTAGE: $55.37
  • AETNA — Qhp/Ipf: $254
  • AMERIHEALTH — Managed Medicaid: $81.15
  • Amish Community Aid Plan — ALL PRODUCTS: $114.30
  • ANTHEM — HPN: $96.67
  • ANTHEM — Managed Medicaid: $77.46
  • ANTHEM — PPO/HMO: $113.74
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WELLNESS EXAMS NEW 40-64 YRS $932 $605.80 $236.82 – $932
Preventive checkup, new patient, age 40–64: 10 of 39 insurance plan rates
  • Aetna — Acop: $210.25
  • Aetna — All Products First Health: $699
  • Aetna — Asa: $745.60
  • Aetna — Qhp/Ifp: $932
  • AmeriHealth — Managed Medicaid: $68.52
  • Anthem — All Products Mid-Level Facility: $130.37
  • Anthem — All Products Mid-Level Non-Facility: $167.87
  • Aultcare — PPO/HMO: $403.56
  • Buckeye — Managed Medicaid: $62.29
  • Caresource — Managed Medicaid: $65.40
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64 $25 $16.25 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $282.28
Preventive checkup, new patient, age 40–64: 10 of 39 insurance plan rates
  • Aetna — Acop: $210.25
  • Aetna — All Products First Health: $18.75
  • Aetna — Asa: $20
  • Aetna — Qhp/Ifp: $25
  • AmeriHealth — Managed Medicaid: $68.52
  • Anthem — All Products Mid-Level Facility: $130.37
  • Anthem — All Products Mid-Level Non-Facility: $167.87
  • Aultcare — PPO/HMO: $10.83
  • Buckeye — Managed Medicaid: $62.29
  • Caresource — Managed Medicaid: $65.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM $1,911 $1,242.15 $540.43 – $1,719.90
Emergency room visit (moderate): 10 of 58 insurance plan rates
  • AETNA — Acop: $718.54
  • AETNA — ALL PRODUCTS: $1,433.25
  • AETNA — Asa_Whirlpool_Peia: $867.59
  • AETNA — MEDICARE ADVANTAGE: $258.26
  • AETNA — Qhp/Ipf: $1,337.70
  • AMERIHEALTH — Managed Medicaid: $81.15
  • Amish Community Aid Plan — ALL PRODUCTS: $859.95
  • ANTHEM — HPN: $727.33
  • ANTHEM — Managed Medicaid: $77.46
  • ANTHEM — MEDICARE ADVANTAGE: $255.84
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM $704 $457.60 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $420.28
Emergency room visit (moderate): 10 of 49 insurance plan rates
  • Aetna — All Products First Health: $528
  • Aetna — Asa: $563.20
  • Aetna — Medicare Advantage: $69.06
  • Aetna — Qhp/Ifp: $492.80
  • AmeriHealth — Managed Medicaid: $41.45
  • Anthem — All Products Mid-Level Facility: $97.30
  • Anthem — All Products Mid-Level Non-Facility: $97.30
  • Anthem — Medicare Advantage: $69.06
  • Aultcare — Medicare Advantage: $72.51
  • Aultcare — PPO/HMO: $304.83
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT LOW MDM $1,911 $1,242.15 $540.43 – $1,719.90
Emergency room visit (moderate): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $955.50
  • ANTHEM — TRADITIONAL: $845.24
  • OSCAR — ALL PRODUCTS: $689.68
  • UNITED — ALL PRODUCTS: $846.57
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM $2,938 $1,909.70 $830.87 – $2,644.20
Emergency room visit (moderately high): 10 of 58 insurance plan rates
  • AETNA — Acop: $1,104.69
  • AETNA — ALL PRODUCTS: $2,203.50
  • AETNA — Asa_Whirlpool_Peia: $1,333.85
  • AETNA — MEDICARE ADVANTAGE: $394.76
  • AETNA — Qhp/Ipf: $2,056.60
  • AMERIHEALTH — Managed Medicaid: $81.15
  • Amish Community Aid Plan — ALL PRODUCTS: $1,322.10
  • ANTHEM — HPN: $1,118.20
  • ANTHEM — Managed Medicaid: $77.46
  • ANTHEM — MEDICARE ADVANTAGE: $393.45
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM $1,206 $783.90 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $652.41
Emergency room visit (moderately high): 10 of 49 insurance plan rates
  • Aetna — All Products First Health: $904.50
  • Aetna — Asa: $964.80
  • Aetna — Medicare Advantage: $117.61
  • Aetna — Qhp/Ifp: $844.20
  • AmeriHealth — Managed Medicaid: $69.20
  • Anthem — All Products Mid-Level Facility: $163.51
  • Anthem — All Products Mid-Level Non-Facility: $163.51
  • Anthem — Medicare Advantage: $117.61
  • Aultcare — Medicare Advantage: $123.49
  • Aultcare — PPO/HMO: $522.20
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT MODERATE MDM $2,938 $1,909.70 $830.87 – $2,644.20
Emergency room visit (moderately high): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,469
  • ANTHEM — TRADITIONAL: $1,299.48
  • OSCAR — ALL PRODUCTS: $1,060.32
  • UNITED — ALL PRODUCTS: $1,301.53
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM $4,230 $2,749.50 $1,196.24 – $3,807
Emergency room visit (high): 10 of 58 insurance plan rates
  • AETNA — Acop: $1,590.48
  • AETNA — ALL PRODUCTS: $3,172.50
  • AETNA — Asa_Whirlpool_Peia: $1,920.42
  • AETNA — MEDICARE ADVANTAGE: $563.42
  • AETNA — Qhp/Ipf: $2,961
  • AMERIHEALTH — Managed Medicaid: $81.15
  • Amish Community Aid Plan — ALL PRODUCTS: $1,903.50
  • ANTHEM — HPN: $1,609.94
  • ANTHEM — Managed Medicaid: $77.46
  • ANTHEM — MEDICARE ADVANTAGE: $566.49
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM $1,760 $1,144 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $946.14
Emergency room visit (high): 10 of 49 insurance plan rates
  • Aetna — All Products First Health: $1,320
  • Aetna — Asa: $1,408
  • Aetna — Medicare Advantage: $170.43
  • Aetna — Qhp/Ifp: $1,232
  • AmeriHealth — Managed Medicaid: $103.65
  • Anthem — All Products Mid-Level Facility: $238.20
  • Anthem — All Products Mid-Level Non-Facility: $238.20
  • Anthem — Medicare Advantage: $170.43
  • Aultcare — Medicare Advantage: $178.95
  • Aultcare — PPO/HMO: $762.08
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT HIGH MDM $4,230 $2,749.50 $1,196.24 – $3,807
Emergency room visit (high): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,115
  • ANTHEM — TRADITIONAL: $1,870.93
  • OSCAR — ALL PRODUCTS: $1,526.61
  • UNITED — ALL PRODUCTS: $1,873.89

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $58 $37.70 $16.40 – $58
Basic metabolic panel (blood test): 10 of 56 insurance plan rates
  • AETNA — Acop: $21.81
  • AETNA — ALL PRODUCTS: $43.50
  • AETNA — Asa_Whirlpool_Peia: $26.33
  • AETNA — MEDICARE ADVANTAGE: $8.46
  • AETNA — Qhp/Ipf: $58
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $26.10
  • ANTHEM — HPN: $22.07
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $25.97
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $58 $37.70 $16.40 – $58
Basic metabolic panel (blood test): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $29
  • ANTHEM — TRADITIONAL: $25.65
  • OSCAR — ALL PRODUCTS: $20.93
  • UNITED — ALL PRODUCTS: $25.69
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE META PANL $73 $47.45 $20.64 – $73
Comprehensive metabolic panel (blood test): 10 of 56 insurance plan rates
  • AETNA — Acop: $27.45
  • AETNA — ALL PRODUCTS: $54.75
  • AETNA — Asa_Whirlpool_Peia: $33.14
  • AETNA — MEDICARE ADVANTAGE: $10.56
  • AETNA — Qhp/Ipf: $73
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $32.85
  • ANTHEM — HPN: $27.78
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $32.69
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPREHENSIVE METABOLIC PANEL $73 $47.45 $18.55 – $73
Comprehensive metabolic panel (blood test): 10 of 30 insurance plan rates
  • Aetna — Acop: $16.44
  • Aetna — All Products First Health: $54.75
  • Aetna — Asa: $58.40
  • Aetna — Qhp/Ifp: $73
  • Anthem — All Products Mid-Level Facility: $14.37
  • Anthem — All Products Mid-Level Non-Facility: $14.37
  • Aultcare — PPO/HMO: $31.61
  • CC EHP — All Products: $39.79
  • Consociate Health — All Products: $54.75
  • GMS — All Products: $51.10
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE META PANL $73 $47.45 $20.64 – $73
Comprehensive metabolic panel (blood test): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $36.50
  • ANTHEM — TRADITIONAL: $32.29
  • OSCAR — ALL PRODUCTS: $26.35
  • UNITED — ALL PRODUCTS: $32.34
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB PANEL $330 $214.50 $93.32 – $330
Obstetric blood test panel: 10 of 56 insurance plan rates
  • AETNA — Acop: $124.08
  • AETNA — ALL PRODUCTS: $247.50
  • AETNA — Asa_Whirlpool_Peia: $149.82
  • AETNA — MEDICARE ADVANTAGE: $47.81
  • AETNA — Qhp/Ipf: $330
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $148.50
  • ANTHEM — HPN: $125.60
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $147.77
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OB PANEL $330 $214.50 $93.32 – $330
Obstetric blood test panel: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $165
  • ANTHEM — TRADITIONAL: $145.96
  • OSCAR — ALL PRODUCTS: $119.10
  • UNITED — ALL PRODUCTS: $146.19
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL $92 $59.80 $26.02 – $92
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates
  • AETNA — Acop: $34.59
  • AETNA — ALL PRODUCTS: $69
  • AETNA — Asa_Whirlpool_Peia: $41.77
  • AETNA — MEDICARE ADVANTAGE: $13.39
  • AETNA — Qhp/Ipf: $92
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $41.40
  • ANTHEM — HPN: $35.02
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $41.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID-LIPO PANEL 1 $92 $59.80 $26.02 – $92
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates
  • AETNA — Acop: $34.59
  • AETNA — ALL PRODUCTS: $69
  • AETNA — Asa_Whirlpool_Peia: $41.77
  • AETNA — MEDICARE ADVANTAGE: $13.39
  • AETNA — Qhp/Ipf: $92
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $41.40
  • ANTHEM — HPN: $35.02
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $41.20
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %NMRLIP CHOLESTEROL $92 $59.80 $26.02 – $92
Cholesterol panel (lipid panel): 10 of 56 insurance plan rates
  • AETNA — Acop: $34.59
  • AETNA — ALL PRODUCTS: $69
  • AETNA — Asa_Whirlpool_Peia: $41.77
  • AETNA — MEDICARE ADVANTAGE: $13.39
  • AETNA — Qhp/Ipf: $92
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $41.40
  • ANTHEM — HPN: $35.02
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $41.20
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNC PANL $60 $39 $16.97 – $60
Kidney function panel: 10 of 56 insurance plan rates
  • AETNA — Acop: $22.56
  • AETNA — ALL PRODUCTS: $45
  • AETNA — Asa_Whirlpool_Peia: $27.24
  • AETNA — MEDICARE ADVANTAGE: $8.68
  • AETNA — Qhp/Ipf: $60
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $27
  • ANTHEM — HPN: $22.84
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $26.87
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNC PANL $60 $39 $16.97 – $60
Kidney function panel: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $30
  • ANTHEM — TRADITIONAL: $26.54
  • OSCAR — ALL PRODUCTS: $21.65
  • UNITED — ALL PRODUCTS: $26.58
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEP FUNC PANL $56 $36.40 $15.84 – $56
Liver function panel: 10 of 56 insurance plan rates
  • AETNA — Acop: $21.06
  • AETNA — ALL PRODUCTS: $42
  • AETNA — Asa_Whirlpool_Peia: $25.42
  • AETNA — MEDICARE ADVANTAGE: $8.17
  • AETNA — Qhp/Ipf: $56
  • AMERIHEALTH — Managed Medicaid: $23.22
  • Amish Community Aid Plan — ALL PRODUCTS: $25.20
  • ANTHEM — HPN: $21.31
  • ANTHEM — Managed Medicaid: $22.17
  • ANTHEM — PPO/HMO: $25.08
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: HEPATIC FUNCTION PNL $56 $36.40 $14.23 – $56
Liver function panel: 10 of 30 insurance plan rates
  • Aetna — Acop: $12.71
  • Aetna — All Products First Health: $42
  • Aetna — Asa: $44.80
  • Aetna — Qhp/Ifp: $56
  • Anthem — All Products Mid-Level Facility: $11.12
  • Anthem — All Products Mid-Level Non-Facility: $11.12
  • Aultcare — PPO/HMO: $24.25
  • CC EHP — All Products: $30.52
  • Consociate Health — All Products: $42
  • GMS — All Products: $39.20
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEP FUNC PANL $56 $36.40 $15.84 – $56
Liver function panel: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $28
  • ANTHEM — TRADITIONAL: $24.77
  • OSCAR — ALL PRODUCTS: $20.21
  • UNITED — ALL PRODUCTS: $24.81
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W SCPE $22 $14.30 $6.22 – $22
Urine test (automated, with microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $8.27
  • AETNA — ALL PRODUCTS: $16.50
  • AETNA — Asa_Whirlpool_Peia: $9.99
  • AETNA — MEDICARE ADVANTAGE: $3.17
  • AETNA — Qhp/Ipf: $22
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $9.90
  • ANTHEM — HPN: $8.37
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $9.85
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS WITH MICRO (POINT OF CARE LAB) $22 $14.30 $6.22 – $22
Urine test (automated, with microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $8.27
  • AETNA — ALL PRODUCTS: $16.50
  • AETNA — Asa_Whirlpool_Peia: $9.99
  • AETNA — MEDICARE ADVANTAGE: $3.17
  • AETNA — Qhp/Ipf: $22
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $9.90
  • ANTHEM — HPN: $8.37
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $9.85
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY $22 $14.30 $1.10 – $5.38
Urine test (automated, with microscope): 10 of 30 insurance plan rates
  • Aetna — Acop: $4.93
  • Aetna — All Products First Health: $16.50
  • Aetna — Asa: $17.60
  • Aetna — Qhp/Ifp: $22
  • Anthem — All Products Mid-Level Facility: $4.32
  • Anthem — All Products Mid-Level Non-Facility: $4.32
  • Aultcare — PPO/HMO: $9.53
  • CC EHP — All Products: $11.99
  • Consociate Health — All Products: $16.50
  • GMS — All Products: $15.40
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA NON-AUTO W/O MICRO (POINT OF CARE LAB) $24 $15.60 $2.96 – $7.52
