Does Uniontown Hospital have an emergency room?

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

Where is Uniontown Hospital?

500 West Berkeley Street, Uniontown, PA 15401, in Fayette County, Pennsylvania.

What is the phone number of Uniontown Hospital?

(724) 430-5000, as listed by Medicare (CMS).

What is the Medicare star rating of Uniontown Hospital?

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

Uniontown Hospital — Uniontown, PA

Quick answers

Does Uniontown Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Uniontown Hospital. In a medical emergency, call 911.
Where is Uniontown Hospital?: 500 West Berkeley Street, Uniontown, PA 15401, in Fayette County, Pennsylvania.
What is the phone number of Uniontown Hospital?: (724) 430-5000, as listed by Medicare (CMS).
What is the Medicare star rating of Uniontown Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][11]

Spine Care & Pain Management
Orthopedics & Bone Health
Neurology & Stroke Care
Primary Care
Urology
Cardiac & Vascular Care
Neurosurgery
Pregnancy care
Women's health
Pediatric care

Conditions treated^[4][9][11]

Treatments^[4][11]

Screening mammograms
Diabetic eye screening

Procedures^[9][11]

Cardiac catheterization
Knee and hip replacement
Robotic-assisted surgery
Point-of-care EEG

Programs and centers^{[4][7][9][11]}

Birthing Center
Family-centered care
Cancer and infusion center
Monthly general cancer support group
STEMI receiving institution

Emergency care (hospital website)^[4][9]

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

Visiting and practical information

Visiting	Visitors 6 am–8 pm use front/outpatient entrances; ED entrance after hours; one overnight support person with charge nurse approval^[8]
Parking	Free parking at the hospital, annex, and ancillary offices^[6]
Interpreters and languages	Free language services for non-English speakers, including qualified interpreting^[5]
Patient portal	MyWVUChart

Recognition^[9]

Certified Primary Stroke Center (Joint Commission and American Stroke Association)

Doctors and clinicians (647)

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

Main specialties

And 623 more: the button below opens the full list.

Other emergency rooms nearby

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

Penn Highlands Connellsville12 mi · Connellsville, PA · Acute Care Hospital
Mon Health Medical Center20 mi · Morgantown, WV · Acute Care Hospital
Excela Health - Frick Hospital20 mi · Mount Pleasant, PA · Acute Care Hospital
West Virginia University Hospitals, Inc21 mi · Morgantown, WV · Acute Care Hospital
Penn Highlands Mon Valley21 mi · Monongahela, PA · Acute Care Hospital

Other hospitals nearby

Select Specialty Hospital - Morgantown20 mi · Morgantown, WV · Long-Term Acute Care Hospital
Encompass Health Rehab Hospital of Morgantown20 mi · Morgantown, WV · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Terrace Health & Rehab Center0.5 mi · Uniontown, PA · 4 of 5 stars
Mt Macrina Manor0.6 mi · Uniontown, PA · 3 of 5 stars
Lafayette Manor, Inc0.8 mi · Uniontown, PA · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Amedisys Hospice of PA0.0 mi · Uniontown, PA · 4 of 5 stars
Wvuhs Home Care, LLC0.0 mi · Uniontown, PA
Ospta Hospice18 mi · Belle Vernon, PA · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Abby Health Care Inc0.0 mi · Uniontown, PA
Amedisys Home Health of PA0.0 mi · Uniontown, PA
Wvuhs Home Care, LLC0.0 mi · Uniontown, PA · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Fayette County Dialysis0.0 mi · Uniontown, PA · 4 of 5 stars
FKC Uniontown0.0 mi · Uniontown, PA · 3 of 5 stars
FKC Redstone Centerville12 mi · Brownsville, PA · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Southwestern Endoscopy Center, LLC0.0 mi · Uniontown, PA
Mon Health Center for Outpatient Surgery20 mi · Morgantown, WV
Surgical Eye Center of Morgantown20 mi · Morgantown, WV

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

Uniontown Family Doctors0.6 mi · Uniontown, PA · Community health center
Cornerstone Care Community Dental Center of Uniontown1.3 mi · Uniontown, PA · Community health center
Cornerstone Care Vision Center of Uniontown1.3 mi · Uniontown, PA · Community health center