Urine test (manual, without microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $9.02
  • AETNA — ALL PRODUCTS: $18
  • AETNA — Asa_Whirlpool_Peia: $10.90
  • AETNA — MEDICARE ADVANTAGE: $3.48
  • AETNA — Qhp/Ipf: $24
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $10.80
  • ANTHEM — HPN: $9.13
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $10.75
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) $24 $15.60 $6.79 – $24
Urine test (manual, without microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $9.02
  • AETNA — ALL PRODUCTS: $18
  • AETNA — Asa_Whirlpool_Peia: $10.90
  • AETNA — MEDICARE ADVANTAGE: $3.48
  • AETNA — Qhp/Ipf: $24
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $10.80
  • ANTHEM — HPN: $9.13
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $10.75
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $24 $15.60 $1.10 – $5.38
Urine test (manual, without microscope): 10 of 30 insurance plan rates
  • Aetna — Acop: $4.87
  • Aetna — All Products First Health: $18
  • Aetna — Asa: $19.20
  • Aetna — Qhp/Ifp: $24
  • Anthem — All Products Mid-Level Facility: $4.73
  • Anthem — All Products Mid-Level Non-Facility: $4.73
  • Aultcare — PPO/HMO: $10.39
  • CC EHP — All Products: $13.08
  • Consociate Health — All Products: $18
  • GMS — All Products: $16.80
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS (POINT OF CARE LAB) $16 $10.40 $4.52 – $16
Urine test (automated, without microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $6.02
  • AETNA — ALL PRODUCTS: $12
  • AETNA — Asa_Whirlpool_Peia: $7.26
  • AETNA — MEDICARE ADVANTAGE: $2.25
  • AETNA — Qhp/Ipf: $16
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $7.20
  • ANTHEM — HPN: $6.09
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $7.16
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) $16 $10.40 $1.91 – $7.52
Urine test (automated, without microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $6.02
  • AETNA — ALL PRODUCTS: $12
  • AETNA — Asa_Whirlpool_Peia: $7.26
  • AETNA — MEDICARE ADVANTAGE: $2.25
  • AETNA — Qhp/Ipf: $16
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $7.20
  • ANTHEM — HPN: $6.09
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $7.16
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO WO SCPE $16 $10.40 $4.52 – $16
Urine test (automated, without microscope): 10 of 56 insurance plan rates
  • AETNA — Acop: $6.02
  • AETNA — ALL PRODUCTS: $12
  • AETNA — Asa_Whirlpool_Peia: $7.26
  • AETNA — MEDICARE ADVANTAGE: $2.25
  • AETNA — Qhp/Ipf: $16
  • AMERIHEALTH — Managed Medicaid: $7.52
  • Amish Community Aid Plan — ALL PRODUCTS: $7.20
  • ANTHEM — HPN: $6.09
  • ANTHEM — Managed Medicaid: $7.18
  • ANTHEM — PPO/HMO: $7.16
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC $127 $82.55 $35.92 – $127
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates
  • AETNA — Acop: $47.75
  • AETNA — ALL PRODUCTS: $95.25
  • AETNA — Asa_Whirlpool_Peia: $57.66
  • AETNA — MEDICARE ADVANTAGE: $18.39
  • AETNA — Qhp/Ipf: $127
  • AMERIHEALTH — Managed Medicaid: $21.43
  • Amish Community Aid Plan — ALL PRODUCTS: $57.15
  • ANTHEM — HPN: $48.34
  • ANTHEM — Managed Medicaid: $20.45
  • ANTHEM — PPO/HMO: $56.87
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA SCREENING $127 $82.55 $15.63 – $21.43
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates
  • AETNA — Acop: $47.75
  • AETNA — ALL PRODUCTS: $95.25
  • AETNA — Asa_Whirlpool_Peia: $57.66
  • AETNA — MEDICARE ADVANTAGE: $18.39
  • AETNA — Qhp/Ipf: $127
  • AMERIHEALTH — Managed Medicaid: $21.43
  • Amish Community Aid Plan — ALL PRODUCTS: $57.15
  • ANTHEM — HPN: $48.34
  • ANTHEM — Managed Medicaid: $20.45
  • ANTHEM — PPO/HMO: $56.87
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %PHI PROST SPEC AG TOT $127 $82.55 $35.92 – $127
PSA (prostate specific antigen) blood test: 10 of 56 insurance plan rates
  • AETNA — Acop: $47.75
  • AETNA — ALL PRODUCTS: $95.25
  • AETNA — Asa_Whirlpool_Peia: $57.66
  • AETNA — MEDICARE ADVANTAGE: $18.39
  • AETNA — Qhp/Ipf: $127
  • AMERIHEALTH — Managed Medicaid: $21.43
  • Amish Community Aid Plan — ALL PRODUCTS: $57.15
  • ANTHEM — HPN: $48.34
  • ANTHEM — Managed Medicaid: $20.45
  • ANTHEM — PPO/HMO: $56.87
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: %NEO TSH $116 $75.40 $14.28 – $25.97
Thyroid stimulating hormone (TSH) test: 10 of 56 insurance plan rates
  • AETNA — Acop: $43.62
  • AETNA — ALL PRODUCTS: $87
  • AETNA — Asa_Whirlpool_Peia: $52.66
  • AETNA — MEDICARE ADVANTAGE: $16.80
  • AETNA — Qhp/Ipf: $116
  • AMERIHEALTH — Managed Medicaid: $25.97
  • Amish Community Aid Plan — ALL PRODUCTS: $52.20
  • ANTHEM — HPN: $44.15
  • ANTHEM — Managed Medicaid: $24.79
  • ANTHEM — PPO/HMO: $51.94
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE (TSH) $116 $75.40 $32.80 – $116
Thyroid stimulating hormone (TSH) test: 10 of 56 insurance plan rates
  • AETNA — Acop: $43.62
  • AETNA — ALL PRODUCTS: $87
  • AETNA — Asa_Whirlpool_Peia: $52.66
  • AETNA — MEDICARE ADVANTAGE: $16.80
  • AETNA — Qhp/Ipf: $116
  • AMERIHEALTH — Managed Medicaid: $25.97
  • Amish Community Aid Plan — ALL PRODUCTS: $52.20
  • ANTHEM — HPN: $44.15
  • ANTHEM — Managed Medicaid: $24.79
  • ANTHEM — PPO/HMO: $51.94
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: %NEO TSH $116 $75.40 $32.80 – $116
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $58
  • ANTHEM — TRADITIONAL: $51.31
  • OSCAR — ALL PRODUCTS: $41.86
  • UNITED — ALL PRODUCTS: $51.39
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO W AUTO DIFF $54 $35.10 $6.60 – $10.02
Complete blood count (CBC) with differential: 10 of 56 insurance plan rates
  • AETNA — Acop: $20.30
  • AETNA — ALL PRODUCTS: $40.50
  • AETNA — Asa_Whirlpool_Peia: $24.52
  • AETNA — MEDICARE ADVANTAGE: $7.77
  • AETNA — Qhp/Ipf: $54
  • AMERIHEALTH — Managed Medicaid: $10.02
  • Amish Community Aid Plan — ALL PRODUCTS: $24.30
  • ANTHEM — HPN: $20.55
  • ANTHEM — Managed Medicaid: $9.57
  • ANTHEM — PPO/HMO: $24.18
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $54 $35.10 $13.72 – $54
Complete blood count (CBC) with differential: 10 of 30 insurance plan rates
  • Aetna — Acop: $12.08
  • Aetna — All Products First Health: $40.50
  • Aetna — Asa: $43.20
  • Aetna — Qhp/Ifp: $54
  • Anthem — All Products Mid-Level Facility: $10.57
  • Anthem — All Products Mid-Level Non-Facility: $10.57
  • Aultcare — PPO/HMO: $23.38
  • CC EHP — All Products: $29.43
  • Consociate Health — All Products: $40.50
  • GMS — All Products: $37.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO W AUTO DIFF $54 $35.10 $15.27 – $54
Complete blood count (CBC) with differential: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $27
  • ANTHEM — TRADITIONAL: $23.88
  • OSCAR — ALL PRODUCTS: $19.49
  • UNITED — ALL PRODUCTS: $23.92
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF $45 $29.25 $5.50 – $10.02
Complete blood count (CBC), automated: 10 of 56 insurance plan rates
  • AETNA — Acop: $16.92
  • AETNA — ALL PRODUCTS: $33.75
  • AETNA — Asa_Whirlpool_Peia: $20.43
  • AETNA — MEDICARE ADVANTAGE: $6.47
  • AETNA — Qhp/Ipf: $45
  • AMERIHEALTH — Managed Medicaid: $10.02
  • Amish Community Aid Plan — ALL PRODUCTS: $20.25
  • ANTHEM — HPN: $17.13
  • ANTHEM — Managed Medicaid: $9.57
  • ANTHEM — PPO/HMO: $20.15
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: BLOOD COUNT COMPLETE AUTOMATED $45 $29.25 $11.43 – $45
Complete blood count (CBC), automated: 10 of 30 insurance plan rates
  • Aetna — Acop: $10.05
  • Aetna — All Products First Health: $33.75
  • Aetna — Asa: $36
  • Aetna — Qhp/Ifp: $45
  • Anthem — All Products Mid-Level Facility: $8.81
  • Anthem — All Products Mid-Level Non-Facility: $8.81
  • Aultcare — PPO/HMO: $19.49
  • CC EHP — All Products: $24.53
  • Consociate Health — All Products: $33.75
  • GMS — All Products: $31.50
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO WO DIFF $45 $29.25 $12.73 – $45
Complete blood count (CBC), automated: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $22.50
  • ANTHEM — TRADITIONAL: $19.90
  • OSCAR — ALL PRODUCTS: $16.24
  • UNITED — ALL PRODUCTS: $19.94
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME AND INR (POINT OF CARE LAB) $30 $19.50 $8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates
  • AETNA — Acop: $11.28
  • AETNA — ALL PRODUCTS: $22.50
  • AETNA — Asa_Whirlpool_Peia: $13.62
  • AETNA — MEDICARE ADVANTAGE: $4.29
  • AETNA — Qhp/Ipf: $30
  • AMERIHEALTH — Managed Medicaid: $11.47
  • Amish Community Aid Plan — ALL PRODUCTS: $13.50
  • ANTHEM — HPN: $11.42
  • ANTHEM — Managed Medicaid: $10.95
  • ANTHEM — PPO/HMO: $13.43
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLOTTING TEST (POINT OF CARE LAB) $30 $19.50 $8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates
  • AETNA — Acop: $11.28
  • AETNA — ALL PRODUCTS: $22.50
  • AETNA — Asa_Whirlpool_Peia: $13.62
  • AETNA — MEDICARE ADVANTAGE: $4.29
  • AETNA — Qhp/Ipf: $30
  • AMERIHEALTH — Managed Medicaid: $11.47
  • Amish Community Aid Plan — ALL PRODUCTS: $13.50
  • ANTHEM — HPN: $11.42
  • ANTHEM — Managed Medicaid: $10.95
  • ANTHEM — PPO/HMO: $13.43
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *PRO TIME $30 $19.50 $8.48 – $30
Blood clotting time test (prothrombin time, PT): 10 of 56 insurance plan rates
  • AETNA — Acop: $11.28
  • AETNA — ALL PRODUCTS: $22.50
  • AETNA — Asa_Whirlpool_Peia: $13.62
  • AETNA — MEDICARE ADVANTAGE: $4.29
  • AETNA — Qhp/Ipf: $30
  • AMERIHEALTH — Managed Medicaid: $11.47
  • Amish Community Aid Plan — ALL PRODUCTS: $13.50
  • ANTHEM — HPN: $11.42
  • ANTHEM — Managed Medicaid: $10.95
  • ANTHEM — PPO/HMO: $13.43
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: *PTT PLASMA/WHOLE BLOOD $41 $26.65 $11.59 – $41
Blood clotting test (partial thromboplastin time, PTT): 10 of 56 insurance plan rates
  • AETNA — Acop: $15.42
  • AETNA — ALL PRODUCTS: $30.75
  • AETNA — Asa_Whirlpool_Peia: $18.61
  • AETNA — MEDICARE ADVANTAGE: $6.01
  • AETNA — Qhp/Ipf: $41
  • AMERIHEALTH — Managed Medicaid: $11.47
  • Amish Community Aid Plan — ALL PRODUCTS: $18.45
  • ANTHEM — HPN: $15.60
  • ANTHEM — Managed Medicaid: $10.95
  • ANTHEM — PPO/HMO: $18.36
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL HEME - PTT PLASMA/WHOLE BLOOD $41 $26.65 $5.11 – $11.47
Blood clotting test (partial thromboplastin time, PTT): 10 of 56 insurance plan rates
  • AETNA — Acop: $15.42
  • AETNA — ALL PRODUCTS: $30.75
  • AETNA — Asa_Whirlpool_Peia: $18.61
  • AETNA — MEDICARE ADVANTAGE: $6.01
  • AETNA — Qhp/Ipf: $41
  • AMERIHEALTH — Managed Medicaid: $11.47
  • Amish Community Aid Plan — ALL PRODUCTS: $18.45
  • ANTHEM — HPN: $15.60
  • ANTHEM — Managed Medicaid: $10.95
  • ANTHEM — PPO/HMO: $18.36
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: *PTT PLASMA/WHOLE BLOOD $41 $26.65 $11.59 – $41
Blood clotting test (partial thromboplastin time, PTT): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $20.50
  • ANTHEM — TRADITIONAL: $18.13
  • OSCAR — ALL PRODUCTS: $14.80
  • UNITED — ALL PRODUCTS: $18.16

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL $734 $477.10 $207.58 – $734
CT scan of the head or brain, without contrast: 10 of 58 insurance plan rates
  • AETNA — Acop: $275.98
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $333.24
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $464.89
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $279.36
  • ANTHEM — Managed Medicaid: $443.76
  • ANTHEM — MEDICARE ADVANTAGE: $98.26
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL $1,108 $720.20 $281.54 – $1,108
CT scan of the head or brain, without contrast: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $831
  • Aetna — Asa: $886.40
  • Aetna — Medicare Advantage: $100.38
  • Aetna — Qhp/Ifp: $1,108
  • AmeriHealth — Managed Medicaid: $111.06
  • Anthem — All Products Mid-Level Facility: $142.12
  • Anthem — All Products Mid-Level Non-Facility: $142.12
  • Anthem — Medicare Advantage: $100.38
  • Aultcare — Medicare Advantage: $105.40
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O CONTRAST MATERIAL $734 $477.10 $207.58 – $734
CT scan of the head or brain, without contrast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $324.65
  • OSCAR — ALL PRODUCTS: $264.90
  • UNITED — ALL PRODUCTS: $325.16
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $2,464 $1,601.60 $280.55 – $455.84
MRI of the brain, before and after contrast: 10 of 58 insurance plan rates
  • AETNA — Acop: $926.46
  • AETNA — ALL PRODUCTS: $1,848
  • AETNA — Asa_Whirlpool_Peia: $1,118.66
  • AETNA — MEDICARE ADVANTAGE: $330.06
  • AETNA — Qhp/Ipf: $2,464
  • AMERIHEALTH — Managed Medicaid: $455.84
  • Amish Community Aid Plan — ALL PRODUCTS: $1,108.80
  • ANTHEM — HPN: $937.80
  • ANTHEM — Managed Medicaid: $435.12
  • ANTHEM — MEDICARE ADVANTAGE: $329.98
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $3,360 $2,184 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $655.87
MRI of the brain, before and after contrast: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $2,520
  • Aetna — Asa: $2,688
  • Aetna — Medicare Advantage: $297.86
  • Aetna — Qhp/Ifp: $3,360
  • AmeriHealth — Managed Medicaid: $351.72
  • Anthem — All Products Mid-Level Facility: $429.16
  • Anthem — All Products Mid-Level Non-Facility: $429.16
  • Anthem — Medicare Advantage: $297.86
  • Aultcare — Medicare Advantage: $312.75
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $2,464 $1,601.60 $696.82 – $2,464
MRI of the brain, before and after contrast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,232
  • ANTHEM — TRADITIONAL: $1,089.83
  • OSCAR — ALL PRODUCTS: $889.26
  • UNITED — ALL PRODUCTS: $1,091.55
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS $608 $395.20 $171.94 – $608
Chest X-ray, 2 views: 10 of 58 insurance plan rates
  • AETNA — Acop: $228.61
  • AETNA — ALL PRODUCTS: $456
  • AETNA — Asa_Whirlpool_Peia: $276.03
  • AETNA — MEDICARE ADVANTAGE: $82.33
  • AETNA — Qhp/Ipf: $608
  • AMERIHEALTH — Managed Medicaid: $67.05
  • Amish Community Aid Plan — ALL PRODUCTS: $273.60
  • ANTHEM — HPN: $231.40
  • ANTHEM — Managed Medicaid: $64
  • ANTHEM — MEDICARE ADVANTAGE: $81.36
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS $705 $458.25 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $155.90
Chest X-ray, 2 views: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $528.75
  • Aetna — Asa: $564
  • Aetna — Medicare Advantage: $31.02
  • Aetna — Qhp/Ifp: $705
  • AmeriHealth — Managed Medicaid: $25.15
  • Anthem — All Products Mid-Level Facility: $43.49
  • Anthem — All Products Mid-Level Non-Facility: $43.49
  • Anthem — Medicare Advantage: $31.02
  • Aultcare — Medicare Advantage: $32.57
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS $608 $395.20 $171.94 – $608
Chest X-ray, 2 views: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $304
  • ANTHEM — TRADITIONAL: $268.92
  • OSCAR — ALL PRODUCTS: $219.43
  • UNITED — ALL PRODUCTS: $269.34
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $734 $477.10 $207.58 – $734
X-ray of the lower spine, at least 4 views: 10 of 58 insurance plan rates
  • AETNA — Acop: $275.98
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $333.24
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $67.05
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $279.36
  • ANTHEM — Managed Medicaid: $64
  • ANTHEM — MEDICARE ADVANTAGE: $98.26
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $848 $551.20 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $188.16
X-ray of the lower spine, at least 4 views: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $636
  • Aetna — Asa: $678.40
  • Aetna — Medicare Advantage: $49.86
  • Aetna — Qhp/Ifp: $848
  • AmeriHealth — Managed Medicaid: $41.15
  • Anthem — All Products Mid-Level Facility: $65.94
  • Anthem — All Products Mid-Level Non-Facility: $65.94
  • Anthem — Medicare Advantage: $49.86
  • Aultcare — Medicare Advantage: $52.35
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $734 $477.10 $207.58 – $734
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $324.65
  • OSCAR — ALL PRODUCTS: $264.90
  • UNITED — ALL PRODUCTS: $325.16
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $1,668 $1,084.20 $471.71 – $1,668
MRI of the lower back (lumbar spine), without contrast: 10 of 58 insurance plan rates
  • AETNA — Acop: $627.17
  • AETNA — ALL PRODUCTS: $1,251
  • AETNA — Asa_Whirlpool_Peia: $757.27
  • AETNA — MEDICARE ADVANTAGE: $225.74
  • AETNA — Qhp/Ipf: $1,668
  • AMERIHEALTH — Managed Medicaid: $301.64
  • Amish Community Aid Plan — ALL PRODUCTS: $750.60
  • ANTHEM — HPN: $634.84
  • ANTHEM — Managed Medicaid: $287.93
  • ANTHEM — MEDICARE ADVANTAGE: $223.34
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $2,260 $1,469 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $417.54
MRI of the lower back (lumbar spine), without contrast: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $1,695
  • Aetna — Asa: $1,808
  • Aetna — Medicare Advantage: $180.44
  • Aetna — Qhp/Ifp: $2,260
  • AmeriHealth — Managed Medicaid: $207.20
  • Anthem — All Products Mid-Level Facility: $257.28
  • Anthem — All Products Mid-Level Non-Facility: $257.28
  • Anthem — Medicare Advantage: $180.44
  • Aultcare — Medicare Advantage: $189.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $1,668 $1,084.20 $471.71 – $1,668
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $834
  • ANTHEM — TRADITIONAL: $737.76
  • OSCAR — ALL PRODUCTS: $601.98
  • UNITED — ALL PRODUCTS: $738.92
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL $1,228 $798.20 $141.05 – $464.89
CT scan of the pelvis, with contrast: 10 of 58 insurance plan rates
  • AETNA — Acop: $461.73
  • AETNA — ALL PRODUCTS: $921
  • AETNA — Asa_Whirlpool_Peia: $557.51
  • AETNA — MEDICARE ADVANTAGE: $165.94
  • AETNA — Qhp/Ipf: $1,228
  • AMERIHEALTH — Managed Medicaid: $464.89
  • Amish Community Aid Plan — ALL PRODUCTS: $552.60
  • ANTHEM — HPN: $467.38
  • ANTHEM — Managed Medicaid: $443.76
  • ANTHEM — MEDICARE ADVANTAGE: $164.49
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT PELVIS W/CONTRAST MATERIAL $1,738 $1,129.70 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $428.57
CT scan of the pelvis, with contrast: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $1,303.50
  • Aetna — Asa: $1,390.40
  • Aetna — Medicare Advantage: $210.76
  • Aetna — Qhp/Ifp: $1,738
  • AmeriHealth — Managed Medicaid: $210.01
  • Anthem — All Products Mid-Level Facility: $297.89
  • Anthem — All Products Mid-Level Non-Facility: $297.89
  • Anthem — Medicare Advantage: $210.76
  • Aultcare — Medicare Advantage: $221.30
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST MATERIAL $1,228 $798.20 $347.28 – $1,228
CT scan of the pelvis, with contrast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $614
  • ANTHEM — TRADITIONAL: $543.14
  • OSCAR — ALL PRODUCTS: $443.19
  • UNITED — ALL PRODUCTS: $544
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $1,668 $1,084.20 $471.71 – $1,668
MRI of a leg joint (such as the knee), without contrast: 10 of 58 insurance plan rates
  • AETNA — Acop: $627.17
  • AETNA — ALL PRODUCTS: $1,251
  • AETNA — Asa_Whirlpool_Peia: $757.27
  • AETNA — MEDICARE ADVANTAGE: $225.74
  • AETNA — Qhp/Ipf: $1,668
  • AMERIHEALTH — Managed Medicaid: $301.64
  • Amish Community Aid Plan — ALL PRODUCTS: $750.60
  • ANTHEM — HPN: $634.84
  • ANTHEM — Managed Medicaid: $287.93
  • ANTHEM — MEDICARE ADVANTAGE: $223.34
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $1,668 $1,084.20 $471.71 – $1,668
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $834
  • ANTHEM — TRADITIONAL: $737.76
  • OSCAR — ALL PRODUCTS: $601.98
  • UNITED — ALL PRODUCTS: $738.92
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $594 $386.10 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $122.53
MRI of a leg joint (such as the knee), without contrast: 10 of 43 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $445.50
  • Aetna — Asa: $475.20
  • Aetna — Medicare Advantage: $61.69
  • Aetna — Qhp/Ifp: $594
  • Anthem — All Products Mid-Level Facility: $86.68
  • Anthem — All Products Mid-Level Non-Facility: $86.68
  • Anthem — Medicare Advantage: $61.69
  • Aultcare — Medicare Advantage: $64.77
  • Aultcare — PPO/HMO: $257.20
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $2,464 $1,601.60 $696.82 – $2,464
CT scan of the abdomen and pelvis, with contrast: 10 of 58 insurance plan rates
  • AETNA — Acop: $926.46
  • AETNA — ALL PRODUCTS: $1,848
  • AETNA — Asa_Whirlpool_Peia: $1,118.66
  • AETNA — MEDICARE ADVANTAGE: $330.06
  • AETNA — Qhp/Ipf: $2,464
  • AMERIHEALTH — Managed Medicaid: $464.89
  • Amish Community Aid Plan — ALL PRODUCTS: $1,108.80
  • ANTHEM — HPN: $937.80
  • ANTHEM — Managed Medicaid: $443.76
  • ANTHEM — MEDICARE ADVANTAGE: $329.98
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CT ABD & PELVIS W/CONTRAST $3,265 $2,122.25 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $655.87
CT scan of the abdomen and pelvis, with contrast: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $2,448.75
  • Aetna — Asa: $2,612
  • Aetna — Medicare Advantage: $281.10
  • Aetna — Qhp/Ifp: $3,265
  • AmeriHealth — Managed Medicaid: $203.62
  • Anthem — All Products Mid-Level Facility: $408.48
  • Anthem — All Products Mid-Level Non-Facility: $408.48
  • Anthem — Medicare Advantage: $281.10
  • Aultcare — Medicare Advantage: $295.16
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $2,464 $1,601.60 $696.82 – $2,464
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,232
  • ANTHEM — TRADITIONAL: $1,089.83
  • OSCAR — ALL PRODUCTS: $889.26
  • UNITED — ALL PRODUCTS: $1,091.55
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $734 $477.10 $207.58 – $734
Ultrasound of the abdomen, complete: 10 of 58 insurance plan rates
  • AETNA — Acop: $275.98
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $333.24
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $177.42
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $279.36
  • ANTHEM — Managed Medicaid: $169.35
  • ANTHEM — MEDICARE ADVANTAGE: $98.26
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $734 $477.10 $207.58 – $734
Ultrasound of the abdomen, complete: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $324.65
  • OSCAR — ALL PRODUCTS: $264.90
  • UNITED — ALL PRODUCTS: $325.16
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $356 $231.40 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $72.56
Ultrasound of the abdomen, complete: 10 of 43 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $267
  • Aetna — Asa: $284.80
  • Aetna — Medicare Advantage: $36.76
  • Aetna — Qhp/Ifp: $356
  • Anthem — All Products Mid-Level Facility: $51.49
  • Anthem — All Products Mid-Level Non-Facility: $51.49
  • Anthem — Medicare Advantage: $36.76
  • Aultcare — Medicare Advantage: $38.60
  • Aultcare — PPO/HMO: $154.15
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $734 $477.10 $207.58 – $734
Pregnancy ultrasound (after the first trimester): 10 of 58 insurance plan rates
  • AETNA — Acop: $275.98
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $333.24
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $138.01
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $279.36
  • ANTHEM — Managed Medicaid: $131.73
  • ANTHEM — MEDICARE ADVANTAGE: $98.26
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $1,130 $734.50 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $249.40
Pregnancy ultrasound (after the first trimester): 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $847.50
  • Aetna — Asa: $904
  • Aetna — Medicare Advantage: $127.79
  • Aetna — Qhp/Ifp: $1,130
  • AmeriHealth — Managed Medicaid: $109.58
  • Anthem — All Products Mid-Level Facility: $175.98
  • Anthem — All Products Mid-Level Non-Facility: $175.98
  • Anthem — Medicare Advantage: $127.79
  • Aultcare — Medicare Advantage: $134.18
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $734 $477.10 $207.58 – $734
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $324.65
  • OSCAR — ALL PRODUCTS: $264.90
  • UNITED — ALL PRODUCTS: $325.16
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $734 $477.10 $207.58 – $734
Transvaginal ultrasound: 10 of 58 insurance plan rates
  • AETNA — Acop: $275.98
  • AETNA — ALL PRODUCTS: $550.50
  • AETNA — Asa_Whirlpool_Peia: $333.24
  • AETNA — MEDICARE ADVANTAGE: $98.91
  • AETNA — Qhp/Ipf: $734
  • AMERIHEALTH — Managed Medicaid: $115.36
  • Amish Community Aid Plan — ALL PRODUCTS: $330.30
  • ANTHEM — HPN: $279.36
  • ANTHEM — Managed Medicaid: $110.11
  • ANTHEM — MEDICARE ADVANTAGE: $98.26
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: US TRANSVAGINAL $1,038 $674.70 $263.76 – $1,038
Transvaginal ultrasound: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $778.50
  • Aetna — Asa: $830.40
  • Aetna — Medicare Advantage: $110.03
  • Aetna — Qhp/Ifp: $1,038
  • AmeriHealth — Managed Medicaid: $78.65
  • Anthem — All Products Mid-Level Facility: $154.93
  • Anthem — All Products Mid-Level Non-Facility: $154.93
  • Anthem — Medicare Advantage: $110.03
  • Aultcare — Medicare Advantage: $115.53
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $734 $477.10 $207.58 – $734
Transvaginal ultrasound: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $367
  • ANTHEM — TRADITIONAL: $324.65
  • OSCAR — ALL PRODUCTS: $264.90
  • UNITED — ALL PRODUCTS: $325.16
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $563 $365.95 $159.22 – $563
Diagnostic mammogram, one breast: 10 of 56 insurance plan rates
  • AETNA — Acop: $211.69
  • AETNA — ALL PRODUCTS: $422.25
  • AETNA — Asa_Whirlpool_Peia: $255.60
  • AETNA — MEDICARE ADVANTAGE: $168.11
  • AETNA — Qhp/Ipf: $563
  • AMERIHEALTH — Managed Medicaid: $61.20
  • Amish Community Aid Plan — ALL PRODUCTS: $253.35
  • ANTHEM — HPN: $214.28
  • ANTHEM — Managed Medicaid: $58.42
  • ANTHEM — PPO/HMO: $252.11
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $887 $576.55 $225.39 – $887
Diagnostic mammogram, one breast: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $665.25
  • Aetna — Asa: $709.60
  • Aetna — Medicare Advantage: $116.20
  • Aetna — Qhp/Ifp: $887
  • AmeriHealth — Managed Medicaid: $65.38
  • Anthem — All Products Mid-Level Facility: $161.71
  • Anthem — All Products Mid-Level Non-Facility: $161.71
  • Anthem — Medicare Advantage: $116.20
  • Aultcare — Medicare Advantage: $122.01
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $563 $365.95 $159.22 – $563
Diagnostic mammogram, one breast: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $281.50