Clinics and urgent care

Medexpress Urgent Care, PC - Pennsylvania0.0 mi · Uniontown, PA · Urgent care center
Medexpress Urgent Care, PC - Pennsylvania0.0 mi · Uniontown, PA · Urgent care center
Medexpress Urgent Care, PC - Pennsylvania14 mi · Connellsville, PA · Urgent care center

Pharmacies

Altruix Uniontown, LLC0.0 mi · Uniontown, PA · Community/retail pharmacy
Daneron LLC0.0 mi · Uniontown, PA · Community/retail pharmacy
Giant Eagle, Inc.0.0 mi · Uniontown, PA · Community/retail pharmacy

Assisted living nearby

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

Beechwood Court at Lafayette Manor0.0 mi · Uniontown, PA
Graysful Living LLC0.0 mi · Uniontown, PA
Hillside Manor Personal Care Home0.0 mi · Uniontown, PA
McVey Personal Care Home0.0 mi · Uniontown, PA

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	62%National average: 72%
Would definitely recommend the hospital	56%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	79%National average: 80%
Staff “always” explained medicines before giving them	58%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	63%National average: 74%
Area around the room “always” quiet at night	51%National average: 60%
Completed surveys	822Response 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)	0.376No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.965No different from the national benchmark
Surgical site infections after colon surgery	0No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.645No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.654No 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 patients	13.1%
Deaths within 30 days: heart failure patients	11.3%
Deaths within 30 days: pneumonia patients	14.7%
Deaths within 30 days: COPD patients	9.5%
Deaths within 30 days: stroke patients	10.4%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.93No different from the national rate
Complications after hip or knee replacement	Too 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 attack	15.3%
Readmitted within 30 days: heart failure	21.3%
Readmitted within 30 days: pneumonia	16%
Readmitted within 30 days: COPD	19.8%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too 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)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	186 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)	61%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 Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 70 common services exactly as Uniontown 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 →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN	$374	$187	$59.68 – $171.55
New patient office visit (about 30–44 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $163.43 Aetna — Better Health Mgd Medicaid: $62.94 Aetna Better Health PA — CHIP: $59.68 Aetna Better Health WV — CHIP: $62.94 Aetna Medicare Advantage — All Plans: $73.65 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $67.81 AmeriHealth Caritas PA Medicare Advantage — All Pl: $73.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $145.68 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $145.68 Coventry Health Care — Worker's Compensation: $110.82
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$374	$187	$59.68 – $171.55
New patient office visit (about 30–44 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $163.43 Aetna — Better Health Mgd Medicaid: $62.94 Aetna Better Health PA — CHIP: $59.68 Aetna Better Health WV — CHIP: $62.94 Aetna Medicare Advantage — All Plans: $73.65 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $67.81 AmeriHealth Caritas PA Medicare Advantage — All Pl: $73.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $145.68 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $145.68 Coventry Health Care — Worker's Compensation: $110.82
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$374	$187	$70.14 – $171.55
New patient office visit (about 30–44 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $163.43 Aetna Medicare Advantage — All Plans: $73.65 AmeriHealth Caritas PA Medicare Advantage — All Pl: $73.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $145.68 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $145.68 Coventry Health Care — Worker's Compensation: $110.82 Geisinger PA Medicare Advantage — All Plans: $74.35 Highmark PA — CHIP: $94.70 Humana Medicare Advantage — All Plans: $73.65 PA Health & Wellness Medicare Advantage — All Plan: $74.35
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN	$374	$187	$99.41 – $267.16
New patient office visit (about 45–59 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $267.16 Aetna — Better Health Mgd Medicaid: $102.54 Aetna Better Health PA — CHIP: $99.41 Aetna Better Health WV — CHIP: $102.54 Aetna Medicare Advantage — All Plans: $120.39 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $112.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $120.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $238.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $238.15 Coventry Health Care — Worker's Compensation: $181.16
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$374	$187	$114.66 – $267.16
New patient office visit (about 45–59 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $267.16 Aetna Medicare Advantage — All Plans: $120.39 AmeriHealth Caritas PA Medicare Advantage — All Pl: $120.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $238.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $238.15 Coventry Health Care — Worker's Compensation: $181.16 Geisinger PA Medicare Advantage — All Plans: $121.54 Highmark PA — CHIP: $154.81 Humana Medicare Advantage — All Plans: $120.39 PA Health & Wellness Medicare Advantage — All Plan: $121.54
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_U9 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$374	$187	$114.66 – $267.16