  • ANTHEM — TRADITIONAL: $249.01
  • OSCAR — ALL PRODUCTS: $203.19
  • UNITED — ALL PRODUCTS: $249.41
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $706 $458.90 $199.66 – $706
Diagnostic mammogram, both breasts: 10 of 56 insurance plan rates
  • AETNA — Acop: $265.46
  • AETNA — ALL PRODUCTS: $529.50
  • AETNA — Asa_Whirlpool_Peia: $320.52
  • AETNA — MEDICARE ADVANTAGE: $213.08
  • AETNA — Qhp/Ipf: $706
  • AMERIHEALTH — Managed Medicaid: $61.20
  • Amish Community Aid Plan — ALL PRODUCTS: $317.70
  • ANTHEM — HPN: $268.70
  • ANTHEM — Managed Medicaid: $58.42
  • ANTHEM — PPO/HMO: $316.15
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $706 $458.90 $199.66 – $706
Diagnostic mammogram, both breasts: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $353
  • ANTHEM — TRADITIONAL: $312.26
  • OSCAR — ALL PRODUCTS: $254.80
  • UNITED — ALL PRODUCTS: $312.76
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $706 $458.90 $179.39 – $706
Diagnostic mammogram, both breasts: 10 of 44 insurance plan rates
  • Aetna — Acop: $142.76
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $529.50
  • Aetna — Asa: $564.80
  • Aetna — Medicare Advantage: $101.51
  • Aetna — Qhp/Ifp: $706
  • Anthem — All Products Mid-Level Facility: $140.50
  • Anthem — All Products Mid-Level Non-Facility: $140.50
  • Anthem — Medicare Advantage: $101.51
  • Aultcare — Medicare Advantage: $106.59
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $609 $395.85 $172.23 – $609
Screening mammogram, both breasts: 10 of 56 insurance plan rates
  • AETNA — Acop: $228.98
  • AETNA — ALL PRODUCTS: $456.75
  • AETNA — Asa_Whirlpool_Peia: $276.49
  • AETNA — MEDICARE ADVANTAGE: $172.34
  • AETNA — Qhp/Ipf: $609
  • AMERIHEALTH — Managed Medicaid: $61.20
  • Amish Community Aid Plan — ALL PRODUCTS: $274.05
  • ANTHEM — HPN: $231.79
  • ANTHEM — Managed Medicaid: $58.42
  • ANTHEM — PPO/HMO: $272.71
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $913 $593.45 $231.99 – $913
Screening mammogram, both breasts: 10 of 48 insurance plan rates
  • Aetna — ALL PRODUCTS: $1.65 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Aetna — All Products First Health: $684.75
  • Aetna — Asa: $730.40
  • Aetna — Medicare Advantage: $118.17
  • Aetna — Qhp/Ifp: $913
  • AmeriHealth — Managed Medicaid: $66.84
  • Anthem — All Products Mid-Level Facility: $165.30
  • Anthem — All Products Mid-Level Non-Facility: $165.30
  • Anthem — Medicare Advantage: $118.17
  • Aultcare — Medicare Advantage: $124.08
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $609 $395.85 $172.23 – $609
Screening mammogram, both breasts: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $304.50
  • ANTHEM — TRADITIONAL: $269.36
  • OSCAR — ALL PRODUCTS: $219.79
  • UNITED — ALL PRODUCTS: $269.79

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $75 $48.75 $19.06 – $75
Electrocardiogram (ECG/EKG) with reading: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $56.25
  • Aetna — Asa: $60
  • Aetna — Medicare Advantage: $14.66
  • Aetna — Qhp/Ifp: $75
  • AmeriHealth — Managed Medicaid: $15.29
  • Anthem — All Products Mid-Level Facility: $18.91
  • Anthem — All Products Mid-Level Non-Facility: $18.91
  • Anthem — Medicare Advantage: $14.66
  • Aultcare — Medicare Advantage: $15.39
  • Aultcare — PPO/HMO: $32.48
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $415 $269.75 $90.47 – $415
Electrocardiogram (ECG/EKG) with reading: 10 of 43 insurance plan rates
  • AETNA — Acop: $156.04
  • AETNA — ALL PRODUCTS: $311.25
  • AETNA — Asa_Whirlpool_Peia: $188.41
  • AETNA — International: $197.54
  • AETNA — MEDICARE ADVANTAGE: $90.47
  • AETNA — Qhp/Ipf: $415
  • AMERIHEALTH — Managed Medicaid: $27.75
  • Amish Community Aid Plan — ALL PRODUCTS: $186.75
  • ANTHEM — HPN: $157.95
  • ANTHEM — Managed Medicaid: $26.49
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $415 $269.75 $90.47 – $415
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $207.50
  • ANTHEM — TRADITIONAL: $183.55
  • OSCAR — ALL PRODUCTS: $149.77
  • UNITED — ALL PRODUCTS: $183.85
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $18,494 $12,021.10 $5,230.10 – $18,494
Left heart catheterization (diagnostic): 10 of 59 insurance plan rates
  • AETNA — Acop: $6,953.74
  • AETNA — ALL PRODUCTS: $13,870.50
  • AETNA — Asa_Whirlpool_Peia: $8,396.28
  • AETNA — International: $8,803.14
  • AETNA — MEDICARE ADVANTAGE: $3,067.12
  • AETNA — Qhp/Ipf: $18,494
  • AMERIHEALTH — Managed Medicaid: $2,299.77
  • Amish Community Aid Plan — ALL PRODUCTS: $8,322.30
  • ANTHEM — HPN: $7,038.82
  • ANTHEM — Managed Medicaid: $2,195.24
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $18,494 $12,021.10 $5,230.10 – $18,494
Left heart catheterization (diagnostic): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $9,247
  • ANTHEM — TRADITIONAL: $8,179.90
  • OSCAR — ALL PRODUCTS: $6,674.48
  • UNITED — ALL PRODUCTS: $8,192.84
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier 26 In the file: L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $1,980 $1,287 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $514.65
Left heart catheterization (diagnostic): 10 of 42 insurance plan rates
  • Aetna — All Products First Health: $1,485
  • Aetna — Asa: $1,584
  • Aetna — Medicare Advantage: $227.61
  • Aetna — Qhp/Ifp: $1,980
  • Anthem — All Products Mid-Level Facility: $312.24
  • Anthem — All Products Mid-Level Non-Facility: $312.24
  • Anthem — Medicare Advantage: $227.61
  • Aultcare — Medicare Advantage: $238.99
  • Aultcare — PPO/HMO: $857.34
  • CC EHP — All Products: $263.11
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $43,632 $28,360.80 $1,674.49 – $8,116.99
Heart rhythm study (electrophysiology evaluation): 10 of 58 insurance plan rates
  • AETNA — Acop: $16,405.63
  • AETNA — ALL PRODUCTS: $32,724
  • AETNA — Asa_Whirlpool_Peia: $19,808.93
  • AETNA — MEDICARE ADVANTAGE: $7,379.08
  • AETNA — Qhp/Ipf: $43,632
  • AMERIHEALTH — Managed Medicaid: $1,841.94
  • Amish Community Aid Plan — ALL PRODUCTS: $19,634.40
  • ANTHEM — HPN: $16,606.34
  • ANTHEM — Managed Medicaid: $1,758.21
  • ANTHEM — MEDICARE ADVANTAGE: $7,011.25
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $46,632 $30,310.80 $11,849.19 – $46,632
Heart rhythm study (electrophysiology evaluation): 10 of 34 insurance plan rates
  • Aetna — All Products First Health: $34,974
  • Aetna — Asa: $37,305.60
  • Aetna — Qhp/Ifp: $46,632
  • AmeriHealth — Managed Medicaid: $652.44
  • Anthem — All Products Mid-Level Facility: $999.09
  • Anthem — All Products Mid-Level Non-Facility: $999.09
  • Aultcare — PPO/HMO: $20,191.66
  • Buckeye — Managed Medicaid: $593.13
  • Caresource — Managed Medicaid: $622.79
  • CC EHP — All Products: $25,414.44
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION $43,632 $28,360.80 $12,339.13 – $43,632
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $21,816
  • ANTHEM — TRADITIONAL: $19,298.43
  • OSCAR — ALL PRODUCTS: $15,746.79
  • UNITED — ALL PRODUCTS: $19,328.98
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION $69,628 $45,258.20 $19,690.80 – $69,628
Heart rhythm study with ablation for atrial fibrillation: 10 of 58 insurance plan rates
  • AETNA — Acop: $26,180.13
  • AETNA — ALL PRODUCTS: $52,221
  • AETNA — Asa_Whirlpool_Peia: $31,611.11
  • AETNA — MEDICARE ADVANTAGE: $24,728.43
  • AETNA — Qhp/Ipf: $69,628
  • AMERIHEALTH — Managed Medicaid: $14,312.69
  • Amish Community Aid Plan — ALL PRODUCTS: $31,332.60
  • ANTHEM — HPN: $26,500.42
  • ANTHEM — Managed Medicaid: $13,662.12
  • ANTHEM — MEDICARE ADVANTAGE: $22,667.35
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION $7,480 $4,862 $1,900.67 – $7,480
Heart rhythm study with ablation for atrial fibrillation: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $5,610
  • Aetna — Asa: $5,984
  • Aetna — Medicare Advantage: $801.02
  • Aetna — Qhp/Ifp: $7,480
  • AmeriHealth — Managed Medicaid: $896.53
  • Anthem — All Products Mid-Level Facility: $1,272.93
  • Anthem — All Products Mid-Level Non-Facility: $1,272.93
  • Anthem — Medicare Advantage: $801.02
  • Aultcare — Medicare Advantage: $841.07
  • Aultcare — PPO/HMO: $3,238.84
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION $69,628 $45,258.20 $19,690.80 – $69,628
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $34,814
  • ANTHEM — TRADITIONAL: $30,796.46
  • OSCAR — ALL PRODUCTS: $25,128.75
  • UNITED — ALL PRODUCTS: $30,845.20
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $7,020 $4,563 $1,985.26 – $7,020
Sleep study (overnight, in a sleep lab): 10 of 52 insurance plan rates
  • AETNA — Acop: $2,639.52
  • AETNA — ALL PRODUCTS: $5,265
  • AETNA — Asa_Whirlpool_Peia: $3,187.08
  • AETNA — MEDICARE ADVANTAGE: $812.43
  • AETNA — Qhp/Ipf: $7,020
  • Amish Community Aid Plan — ALL PRODUCTS: $3,159
  • ANTHEM — HPN: $2,671.81
  • ANTHEM — MEDICARE ADVANTAGE: $940.05
  • ANTHEM — PPO/HMO: $3,143.56
  • ANTHEM — TRADITIONAL: $3,045.98
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $8,120 $5,278 $2,063.29 – $8,120
Sleep study (overnight, in a sleep lab): 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $6,090
  • Aetna — Asa: $6,496
  • Aetna — Medicare Advantage: $626.11
  • Aetna — Qhp/Ifp: $8,120
  • AmeriHealth — Managed Medicaid: $396.29
  • Anthem — All Products Mid-Level Facility: $774.90
  • Anthem — All Products Mid-Level Non-Facility: $774.90
  • Anthem — Medicare Advantage: $626.11
  • Aultcare — Medicare Advantage: $657.42
  • Aultcare — PPO/HMO: $3,515.96
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $7,020 $4,563 $1,985.26 – $7,020
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $3,510
  • ANTHEM — TRADITIONAL: $3,104.95
  • OSCAR — ALL PRODUCTS: $2,533.52
  • UNITED — ALL PRODUCTS: $3,109.86

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERA EXER 1 $258 $167.70 $31.71 – $100.45
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates
  • AETNA — Acop: $97.01
  • AETNA — ALL PRODUCTS: $193.50
  • AETNA — Asa_Whirlpool_Peia: $117.13
  • AETNA — MEDICARE ADVANTAGE: $37.31
  • AETNA — Qhp/Ipf: $258
  • AMERIHEALTH — Managed Medicaid: $100.45
  • Amish Community Aid Plan — ALL PRODUCTS: $116.10
  • ANTHEM — HPN: $98.19
  • ANTHEM — Managed Medicaid: $95.89
  • ANTHEM — PPO/HMO: $115.53
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERA EXER 15MIN $258 $167.70 $72.96 – $258
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates
  • AETNA — Acop: $97.01
  • AETNA — ALL PRODUCTS: $193.50
  • AETNA — Asa_Whirlpool_Peia: $117.13
  • AETNA — MEDICARE ADVANTAGE: $37.31
  • AETNA — Qhp/Ipf: $258
  • AMERIHEALTH — Managed Medicaid: $100.45
  • Amish Community Aid Plan — ALL PRODUCTS: $116.10
  • ANTHEM — HPN: $98.19
  • ANTHEM — Managed Medicaid: $95.89
  • ANTHEM — PPO/HMO: $115.53
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT THERAPEUT PROC/EXER, 15 MIN $258 $167.70 $72.96 – $258
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 56 insurance plan rates
  • AETNA — Acop: $97.01
  • AETNA — ALL PRODUCTS: $193.50
  • AETNA — Asa_Whirlpool_Peia: $117.13
  • AETNA — MEDICARE ADVANTAGE: $37.31
  • AETNA — Qhp/Ipf: $258
  • AMERIHEALTH — Managed Medicaid: $100.45
  • Amish Community Aid Plan — ALL PRODUCTS: $116.10
  • ANTHEM — HPN: $98.19
  • ANTHEM — Managed Medicaid: $95.89
  • ANTHEM — PPO/HMO: $115.53
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION LOW COMPLEXITY (97161) $605 $393.25 $171.09 – $605
Physical therapy evaluation (low complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS $605 $393.25 $171.09 – $605
Physical therapy evaluation (low complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - LOW $605 $393.25 $171.09 – $605
Physical therapy evaluation (low complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION MODERATE COMPLEXITY (97162) $605 $393.25 $171.09 – $605
Physical therapy evaluation (moderate complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - MOD $605 $393.25 $171.09 – $605
Physical therapy evaluation (moderate complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION MODERATE COMPLEXITY (97162) $605 $393.25 $171.09 – $605
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $302.50
  • ANTHEM — TRADITIONAL: $267.59
  • OSCAR — ALL PRODUCTS: $218.34
  • UNITED — ALL PRODUCTS: $268.02
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VV EVALUATION HIGH COMPLEXITY (97163) $605 $393.25 $171.09 – $605
Physical therapy evaluation (high complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL - HIGH $605 $393.25 $171.09 – $605
Physical therapy evaluation (high complexity): 10 of 56 insurance plan rates
  • AETNA — Acop: $227.48
  • AETNA — ALL PRODUCTS: $453.75
  • AETNA — Asa_Whirlpool_Peia: $274.67
  • AETNA — MEDICARE ADVANTAGE: $126.43
  • AETNA — Qhp/Ipf: $605
  • AMERIHEALTH — Managed Medicaid: $110.02
  • Amish Community Aid Plan — ALL PRODUCTS: $272.25
  • ANTHEM — HPN: $230.26
  • ANTHEM — Managed Medicaid: $105.02
  • ANTHEM — PPO/HMO: $270.92
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: VV EVALUATION HIGH COMPLEXITY (97163) $605 $393.25 $171.09 – $605
Physical therapy evaluation (high complexity): rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $302.50
  • ANTHEM — TRADITIONAL: $267.59
  • OSCAR — ALL PRODUCTS: $218.34
  • UNITED — ALL PRODUCTS: $268.02
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 30 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 30 minutes: 10 of 58 insurance plan rates
  • AETNA — Acop: $181.23
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $218.83
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $112.29
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.45
  • ANTHEM — Managed Medicaid: $107.18
  • ANTHEM — MEDICARE ADVANTAGE: $148.46
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 30 MINUTES PATIENT $744 $483.60 $189.05 – $744
Psychotherapy, 30 minutes: 10 of 54 insurance plan rates
  • Aetna — Acop: $94.42
  • Aetna — All Products First Health: $558
  • Aetna — Asa: $595.20
  • Aetna — Medicare Advantage: $69.44
  • Aetna — Qhp/Ifp: $744
  • AmeriHealth — Managed Medicaid: $39.14
  • Anthem — All Products Mid-Level Facility: $89.59
  • Anthem — All Products Mid-Level Non-Facility: $100.93
  • Anthem — Medicare Advantage: $69.44
  • Aultcare — Medicare Advantage: $72.91
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS $744 $483.60 $189.05 – $744
Psychotherapy, 30 minutes: 10 of 54 insurance plan rates
  • Aetna — Acop: $94.42
  • Aetna — All Products First Health: $558
  • Aetna — Asa: $595.20
  • Aetna — Medicare Advantage: $69.44
  • Aetna — Qhp/Ifp: $744
  • AmeriHealth — Managed Medicaid: $39.14
  • Anthem — All Products Mid-Level Facility: $89.59
  • Anthem — All Products Mid-Level Non-Facility: $100.93
  • Anthem — Medicare Advantage: $69.44
  • Aultcare — Medicare Advantage: $72.91
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 45 MINUTES $482 $313.30 $136.31 – $482
Psychotherapy, 45 minutes: 10 of 58 insurance plan rates
  • AETNA — Acop: $181.23
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $218.83
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $140.47
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.45
  • ANTHEM — Managed Medicaid: $134.09
  • ANTHEM — MEDICARE ADVANTAGE: $148.46
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 45 MINUTES WITH PATIENT $980 $637 $249.02 – $980
Psychotherapy, 45 minutes: 10 of 54 insurance plan rates
  • Aetna — Acop: $125.75
  • Aetna — All Products First Health: $735
  • Aetna — Asa: $784
  • Aetna — Medicare Advantage: $91.82
  • Aetna — Qhp/Ifp: $980
  • AmeriHealth — Managed Medicaid: $54.37
  • Anthem — All Products Mid-Level Facility: $118.82
  • Anthem — All Products Mid-Level Non-Facility: $133.54
  • Anthem — Medicare Advantage: $91.82
  • Aultcare — Medicare Advantage: $96.41
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS $980 $637 $249.02 – $980
Psychotherapy, 45 minutes: 10 of 54 insurance plan rates
  • Aetna — Acop: $125.75
  • Aetna — All Products First Health: $735
  • Aetna — Asa: $784
  • Aetna — Medicare Advantage: $91.82
  • Aetna — Qhp/Ifp: $980
  • AmeriHealth — Managed Medicaid: $54.37
  • Anthem — All Products Mid-Level Facility: $118.82
  • Anthem — All Products Mid-Level Non-Facility: $133.54
  • Anthem — Medicare Advantage: $91.82
  • Aultcare — Medicare Advantage: $96.41
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYCHOTHERAPY W/PATIENT 60 MINUTES $482 $313.30 $127.70 – $184.72
Psychotherapy, 60 minutes: 10 of 58 insurance plan rates
  • AETNA — Acop: $181.23
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $218.83
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $140.47
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.45
  • ANTHEM — Managed Medicaid: $134.09
  • ANTHEM — MEDICARE ADVANTAGE: $148.46
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY 60 MINUTES WITH PATIENT $1,452 $943.80 $368.95 – $1,452
Psychotherapy, 60 minutes: 10 of 54 insurance plan rates
  • Aetna — Acop: $188.86
  • Aetna — All Products First Health: $1,089
  • Aetna — Asa: $1,161.60
  • Aetna — Medicare Advantage: $135.22
  • Aetna — Qhp/Ifp: $1,452
  • AmeriHealth — Managed Medicaid: $83.35
  • Anthem — All Products Mid-Level Facility: $174.60
  • Anthem — All Products Mid-Level Non-Facility: $196.45
  • Anthem — Medicare Advantage: $135.22
  • Aultcare — Medicare Advantage: $141.98
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS $1,452 $943.80 $368.95 – $1,452
Psychotherapy, 60 minutes: 10 of 54 insurance plan rates
  • Aetna — Acop: $188.86
  • Aetna — All Products First Health: $1,089
  • Aetna — Asa: $1,161.60
  • Aetna — Medicare Advantage: $135.22
  • Aetna — Qhp/Ifp: $1,452
  • AmeriHealth — Managed Medicaid: $83.35
  • Anthem — All Products Mid-Level Facility: $174.60
  • Anthem — All Products Mid-Level Non-Facility: $196.45
  • Anthem — Medicare Advantage: $135.22
  • Aultcare — Medicare Advantage: $141.98
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $482 $313.30 $136.31 – $482
Family psychotherapy, without the patient: 10 of 58 insurance plan rates
  • AETNA — Acop: $181.23
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $218.83
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $187.50
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.45
  • ANTHEM — Managed Medicaid: $178.97
  • ANTHEM — MEDICARE ADVANTAGE: $148.46
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $1,052 $683.80 $267.31 – $1,052
Family psychotherapy, without the patient: 10 of 54 insurance plan rates
  • Aetna — Acop: $152.03
  • Aetna — All Products First Health: $789
  • Aetna — Asa: $841.60
  • Aetna — Medicare Advantage: $99.12
  • Aetna — Qhp/Ifp: $1,052
  • AmeriHealth — Managed Medicaid: $63.43
  • Anthem — All Products Mid-Level Facility: $128.37
  • Anthem — All Products Mid-Level Non-Facility: $128.79
  • Anthem — Medicare Advantage: $99.12
  • Aultcare — Medicare Advantage: $104.08
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: VIRTUAL VISIT FAMILY PSYCHOTHERAPY W/O PATIENT $1,052 $683.80 $267.31 – $1,052
Family psychotherapy, without the patient: 10 of 54 insurance plan rates
  • Aetna — Acop: $152.03
  • Aetna — All Products First Health: $789
  • Aetna — Asa: $841.60
  • Aetna — Medicare Advantage: $99.12
  • Aetna — Qhp/Ifp: $1,052
  • AmeriHealth — Managed Medicaid: $63.43
  • Anthem — All Products Mid-Level Facility: $128.37
  • Anthem — All Products Mid-Level Non-Facility: $128.79
  • Anthem — Medicare Advantage: $99.12
  • Aultcare — Medicare Advantage: $104.08
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAM THERAPY W PATIENT DTOX $482 $313.30 $136.31 – $482
Family psychotherapy, with the patient: 10 of 58 insurance plan rates
  • AETNA — Acop: $181.23
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $218.83
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $187.50
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.45
  • ANTHEM — Managed Medicaid: $178.97
  • ANTHEM — MEDICARE ADVANTAGE: $148.46
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $482 $313.30 $136.31 – $482
Family psychotherapy, with the patient: 10 of 58 insurance plan rates
  • AETNA — Acop: $181.23
  • AETNA — ALL PRODUCTS: $361.50
  • AETNA — Asa_Whirlpool_Peia: $218.83
  • AETNA — MEDICARE ADVANTAGE: $167.92
  • AETNA — Qhp/Ipf: $482
  • AMERIHEALTH — Managed Medicaid: $187.50
  • Amish Community Aid Plan — ALL PRODUCTS: $216.90
  • ANTHEM — HPN: $183.45
  • ANTHEM — Managed Medicaid: $178.97
  • ANTHEM — MEDICARE ADVANTAGE: $148.46
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $1,096 $712.40 $278.49 – $1,096
Family psychotherapy, with the patient: 10 of 54 insurance plan rates
  • Aetna — Acop: $158
  • Aetna — All Products First Health: $822
  • Aetna — Asa: $876.80
  • Aetna — Medicare Advantage: $102.81
  • Aetna — Qhp/Ifp: $1,096
  • AmeriHealth — Managed Medicaid: $74.48
  • Anthem — All Products Mid-Level Facility: $133.82
  • Anthem — All Products Mid-Level Non-Facility: $134.23
  • Anthem — Medicare Advantage: $102.81
  • Aultcare — Medicare Advantage: $107.95
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IOP HALF DAY RATE $834 $542.10 $235.86 – $834
Group psychotherapy: 10 of 58 insurance plan rates
  • AETNA — Acop: $313.58
  • AETNA — ALL PRODUCTS: $625.50
  • AETNA — Asa_Whirlpool_Peia: $378.64
  • AETNA — MEDICARE ADVANTAGE: $96.11
  • AETNA — Qhp/Ipf: $834
  • AMERIHEALTH — Managed Medicaid: $155.57
  • Amish Community Aid Plan — ALL PRODUCTS: $375.30
  • ANTHEM — HPN: $317.42
  • ANTHEM — Managed Medicaid: $148.50
  • ANTHEM — MEDICARE ADVANTAGE: $85.47
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VIRTUAL VISIT IOP HALF DAY RATE $834 $542.10 $235.86 – $834
Group psychotherapy: 10 of 58 insurance plan rates
  • AETNA — Acop: $313.58
  • AETNA — ALL PRODUCTS: $625.50
  • AETNA — Asa_Whirlpool_Peia: $378.64
  • AETNA — MEDICARE ADVANTAGE: $96.11
  • AETNA — Qhp/Ipf: $834
  • AMERIHEALTH — Managed Medicaid: $155.57
  • Amish Community Aid Plan — ALL PRODUCTS: $375.30
  • ANTHEM — HPN: $317.42
  • ANTHEM — Managed Medicaid: $148.50
  • ANTHEM — MEDICARE ADVANTAGE: $85.47
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CD IOP DAY $834 $542.10 $235.86 – $834
Group psychotherapy: 10 of 58 insurance plan rates
  • AETNA — Acop: $313.58
  • AETNA — ALL PRODUCTS: $625.50
  • AETNA — Asa_Whirlpool_Peia: $378.64
  • AETNA — MEDICARE ADVANTAGE: $96.11
  • AETNA — Qhp/Ipf: $834
  • AMERIHEALTH — Managed Medicaid: $155.57
  • Amish Community Aid Plan — ALL PRODUCTS: $375.30
  • ANTHEM — HPN: $317.42
  • ANTHEM — Managed Medicaid: $148.50
  • ANTHEM — MEDICARE ADVANTAGE: $85.47

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $11,488 $7,467.20 $3,248.81 – $11,488
Removal of breast growth (open surgery): 10 of 59 insurance plan rates
  • AETNA — Acop: $4,319.49
  • AETNA — ALL PRODUCTS: $8,616
  • AETNA — Asa_Whirlpool_Peia: $5,215.55
  • AETNA — International: $5,468.29
  • AETNA — MEDICARE ADVANTAGE: $3,704.30
  • AETNA — Qhp/Ipf: $11,488
  • AMERIHEALTH — Managed Medicaid: $1,218.23
  • Amish Community Aid Plan — ALL PRODUCTS: $5,169.60
  • ANTHEM — HPN: $4,372.33
  • ANTHEM — Managed Medicaid: $1,162.85
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $2,368 $1,539.20 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $6,508.54
Removal of breast growth (open surgery): 10 of 50 insurance plan rates
  • Aetna — Acop: $692.54
  • Aetna — All Products First Health: $1,776
  • Aetna — Asa: $1,894.40
  • Aetna — Medicare Advantage: $395.68
  • Aetna — Qhp/Ifp: $2,368
  • AmeriHealth — Managed Medicaid: $236.59
  • Anthem — All Products Mid-Level Facility: $561.27
  • Anthem — All Products Mid-Level Non-Facility: $690.34
  • Anthem — Medicare Advantage: $395.68
  • Aultcare — Medicare Advantage: $415.46
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: REMOVAL OF BREAST LESION $657 $427.05 $166.94 – $657
Removal of breast growth (open surgery): 10 of 50 insurance plan rates
  • Aetna — Acop: $692.54
  • Aetna — All Products First Health: $492.75
  • Aetna — Asa: $525.60
  • Aetna — Medicare Advantage: $395.68
  • Aetna — Qhp/Ifp: $657
  • AmeriHealth — Managed Medicaid: $236.59
  • Anthem — All Products Mid-Level Facility: $561.27
  • Anthem — All Products Mid-Level Non-Facility: $690.34
  • Anthem — Medicare Advantage: $395.68
  • Aultcare — Medicare Advantage: $415.46
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $8,624 $5,605.60 $2,191.36 – $8,624
Total hip replacement: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $6,468
  • Aetna — Asa: $6,899.20
  • Aetna — Medicare Advantage: $1,134.94
  • Aetna — Qhp/Ifp: $8,624
  • AmeriHealth — Managed Medicaid: $1,269.74
  • Anthem — All Products Mid-Level Facility: $1,721.01
  • Anthem — All Products Mid-Level Non-Facility: $1,721.01
  • Anthem — Medicare Advantage: $1,134.94
  • Aultcare — Medicare Advantage: $1,191.69
  • Aultcare — PPO/HMO: $3,734.19
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY Not listed in the file Not listed in the file $8,460.37 – $13,361.02
Total hip replacement: 10 of 18 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $12,146.38
  • ANTHEM — MEDICARE ADVANTAGE: $11,888.68
  • Aultcare — MEDICARE ADVANTAGE: $10,324.42
  • CIGNA — MEDICARE ADVANTAGE: $12,510.77
  • CommuniCare — MEDICARE ADVANTAGE: $12,753.70
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $12,146.38
  • HUMANA — Medicare Advantage HMO: $11,888.68
  • MMO — MEDICARE HMO: $11,888.68
  • MMO — Medicare PPO: $12,245.34
  • OPTUM — All Products VA: $11,888.68
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty Not listed in the file Not listed in the file $8,460.37 – $13,361.02
Total hip replacement: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $9,306.41
  • ANTHEM — Managed Medicaid: $8,883.39
  • Buckeye — Managed Medicaid: $8,460.37
  • CARESOURCE — Managed Medicaid: $9,052.60
  • MOLINA — Managed Medicaid: $8,883.39
  • UNITED — Managed Medicaid: $9,052.60
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $7,840 $5,096 $1,992.14 – $7,840
Total knee replacement: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $5,880
  • Aetna — Asa: $6,272
  • Aetna — Medicare Advantage: $1,132.39
  • Aetna — Qhp/Ifp: $7,840
  • AmeriHealth — Managed Medicaid: $1,350.81
  • Anthem — All Products Mid-Level Facility: $1,719.26
  • Anthem — All Products Mid-Level Non-Facility: $1,719.26
  • Anthem — Medicare Advantage: $1,132.39
  • Aultcare — Medicare Advantage: $1,189.01
  • Aultcare — PPO/HMO: $3,394.72
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY Not listed in the file Not listed in the file $8,460.37 – $13,361.02
Total knee replacement: 10 of 19 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $12,146.38
  • ANTHEM — MEDICARE ADVANTAGE: $11,888.68
  • Aultcare — MEDICARE ADVANTAGE: $10,324.42
  • CIGNA — ALL PRODUCTS: $9,250
  • CIGNA — MEDICARE ADVANTAGE: $12,510.77
  • CommuniCare — MEDICARE ADVANTAGE: $12,753.70
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $12,146.38
  • HUMANA — Medicare Advantage HMO: $11,888.68
  • MMO — MEDICARE HMO: $11,888.68
  • MMO — Medicare PPO: $12,245.34
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty Not listed in the file Not listed in the file $8,460.37 – $13,361.02
Total knee replacement: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $9,306.41
  • ANTHEM — Managed Medicaid: $8,883.39
  • Buckeye — Managed Medicaid: $8,460.37
  • CARESOURCE — Managed Medicaid: $9,052.60
  • MOLINA — Managed Medicaid: $8,883.39
  • UNITED — Managed Medicaid: $9,052.60
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $1,320 $858 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $423.05
Shoulder arthroscopy: shaving of shoulder bone: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $990
  • Aetna — Asa: $1,056
  • Aetna — Medicare Advantage: $145.87
  • Aetna — Qhp/Ifp: $1,320
  • AmeriHealth — Managed Medicaid: $177.29
  • Anthem — All Products Mid-Level Facility: $231.06
  • Anthem — All Products Mid-Level Non-Facility: $231.06
  • Anthem — Medicare Advantage: $145.87
  • Aultcare — Medicare Advantage: $153.16
  • Aultcare — PPO/HMO: $571.56
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sho arthrs srg decompression Not listed in the file Not listed in the file $1,965.80 – $5,520
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $2,162.38
  • ANTHEM — Managed Medicaid: $2,064.09
  • Buckeye — Managed Medicaid: $1,965.80
  • CARESOURCE — Managed Medicaid: $2,103.41
  • MOLINA — Managed Medicaid: $2,064.09
  • UNITED — Managed Medicaid: $2,103.41
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION Not listed in the file Not listed in the file $1,965.80 – $5,520
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans
  • CIGNA — ALL PRODUCTS: $5,520
  • MMO — ALL PRODUCTS: $3,321
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG $3,093 $2,010.45 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,526.53
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $2,319.75
  • Aetna — Asa: $2,474.40
  • Aetna — Medicare Advantage: $497.66
  • Aetna — Qhp/Ifp: $3,093
  • AmeriHealth — Managed Medicaid: $499.32
  • Anthem — All Products Mid-Level Facility: $724.56
  • Anthem — All Products Mid-Level Non-Facility: $724.56
  • Anthem — Medicare Advantage: $497.66
  • Aultcare — Medicare Advantage: $522.54
  • Aultcare — PPO/HMO: $1,339.27
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L Not listed in the file Not listed in the file $1,965.80 – $6,565
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $3,095.56
  • ANTHEM — MEDICARE ADVANTAGE: $2,997.95
  • Aultcare — MEDICARE ADVANTAGE: $2,631.23
  • CIGNA — ALL PRODUCTS: $6,565
  • CIGNA — MEDICARE ADVANTAGE: $3,188.43
  • CommuniCare — MEDICARE ADVANTAGE: $3,250.34
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $3,095.56
  • HUMANA — Medicare Advantage HMO: $2,997.95
  • MMO — ALL PRODUCTS: $4,042
  • MMO — MEDICARE HMO: $2,997.95
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Arthrs kne srg mnisectmy m/l Not listed in the file Not listed in the file $1,965.80 – $6,565
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $2,162.38
  • ANTHEM — Managed Medicaid: $2,064.09
  • Buckeye — Managed Medicaid: $1,965.80
  • CARESOURCE — Managed Medicaid: $2,103.41
  • MOLINA — Managed Medicaid: $2,064.09
  • UNITED — Managed Medicaid: $2,103.41
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TONSILLECTOMY & ADENOIDECTOMY <AGE 12 $1,688 $1,097.20 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,999.36
Removal of tonsils and adenoids (under age 12): 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $1,266
  • Aetna — Asa: $1,350.40
  • Aetna — Medicare Advantage: $253.24
  • Aetna — Qhp/Ifp: $1,688
  • AmeriHealth — Managed Medicaid: $214.31
  • Anthem — All Products Mid-Level Facility: $389.53
  • Anthem — All Products Mid-Level Non-Facility: $389.53
  • Anthem — Medicare Advantage: $253.24
  • Aultcare — Medicare Advantage: $265.90
  • Aultcare — PPO/HMO: $730.90
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS Not listed in the file Not listed in the file $1,539.76 – $6,160.68
Removal of tonsils and adenoids (under age 12): 10 of 18 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $5,600.62
  • ANTHEM — MEDICARE ADVANTAGE: $5,465.95
  • Aultcare — MEDICARE ADVANTAGE: $4,760.52
  • CIGNA — MEDICARE ADVANTAGE: $5,768.63
  • CommuniCare — MEDICARE ADVANTAGE: $5,880.65
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $5,600.62
  • HUMANA — Medicare Advantage HMO: $5,465.95
  • MMO — MEDICARE HMO: $5,465.95
  • MMO — Medicare PPO: $5,629.93
  • OPTUM — All Products VA: $5,465.95
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids Not listed in the file Not listed in the file $1,539.76 – $6,160.68
Removal of tonsils and adenoids (under age 12): rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,693.74
  • ANTHEM — Managed Medicaid: $1,616.75
  • Buckeye — Managed Medicaid: $1,539.76
  • CARESOURCE — Managed Medicaid: $1,647.54
  • MOLINA — Managed Medicaid: $1,616.75
  • UNITED — Managed Medicaid: $1,647.54
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $4,313 $2,803.45 $1,219.72 – $4,313
Upper GI endoscopy (diagnostic): 10 of 58 insurance plan rates
  • AETNA — Acop: $1,621.69
  • AETNA — ALL PRODUCTS: $3,234.75
  • AETNA — Asa_Whirlpool_Peia: $1,958.10
  • AETNA — MEDICARE ADVANTAGE: $858.08
  • AETNA — Qhp/Ipf: $4,313
  • AMERIHEALTH — Managed Medicaid: $921.27
  • Amish Community Aid Plan — ALL PRODUCTS: $1,940.85
  • ANTHEM — HPN: $1,641.53
  • ANTHEM — Managed Medicaid: $879.40
  • ANTHEM — MEDICARE ADVANTAGE: $866.29
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $836 $543.40 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy (diagnostic): 10 of 50 insurance plan rates
  • Aetna — Acop: $362.08
  • Aetna — All Products First Health: $627
  • Aetna — Asa: $668.80
  • Aetna — Medicare Advantage: $108.16
  • Aetna — Qhp/Ifp: $836
  • AmeriHealth — Managed Medicaid: $136.66
  • Anthem — All Products Mid-Level Facility: $161.64
  • Anthem — All Products Mid-Level Non-Facility: $374.38
  • Anthem — Medicare Advantage: $108.16
  • Aultcare — Medicare Advantage: $113.57
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPR GI ENDOSCOPY, DIAGNOSIS $468 $304.20 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy (diagnostic): 10 of 50 insurance plan rates
  • Aetna — Acop: $362.08
  • Aetna — All Products First Health: $351
  • Aetna — Asa: $374.40
  • Aetna — Medicare Advantage: $108.16
  • Aetna — Qhp/Ifp: $468
  • AmeriHealth — Managed Medicaid: $136.66
  • Anthem — All Products Mid-Level Facility: $161.64
  • Anthem — All Products Mid-Level Non-Facility: $374.38
  • Anthem — Medicare Advantage: $108.16
  • Aultcare — Medicare Advantage: $113.57
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $4,313 $2,803.45 $1,219.72 – $4,313
Upper GI endoscopy with biopsy: 10 of 58 insurance plan rates
  • AETNA — Acop: $1,621.69
  • AETNA — ALL PRODUCTS: $3,234.75
  • AETNA — Asa_Whirlpool_Peia: $1,958.10
  • AETNA — MEDICARE ADVANTAGE: $858.08
  • AETNA — Qhp/Ipf: $4,313
  • AMERIHEALTH — Managed Medicaid: $921.27
  • Amish Community Aid Plan — ALL PRODUCTS: $1,940.85
  • ANTHEM — HPN: $1,641.53
  • ANTHEM — Managed Medicaid: $879.40
  • ANTHEM — MEDICARE ADVANTAGE: $866.29
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $1,052 $683.80 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy with biopsy: 10 of 50 insurance plan rates
  • Aetna — Acop: $482.89
  • Aetna — All Products First Health: $789
  • Aetna — Asa: $841.60
  • Aetna — Medicare Advantage: $121.06
  • Aetna — Qhp/Ifp: $1,052
  • AmeriHealth — Managed Medicaid: $153.79
  • Anthem — All Products Mid-Level Facility: $182.43
  • Anthem — All Products Mid-Level Non-Facility: $488.50
  • Anthem — Medicare Advantage: $121.06
  • Aultcare — Medicare Advantage: $127.11
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: UPPER GI ENDOSCOPY, BIOPSY $508 $330.20 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,548.29
Upper GI endoscopy with biopsy: 10 of 50 insurance plan rates
  • Aetna — Acop: $482.89
  • Aetna — All Products First Health: $381
  • Aetna — Asa: $406.40
  • Aetna — Medicare Advantage: $121.06
  • Aetna — Qhp/Ifp: $508
  • AmeriHealth — Managed Medicaid: $153.79
  • Anthem — All Products Mid-Level Facility: $182.43
  • Anthem — All Products Mid-Level Non-Facility: $488.50
  • Anthem — Medicare Advantage: $121.06
  • Aultcare — Medicare Advantage: $127.11
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $4,194 $2,726.10 $1,186.06 – $4,194
Colonoscopy (diagnostic): 10 of 58 insurance plan rates
  • AETNA — Acop: $1,576.94
  • AETNA — ALL PRODUCTS: $3,145.50
  • AETNA — Asa_Whirlpool_Peia: $1,904.08
  • AETNA — MEDICARE ADVANTAGE: $879.81
  • AETNA — Qhp/Ipf: $4,194
  • AMERIHEALTH — Managed Medicaid: $1,051.07
  • Amish Community Aid Plan — ALL PRODUCTS: $1,887.30
  • ANTHEM — HPN: $1,596.24
  • ANTHEM — Managed Medicaid: $1,003.30
  • ANTHEM — MEDICARE ADVANTAGE: $842.40
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $1,434 $932.10 $364.38 – $1,434
Colonoscopy (diagnostic): 10 of 50 insurance plan rates
  • Aetna — Acop: $440.43
  • Aetna — All Products First Health: $1,075.50
  • Aetna — Asa: $1,147.20
  • Aetna — Medicare Advantage: $161.68
  • Aetna — Qhp/Ifp: $1,434
  • AmeriHealth — Managed Medicaid: $102.78
  • Anthem — All Products Mid-Level Facility: $244.03
  • Anthem — All Products Mid-Level Non-Facility: $444.58
  • Anthem — Medicare Advantage: $161.68
  • Aultcare — Medicare Advantage: $169.76
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY $630 $409.50 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,560.83
Colonoscopy (diagnostic): 10 of 50 insurance plan rates
  • Aetna — Acop: $440.43
  • Aetna — All Products First Health: $472.50
  • Aetna — Asa: $504
  • Aetna — Medicare Advantage: $161.68
  • Aetna — Qhp/Ifp: $630
  • AmeriHealth — Managed Medicaid: $102.78
  • Anthem — All Products Mid-Level Facility: $244.03
  • Anthem — All Products Mid-Level Non-Facility: $444.58
  • Anthem — Medicare Advantage: $161.68
  • Aultcare — Medicare Advantage: $169.76
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $5,424 $3,525.60 $955.52 – $3,465
Colonoscopy with biopsy: 10 of 58 insurance plan rates
  • AETNA — Acop: $2,039.42
  • AETNA — ALL PRODUCTS: $4,068
  • AETNA — Asa_Whirlpool_Peia: $2,462.50
  • AETNA — MEDICARE ADVANTAGE: $1,132.12
  • AETNA — Qhp/Ipf: $5,424
  • AMERIHEALTH — Managed Medicaid: $1,051.07
  • Amish Community Aid Plan — ALL PRODUCTS: $2,440.80
  • ANTHEM — HPN: $2,064.37
  • ANTHEM — Managed Medicaid: $1,003.30
  • ANTHEM — MEDICARE ADVANTAGE: $1,089.45
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $1,566 $1,017.90 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,014.21
Colonoscopy with biopsy: 10 of 50 insurance plan rates
  • Aetna — Acop: $562.48
  • Aetna — All Products First Health: $1,174.50
  • Aetna — Asa: $1,252.80
  • Aetna — Medicare Advantage: $174.52
  • Aetna — Qhp/Ifp: $1,566
  • AmeriHealth — Managed Medicaid: $223.07
  • Anthem — All Products Mid-Level Facility: $265.15
  • Anthem — All Products Mid-Level Non-Facility: $565.76
  • Anthem — Medicare Advantage: $174.52
  • Aultcare — Medicare Advantage: $183.25
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY $706 $458.90 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,014.21
Colonoscopy with biopsy: 10 of 50 insurance plan rates
  • Aetna — Acop: $562.48
  • Aetna — All Products First Health: $529.50
  • Aetna — Asa: $564.80
  • Aetna — Medicare Advantage: $174.52
  • Aetna — Qhp/Ifp: $706
  • AmeriHealth — Managed Medicaid: $223.07
  • Anthem — All Products Mid-Level Facility: $265.15
  • Anthem — All Products Mid-Level Non-Facility: $565.76
  • Anthem — Medicare Advantage: $174.52
  • Aultcare — Medicare Advantage: $183.25
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $5,424 $3,525.60 $955.52 – $3,465
Colonoscopy with removal of polyps (snare): 10 of 58 insurance plan rates
  • AETNA — Acop: $2,039.42
  • AETNA — ALL PRODUCTS: $4,068
  • AETNA — Asa_Whirlpool_Peia: $2,462.50
  • AETNA — MEDICARE ADVANTAGE: $1,132.12
  • AETNA — Qhp/Ipf: $5,424
  • AMERIHEALTH — Managed Medicaid: $1,051.07
  • Amish Community Aid Plan — ALL PRODUCTS: $2,440.80
  • ANTHEM — HPN: $2,064.37
  • ANTHEM — Managed Medicaid: $1,003.30
  • ANTHEM — MEDICARE ADVANTAGE: $1,089.45
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $2,011 $1,307.15 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,014.21
Colonoscopy with removal of polyps (snare): 10 of 50 insurance plan rates
  • Aetna — Acop: $594.64
  • Aetna — All Products First Health: $1,508.25
  • Aetna — Asa: $1,608.80
  • Aetna — Medicare Advantage: $219.68
  • Aetna — Qhp/Ifp: $2,011
  • AmeriHealth — Managed Medicaid: $283.60
  • Anthem — All Products Mid-Level Facility: $335.61
  • Anthem — All Products Mid-Level Non-Facility: $594.58
  • Anthem — Medicare Advantage: $219.68
  • Aultcare — Medicare Advantage: $230.66
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LESION REMOVAL COLONOSCOPY $970 $630.50 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,014.21
Colonoscopy with removal of polyps (snare): 10 of 50 insurance plan rates
  • Aetna — Acop: $594.64
  • Aetna — All Products First Health: $727.50
  • Aetna — Asa: $776
  • Aetna — Medicare Advantage: $219.68
  • Aetna — Qhp/Ifp: $970
  • AmeriHealth — Managed Medicaid: $283.60
  • Anthem — All Products Mid-Level Facility: $335.61
  • Anthem — All Products Mid-Level Non-Facility: $594.58
  • Anthem — Medicare Advantage: $219.68
  • Aultcare — Medicare Advantage: $230.66
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX $1,856 $1,206.40 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $2,014.21
Ultrasound of the lower bowel by endoscope: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $1,392
  • Aetna — Asa: $1,484.80
  • Aetna — Medicare Advantage: $222.24
  • Aetna — Qhp/Ifp: $1,856
  • AmeriHealth — Managed Medicaid: $229.80
  • Anthem — All Products Mid-Level Facility: $340.43
  • Anthem — All Products Mid-Level Non-Facility: $340.43
  • Anthem — Medicare Advantage: $222.24
  • Aultcare — Medicare Advantage: $233.35
  • Aultcare — PPO/HMO: $803.65
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US Not listed in the file Not listed in the file $955.52 – $1,245.33
Ultrasound of the lower bowel by endoscope: 10 of 18 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $1,132.12
  • ANTHEM — MEDICARE ADVANTAGE: $1,089.45
  • Aultcare — MEDICARE ADVANTAGE: $962.30
  • CIGNA — MEDICARE ADVANTAGE: $1,166.08
  • CommuniCare — MEDICARE ADVANTAGE: $1,188.72
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $1,132.12
  • HUMANA — Medicare Advantage HMO: $1,089.45
  • MMO — MEDICARE HMO: $1,089.45
  • MMO — Medicare PPO: $1,122.13
  • OPTUM — All Products VA: $1,089.45
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us Not listed in the file Not listed in the file $955.52 – $1,245.33
Ultrasound of the lower bowel by endoscope: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,051.07
  • ANTHEM — Managed Medicaid: $1,003.30
  • Buckeye — Managed Medicaid: $955.52
  • CARESOURCE — Managed Medicaid: $1,022.41
  • MOLINA — Managed Medicaid: $1,003.30
  • UNITED — Managed Medicaid: $1,022.41
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLOSCPY, SCRN; NOT HI RISK $3,647 $2,370.55 $1,031.37 – $3,647
Screening colonoscopy (not high risk): 10 of 58 insurance plan rates
  • AETNA — Acop: $1,371.27
  • AETNA — ALL PRODUCTS: $2,735.25
  • AETNA — Asa_Whirlpool_Peia: $1,655.74
  • AETNA — MEDICARE ADVANTAGE: $879.81
  • AETNA — Qhp/Ipf: $3,647
  • AMERIHEALTH — Managed Medicaid: $1,051.07
  • Amish Community Aid Plan — ALL PRODUCTS: $1,641.15
  • ANTHEM — HPN: $1,388.05
  • ANTHEM — Managed Medicaid: $1,003.30
  • ANTHEM — MEDICARE ADVANTAGE: $842.40
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY SCRN NOT HIGH RISK $1,434 $932.10 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,560.83
Screening colonoscopy (not high risk): 10 of 43 insurance plan rates
  • Aetna — Acop: $440.43
  • Aetna — All Products First Health: $1,075.50
  • Aetna — Asa: $1,147.20
  • Aetna — Medicare Advantage: $162.02
  • Aetna — Qhp/Ifp: $1,434
  • Anthem — All Products Mid-Level Facility: $244.52
  • Anthem — All Products Mid-Level Non-Facility: $445.06
  • Anthem — Medicare Advantage: $162.02
  • Aultcare — Medicare Advantage: $170.12
  • Aultcare — PPO/HMO: $620.92
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY MCR SCREENING $657 $427.05 $166.94 – $657
Screening colonoscopy (not high risk): 10 of 43 insurance plan rates
  • Aetna — Acop: $440.43
  • Aetna — All Products First Health: $492.75
  • Aetna — Asa: $525.60
  • Aetna — Medicare Advantage: $162.02
  • Aetna — Qhp/Ifp: $657
  • Anthem — All Products Mid-Level Facility: $244.52
  • Anthem — All Products Mid-Level Non-Facility: $445.06
  • Anthem — Medicare Advantage: $162.02
  • Aultcare — Medicare Advantage: $170.12
  • Aultcare — PPO/HMO: $284.48
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY SURG CHOLECYSTECTOMY $26,838 $17,444.70 $7,589.79 – $26,838
Gallbladder removal by laparoscope: 10 of 58 insurance plan rates
  • AETNA — Acop: $10,091.09
  • AETNA — ALL PRODUCTS: $20,128.50
  • AETNA — Asa_Whirlpool_Peia: $12,184.45
  • AETNA — MEDICARE ADVANTAGE: $5,719.53
  • AETNA — Qhp/Ipf: $26,838
  • AMERIHEALTH — Managed Medicaid: $3,569.21
  • Amish Community Aid Plan — ALL PRODUCTS: $12,077.10
  • ANTHEM — HPN: $10,214.54
  • ANTHEM — Managed Medicaid: $3,406.98
  • ANTHEM — MEDICARE ADVANTAGE: $5,390.83
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPAROSCOPY SURG CHOLECYSTECTOMY $4,188 $2,722.20 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,852.42
Gallbladder removal by laparoscope: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $3,141
  • Aetna — Asa: $3,350.40
  • Aetna — Medicare Advantage: $618.18
  • Aetna — Qhp/Ifp: $4,188
  • AmeriHealth — Managed Medicaid: $567.25
  • Anthem — All Products Mid-Level Facility: $891.09
  • Anthem — All Products Mid-Level Non-Facility: $891.09
  • Anthem — Medicare Advantage: $618.18
  • Aultcare — Medicare Advantage: $649.09
  • Aultcare — PPO/HMO: $1,813.40
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY $1,406 $913.90 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,852.42
Gallbladder removal by laparoscope: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $1,054.50
  • Aetna — Asa: $1,124.80
  • Aetna — Medicare Advantage: $618.18
  • Aetna — Qhp/Ifp: $1,406
  • AmeriHealth — Managed Medicaid: $567.25
  • Anthem — All Products Mid-Level Facility: $891.09
  • Anthem — All Products Mid-Level Non-Facility: $891.09
  • Anthem — Medicare Advantage: $618.18
  • Aultcare — Medicare Advantage: $649.09
  • Aultcare — PPO/HMO: $608.80
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $16,234 $10,552.10 $4,590.98 – $16,234
Groin (inguinal) hernia repair, age 5 or older: 10 of 58 insurance plan rates
  • AETNA — Acop: $6,103.98
  • AETNA — ALL PRODUCTS: $12,175.50
  • AETNA — Asa_Whirlpool_Peia: $7,370.24
  • AETNA — MEDICARE ADVANTAGE: $3,387.33
  • AETNA — Qhp/Ipf: $16,234
  • AMERIHEALTH — Managed Medicaid: $2,876.79
  • Amish Community Aid Plan — ALL PRODUCTS: $7,305.30
  • ANTHEM — HPN: $6,178.66
  • ANTHEM — Managed Medicaid: $2,746.02
  • ANTHEM — MEDICARE ADVANTAGE: $3,260.78
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $3,184 $2,069.60 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,906.43
Groin (inguinal) hernia repair, age 5 or older: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $2,388
  • Aetna — Asa: $2,547.20
  • Aetna — Medicare Advantage: $495.34
  • Aetna — Qhp/Ifp: $3,184
  • AmeriHealth — Managed Medicaid: $345.06
  • Anthem — All Products Mid-Level Facility: $706.53
  • Anthem — All Products Mid-Level Non-Facility: $706.53
  • Anthem — Medicare Advantage: $495.34
  • Aultcare — Medicare Advantage: $520.11
  • Aultcare — PPO/HMO: $1,378.67
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: REPAIR INGUINAL HERNIA $1,050 $682.50 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,906.43
Groin (inguinal) hernia repair, age 5 or older: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $787.50
  • Aetna — Asa: $840
  • Aetna — Medicare Advantage: $495.34
  • Aetna — Qhp/Ifp: $1,050
  • AmeriHealth — Managed Medicaid: $345.06
  • Anthem — All Products Mid-Level Facility: $706.53
  • Anthem — All Products Mid-Level Non-Facility: $706.53
  • Anthem — Medicare Advantage: $495.34
  • Aultcare — Medicare Advantage: $520.11
  • Aultcare — PPO/HMO: $454.65
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE Not listed in the file Not listed in the file $1,210.66 – $3,465
Prostate biopsy: rates for 9 insurance plans
  • ANTHEM — MEDICARE ADVANTAGE: $1,892.78
  • CIGNA — ALL PRODUCTS: $3,465
  • HUMANA — Medicare Advantage HMO: $1,892.78
  • MMO — ALL PRODUCTS: $2,593
  • MMO — MEDICARE HMO: $1,892.78
  • MMO — Medicare PPO: $1,949.57
  • OPTUM — All Products VA: $1,892.78
  • Perennial Health — MEDICARE ADVANTAGE: $2,044.20
  • UNITED — MEDICARE ADVANTAGE: $1,892.78
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate Not listed in the file Not listed in the file $1,210.66 – $3,465
Prostate biopsy: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,331.73
  • ANTHEM — Managed Medicaid: $1,271.19
  • Buckeye — Managed Medicaid: $1,210.66
  • CARESOURCE — Managed Medicaid: $1,295.41
  • MOLINA — Managed Medicaid: $1,271.19
  • UNITED — Managed Medicaid: $1,295.41
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT $9,882 $6,423.30 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $17,575.94
Prostate removal by laparoscope (radical prostatectomy): 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $7,411.50
  • Aetna — Asa: $7,905.60
  • Aetna — Medicare Advantage: $1,065.64
  • Aetna — Qhp/Ifp: $9,882
  • AmeriHealth — Managed Medicaid: $1,221.73
  • Anthem — All Products Mid-Level Facility: $1,588.88
  • Anthem — All Products Mid-Level Non-Facility: $1,588.88
  • Anthem — Medicare Advantage: $1,065.64
  • Aultcare — Medicare Advantage: $1,118.92
  • Aultcare — PPO/HMO: $4,278.91
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD Not listed in the file Not listed in the file $3,525.65 – $11,062.31
Prostate removal by laparoscope (radical prostatectomy): 10 of 18 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $10,056.64
  • ANTHEM — MEDICARE ADVANTAGE: $9,619.76
  • Aultcare — MEDICARE ADVANTAGE: $8,548.15
  • CIGNA — MEDICARE ADVANTAGE: $10,358.34
  • CommuniCare — MEDICARE ADVANTAGE: $10,559.47
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $10,056.64
  • HUMANA — Medicare Advantage HMO: $9,619.76
  • MMO — MEDICARE HMO: $9,619.76
  • MMO — Medicare PPO: $9,908.35
  • OPTUM — All Products VA: $9,619.76
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laps surg prst8ect rpbic rad Not listed in the file Not listed in the file $3,525.65 – $11,062.31
Prostate removal by laparoscope (radical prostatectomy): rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $3,878.22
  • ANTHEM — Managed Medicaid: $3,701.93
  • Buckeye — Managed Medicaid: $3,525.65
  • CARESOURCE — Managed Medicaid: $3,772.45
  • MOLINA — Managed Medicaid: $3,701.93
  • UNITED — Managed Medicaid: $3,772.45
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $14,626 $9,506.90 $4,136.23 – $14,626
Hysteroscopy with biopsy of the uterus lining: 10 of 58 insurance plan rates
  • AETNA — Acop: $5,499.38
  • AETNA — ALL PRODUCTS: $10,969.50
  • AETNA — Asa_Whirlpool_Peia: $6,640.20
  • AETNA — MEDICARE ADVANTAGE: $3,062.57
  • AETNA — Qhp/Ipf: $14,626
  • AMERIHEALTH — Managed Medicaid: $2,011.76
  • Amish Community Aid Plan — ALL PRODUCTS: $6,581.70
  • ANTHEM — HPN: $5,566.66
  • ANTHEM — Managed Medicaid: $1,920.31
  • ANTHEM — MEDICARE ADVANTAGE: $2,937.82
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $1,835 $1,192.75 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,338.37
Hysteroscopy with biopsy of the uterus lining: 10 of 50 insurance plan rates
  • Aetna — Acop: $1,818.12
  • Aetna — All Products First Health: $1,376.25
  • Aetna — Asa: $1,468
  • Aetna — Medicare Advantage: $201.74
  • Aetna — Qhp/Ifp: $1,835
  • AmeriHealth — Managed Medicaid: $129.43
  • Anthem — All Products Mid-Level Facility: $311.41
  • Anthem — All Products Mid-Level Non-Facility: $1,724.50
  • Anthem — Medicare Advantage: $201.74
  • Aultcare — Medicare Advantage: $211.83
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C $14,626 $9,506.90 $4,136.23 – $14,626
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $7,313
  • ANTHEM — TRADITIONAL: $6,469.08
  • OSCAR — ALL PRODUCTS: $5,278.52
  • UNITED — ALL PRODUCTS: $6,479.32
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $4,778 $3,105.70 $567.65 – $2,123
Spinal injection, lower back (epidural), with imaging guidance: 10 of 58 insurance plan rates
  • AETNA — Acop: $1,796.53
  • AETNA — ALL PRODUCTS: $3,583.50
  • AETNA — Asa_Whirlpool_Peia: $2,169.21
  • AETNA — MEDICARE ADVANTAGE: $667.82
  • AETNA — Qhp/Ipf: $4,778
  • AMERIHEALTH — Managed Medicaid: $667.72
  • Amish Community Aid Plan — ALL PRODUCTS: $2,150.10
  • ANTHEM — HPN: $1,818.51
  • ANTHEM — Managed Medicaid: $637.37
  • ANTHEM — MEDICARE ADVANTAGE: $639.87
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $792 $514.80 $201.25 – $792
Spinal injection, lower back (epidural), with imaging guidance: 10 of 50 insurance plan rates
  • Aetna — Acop: $337.20
  • Aetna — All Products First Health: $594
  • Aetna — Asa: $633.60
  • Aetna — Medicare Advantage: $87.51
  • Aetna — Qhp/Ifp: $792
  • AmeriHealth — Managed Medicaid: $88.96
  • Anthem — All Products Mid-Level Facility: $131.33
  • Anthem — All Products Mid-Level Non-Facility: $333.97
  • Anthem — Medicare Advantage: $87.51
  • Aultcare — Medicare Advantage: $91.89
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $4,778 $3,105.70 $1,351.22 – $4,778
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $2,389
  • ANTHEM — TRADITIONAL: $2,113.31
  • OSCAR — ALL PRODUCTS: $1,724.38
  • UNITED — ALL PRODUCTS: $2,116.65
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $6,143 $3,992.95 $1,737.24 – $6,143
Nerve root injection, lower back, with imaging guidance: 10 of 58 insurance plan rates
  • AETNA — Acop: $2,309.77
  • AETNA — ALL PRODUCTS: $4,607.25
  • AETNA — Asa_Whirlpool_Peia: $2,788.92
  • AETNA — MEDICARE ADVANTAGE: $836.78
  • AETNA — Qhp/Ipf: $6,143
  • AMERIHEALTH — Managed Medicaid: $667.72
  • Amish Community Aid Plan — ALL PRODUCTS: $2,764.35
  • ANTHEM — HPN: $2,338.03
  • ANTHEM — Managed Medicaid: $637.37
  • ANTHEM — MEDICARE ADVANTAGE: $822.61
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $836 $543.40 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $1,555.46
Nerve root injection, lower back, with imaging guidance: 10 of 50 insurance plan rates
  • Aetna — Acop: $306.59
  • Aetna — All Products First Health: $627
  • Aetna — Asa: $668.80
  • Aetna — Medicare Advantage: $97.27
  • Aetna — Qhp/Ifp: $836
  • AmeriHealth — Managed Medicaid: $62.05
  • Anthem — All Products Mid-Level Facility: $146.45
  • Anthem — All Products Mid-Level Non-Facility: $318.40
  • Anthem — Medicare Advantage: $97.27
  • Aultcare — Medicare Advantage: $102.13
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $6,143 $3,992.95 $1,737.24 – $6,143
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $3,071.50
  • ANTHEM — TRADITIONAL: $2,717.05
  • OSCAR — ALL PRODUCTS: $2,217.01
  • UNITED — ALL PRODUCTS: $2,721.35
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE $13,474 $8,758.10 $3,810.45 – $13,474
Carpal tunnel release: 10 of 58 insurance plan rates
  • AETNA — Acop: $5,066.22
  • AETNA — ALL PRODUCTS: $10,105.50
  • AETNA — Asa_Whirlpool_Peia: $6,117.20
  • AETNA — MEDICARE ADVANTAGE: $1,847.43
  • AETNA — Qhp/Ipf: $13,474
  • AMERIHEALTH — Managed Medicaid: $1,287.18
  • Amish Community Aid Plan — ALL PRODUCTS: $6,063.30
  • ANTHEM — HPN: $5,128.20
  • ANTHEM — Managed Medicaid: $1,228.67
  • ANTHEM — MEDICARE ADVANTAGE: $1,804.32
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE $1,988 $1,292.20 $505.15 – $1,988
Carpal tunnel release: 10 of 50 insurance plan rates
  • Aetna — Acop: $601.27
  • Aetna — All Products First Health: $1,491
  • Aetna — Asa: $1,590.40
  • Aetna — Medicare Advantage: $405.62
  • Aetna — Qhp/Ifp: $1,988
  • AmeriHealth — Managed Medicaid: $289.34
  • Anthem — All Products Mid-Level Facility: $581.89
  • Anthem — All Products Mid-Level Non-Facility: $591.98
  • Anthem — Medicare Advantage: $405.62
  • Aultcare — Medicare Advantage: $425.90
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE $13,474 $8,758.10 $3,810.45 – $13,474
Carpal tunnel release: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $6,737
  • ANTHEM — TRADITIONAL: $5,959.55
  • OSCAR — ALL PRODUCTS: $4,862.77
  • UNITED — ALL PRODUCTS: $5,968.98
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST-CATARACT LASER SURGERY $2,524 $1,640.60 $713.79 – $2,524
Laser treatment of clouding after cataract surgery: 10 of 58 insurance plan rates
  • AETNA — Acop: $949.02
  • AETNA — ALL PRODUCTS: $1,893
  • AETNA — Asa_Whirlpool_Peia: $1,145.90
  • AETNA — MEDICARE ADVANTAGE: $520.34
  • AETNA — Qhp/Ipf: $2,524
  • AMERIHEALTH — Managed Medicaid: $375.89
  • Amish Community Aid Plan — ALL PRODUCTS: $1,135.80
  • ANTHEM — HPN: $960.63
  • ANTHEM — Managed Medicaid: $358.81
  • ANTHEM — MEDICARE ADVANTAGE: $506.90
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POST-CATARACT LASER SURGERY $2,524 $1,640.60 $713.79 – $2,524
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans
  • Amish Community Aid Plan — ALL PRODUCTS: $1,262
  • ANTHEM — TRADITIONAL: $1,116.37
  • OSCAR — ALL PRODUCTS: $910.91
  • UNITED — ALL PRODUCTS: $1,118.13
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $3,234 $2,102.10 $1.10 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,978.24
Cataract removal with lens implant: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $2,425.50
  • Aetna — Asa: $2,587.20
  • Aetna — Medicare Advantage: $447.12
  • Aetna — Qhp/Ifp: $3,234
  • AmeriHealth — Managed Medicaid: $597.91
  • Anthem — All Products Mid-Level Facility: $705.93
  • Anthem — All Products Mid-Level Non-Facility: $705.93
  • Anthem — Medicare Advantage: $447.12
  • Aultcare — Medicare Advantage: $469.48
  • Aultcare — PPO/HMO: $1,400.32
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP Not listed in the file Not listed in the file $1,416.91 – $2,401.72
Cataract removal with lens implant: 10 of 18 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $2,183.38
  • ANTHEM — MEDICARE ADVANTAGE: $2,107.35
  • Aultcare — MEDICARE ADVANTAGE: $1,855.87
  • CIGNA — MEDICARE ADVANTAGE: $2,248.88
  • CommuniCare — MEDICARE ADVANTAGE: $2,292.55
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $2,183.38
  • HUMANA — Medicare Advantage HMO: $2,107.35
  • MMO — MEDICARE HMO: $2,107.35
  • MMO — Medicare PPO: $2,170.57
  • OPTUM — All Products VA: $2,107.35
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xcapsl ctrc rmvl w/o ecp Not listed in the file Not listed in the file $1,416.91 – $2,401.72
Cataract removal with lens implant: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,558.60
  • ANTHEM — Managed Medicaid: $1,487.76
  • Buckeye — Managed Medicaid: $1,416.91
  • CARESOURCE — Managed Medicaid: $1,516.09
  • MOLINA — Managed Medicaid: $1,487.76
  • UNITED — Managed Medicaid: $1,516.09

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM $14,800 $9,620 $3,760.68 – $14,800
Vaginal delivery, with care before and after: 10 of 47 insurance plan rates
  • Aetna — All Products First Health: $11,100
  • Aetna — Asa: $11,840
  • Aetna — Medicare Advantage: $2,173.57
  • Aetna — Qhp/Ifp: $14,800
  • AmeriHealth — Managed Medicaid: $2,868.80
  • Anthem — All Products Mid-Level Facility: $3,238.88
  • Anthem — All Products Mid-Level Non-Facility: $3,238.88
  • Anthem — Medicare Advantage: $2,173.57
  • Aultcare — Medicare Advantage: $2,282.25
  • Aultcare — PPO/HMO: $6,408.40
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care Not listed in the file Not listed in the file $2,468.04 – $2,714.84
Vaginal delivery, with care before and after: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $2,714.84
  • ANTHEM — Managed Medicaid: $2,591.44
  • Buckeye — Managed Medicaid: $2,468.04
  • CARESOURCE — Managed Medicaid: $2,640.80
  • MOLINA — Managed Medicaid: $2,591.44
  • UNITED — Managed Medicaid: $2,640.80
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM $16,420 $10,673 $4,172.32 – $16,420
Cesarean delivery (C-section), with care before and after: 10 of 42 insurance plan rates
  • Aetna — All Products First Health: $12,315
  • Aetna — Asa: $13,136
  • Aetna — Medicare Advantage: $2,430.76
  • Aetna — Qhp/Ifp: $16,420
  • Anthem — All Products Mid-Level Facility: $3,590.94
  • Anthem — All Products Mid-Level Non-Facility: $3,590.94
  • Anthem — Medicare Advantage: $2,430.76
  • Aultcare — Medicare Advantage: $2,552.30
  • Aultcare — PPO/HMO: $7,109.86
  • CC EHP — All Products: $2,861.49
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery Not listed in the file Not listed in the file $1,714.21 – $1,885.63
Cesarean delivery (C-section), with care before and after: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $1,885.63
  • ANTHEM — Managed Medicaid: $1,799.92
  • Buckeye — Managed Medicaid: $1,714.21
  • CARESOURCE — Managed Medicaid: $1,834.20
  • MOLINA — Managed Medicaid: $1,799.92
  • UNITED — Managed Medicaid: $1,834.20
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB $15,484 $10,064.60 $3,934.48 – $15,484
Vaginal delivery after a previous C-section, with care before and after: 10 of 42 insurance plan rates
  • Aetna — All Products First Health: $11,613
  • Aetna — Asa: $12,387.20
  • Aetna — Medicare Advantage: $2,291.27
  • Aetna — Qhp/Ifp: $15,484
  • Anthem — All Products Mid-Level Facility: $3,400.33
  • Anthem — All Products Mid-Level Non-Facility: $3,400.33
  • Anthem — Medicare Advantage: $2,291.27
  • Aultcare — Medicare Advantage: $2,405.83
  • Aultcare — PPO/HMO: $6,704.57
  • CC EHP — All Products: $2,699.04
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery Not listed in the file Not listed in the file $2,468.04 – $2,714.84
Vaginal delivery after a previous C-section, with care before and after: rates for 6 insurance plans
  • AMERIHEALTH — Managed Medicaid: $2,714.84
  • ANTHEM — Managed Medicaid: $2,591.44
  • Buckeye — Managed Medicaid: $2,468.04
  • CARESOURCE — Managed Medicaid: $2,640.80
  • MOLINA — Managed Medicaid: $2,591.44
  • UNITED — Managed Medicaid: $2,640.80

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $17,771 – $283,600
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 39 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $67,411.62
  • ANTHEM — HPN: $98,297.57
  • ANTHEM — MEDICARE ADVANTAGE: $67,411.62
  • ANTHEM — PPO/HMO: $115,642.48
  • Aultcare — MEDICARE ADVANTAGE: $57,299.88
  • CIGNA — MEDICARE ADVANTAGE: $69,433.97
  • CommuniCare — MEDICARE ADVANTAGE: $70,782.20
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $67,411.62
  • HUMANA — Medicare Advantage HMO: $67,411.62
  • Medical Benefit Corp — Transplant SMCP: $283,600
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 joint replacement or reattachment of lower extremity w/o MCC Not listed in the file Not listed in the file $11,991.69 – $60,600
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates
  • ANTHEM — HPN: $19,381.59
  • ANTHEM — PPO/HMO: $22,801.53
  • Medical Benefit Corp — Transplant SMCP: $60,600
  • MMO — ALL PRODUCTS: $19,648
  • AETNA — ALL PRODUCTS: 75% (a percentage in the contract, not a dollar amount)
  • AETNA — NAP: 68.8% (a percentage in the contract, not a dollar amount)
  • Amish Community Aid Plan — ALL PRODUCTS: 50% (a percentage in the contract, not a dollar amount)
  • ANTHEM — TRADITIONAL: 44.23% (a percentage in the contract, not a dollar amount)
  • CC EHP — ALL PRODUCTS: 74.6% (a percentage in the contract, not a dollar amount)
  • CIGNA — ALL PRODUCTS: 60.4% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $11,991.69 – $60,600
Hip or knee replacement (major joint of the leg), without major complications: 10 of 19 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $14,107.87
  • ANTHEM — MEDICARE ADVANTAGE: $14,107.87
  • Aultcare — MEDICARE ADVANTAGE: $11,991.69
  • CIGNA — MEDICARE ADVANTAGE: $14,531.11
  • CommuniCare — MEDICARE ADVANTAGE: $14,813.26
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $14,107.87
  • HUMANA — Medicare Advantage HMO: $14,107.87
  • MMO — MEDICARE HMO: $14,107.87
  • MMO — Medicare PPO: $14,531.11
  • OPTUM — All Products VA: $14,107.87
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $14,947.66 – $83,000
Neck (cervical) spinal fusion, without complications: 10 of 39 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $17,585.48
  • ANTHEM — HPN: $24,530.18
  • ANTHEM — MEDICARE ADVANTAGE: $17,585.48
  • ANTHEM — PPO/HMO: $28,858.61
  • Aultcare — MEDICARE ADVANTAGE: $14,947.66
  • CIGNA — MEDICARE ADVANTAGE: $18,113.04
  • CommuniCare — MEDICARE ADVANTAGE: $18,464.75
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $17,585.48
  • HUMANA — Medicare Advantage HMO: $17,585.48
  • Medical Benefit Corp — Transplant SMCP: $83,000
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 Not listed in the file $8,021.54 – $17,785.43
Uterus and ovary surgery (not for cancer), without complications: 10 of 38 insurance plan rates
  • AETNA — MEDICARE ADVANTAGE: $9,437.11
  • ANTHEM — HPN: $12,466.55
  • ANTHEM — MEDICARE ADVANTAGE: $9,437.11
  • ANTHEM — PPO/HMO: $14,666.31
  • Aultcare — MEDICARE ADVANTAGE: $8,021.54
  • CIGNA — MEDICARE ADVANTAGE: $9,720.22
  • CommuniCare — MEDICARE ADVANTAGE: $9,908.97
  • DEVOTED HEALTH — MEDICARE ADVANTAGE: $9,437.11
  • HUMANA — Medicare Advantage HMO: $9,437.11
  • MMO — ALL PRODUCTS: $17,785.43

Source: Union Hospital’s standard charges file (clevelandclinic.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on June 15, 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 typeAcute Care Hospital
Address659 Boulevard, Dover, OH 44622
CountyTuscarawas County
StateOhio
Phone(330) 343‑3311
Emergency servicesYes
OwnershipVoluntary non-profit - Other
Medicare overall rating3 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number360010
Name in Medicare recordsUNION HOSPITAL
Profile levelMedicare data + hospital website
Official websitemy.clevelandclinic.org
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Union Hospital specialties — my.clevelandclinic.org
  2. Union Hospital visitor guide — my.clevelandclinic.org
  3. Quality & Accreditation | Union Hospital — my.clevelandclinic.org
  4. Directions & Parking | Union Hospital — my.clevelandclinic.org
  5. Educational Services | Union Hospital — my.clevelandclinic.org
  6. Emergency Department | Union Hospital — my.clevelandclinic.org
  7. Radiology & Diagnostic Imaging | Union Hospital — my.clevelandclinic.org
  8. Stroke Center | Union Hospital — my.clevelandclinic.org
  9. WorkWell Occupational Services | Union Hospital — my.clevelandclinic.org
  10. Cardiology Center | Union Hospital — my.clevelandclinic.org
  11. Inpatient Rehabilitation | Cleveland Clinic Union Hospital — my.clevelandclinic.org
  12. Maternity Center | Cleveland Clinic Union Hospital — my.clevelandclinic.org
  13. Surgery & Endoscopy Center | Union Hospital — my.clevelandclinic.org