New patient office visit (about 45–59 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $267.16 Aetna Medicare Advantage — All Plans: $120.39 AmeriHealth Caritas PA Medicare Advantage — All Pl: $120.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $238.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $238.15 Coventry Health Care — Worker's Compensation: $181.16 Geisinger PA Medicare Advantage — All Plans: $121.54 Highmark PA — CHIP: $154.81 Humana Medicare Advantage — All Plans: $120.39 PA Health & Wellness Medicare Advantage — All Plan: $121.54
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN	$374	$187	$129.29 – $366.02
New patient office visit (about 60–74 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $366.02 Aetna — Better Health Mgd Medicaid: $139.52 Aetna Better Health PA — CHIP: $129.29 Aetna Better Health WV — CHIP: $139.52 Aetna Medicare Advantage — All Plans: $164.94 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $146.93 AmeriHealth Caritas PA Medicare Advantage — All Pl: $164.94 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $326.28 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $326.28 Coventry Health Care — Worker's Compensation: $248.20
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_U9 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$374	$187	$157.09 – $366.02
New patient office visit (about 60–74 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $366.02 Aetna Medicare Advantage — All Plans: $164.94 AmeriHealth Caritas PA Medicare Advantage — All Pl: $164.94 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $326.28 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $326.28 Coventry Health Care — Worker's Compensation: $248.20 Geisinger PA Medicare Advantage — All Plans: $166.52 Highmark PA — CHIP: $212.10 Humana Medicare Advantage — All Plans: $164.94 PA Health & Wellness Medicare Advantage — All Plan: $166.52
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U9 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$374	$187	$157.09 – $366.02
New patient office visit (about 60–74 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $366.02 Aetna Medicare Advantage — All Plans: $164.94 AmeriHealth Caritas PA Medicare Advantage — All Pl: $164.94 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $326.28 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $326.28 Coventry Health Care — Worker's Compensation: $248.20 Geisinger PA Medicare Advantage — All Plans: $166.52 Highmark PA — CHIP: $212.10 Humana Medicare Advantage — All Plans: $164.94 PA Health & Wellness Medicare Advantage — All Plan: $166.52
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20 MIN	$374	$187	$44 – $171.55
Established patient office visit (about 20–29 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $131.37 Aetna — Better Health Mgd Medicaid: $50.35 Aetna Better Health PA — CHIP: $44 Aetna Better Health WV — CHIP: $50.35 Aetna Medicare Advantage — All Plans: $59.20 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $59.20 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $117.10 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $117.10 Coventry Health Care — Worker's Compensation: $89.08
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$575	$287.50	$44 – $171.55
Established patient office visit (about 20–29 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $131.37 Aetna — Better Health Mgd Medicaid: $50.35 Aetna Better Health PA — CHIP: $44 Aetna Better Health WV — CHIP: $50.35 Aetna Medicare Advantage — All Plans: $59.20 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $59.20 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $117.10 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $117.10 Coventry Health Care — Worker's Compensation: $89.08
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27_U9 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$374	$187	$56.38 – $171.55
Established patient office visit (about 20–29 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $131.37 Aetna Medicare Advantage — All Plans: $59.20 AmeriHealth Caritas PA Medicare Advantage — All Pl: $59.20 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $117.10 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $117.10 Coventry Health Care — Worker's Compensation: $89.08 Geisinger PA Medicare Advantage — All Plans: $59.76 Highmark PA — CHIP: $76.12 Humana Medicare Advantage — All Plans: $59.20 PA Health & Wellness Medicare Advantage — All Plan: $59.76
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30 MIN	$374	$187	$59.86 – $193.30
Established patient office visit (about 30–39 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $193.30 Aetna — Better Health Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $59.86 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $87.11 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $68.03 AmeriHealth Caritas PA Medicare Advantage — All Pl: $87.11 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $172.31 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $172.31 Coventry Health Care — Worker's Compensation: $131.08
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$376	$188	$59.86 – $193.30
Established patient office visit (about 30–39 minutes): 10 of 49 insurance plan rates Aetna — Aetna: $193.30 Aetna — Better Health Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $59.86 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $87.11 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $68.03 AmeriHealth Caritas PA Medicare Advantage — All Pl: $87.11 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $172.31 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $172.31 Coventry Health Care — Worker's Compensation: $131.08
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$434	$217	$82.96 – $193.30
Established patient office visit (about 30–39 minutes): 10 of 35 insurance plan rates Aetna — Aetna: $193.30 Aetna Medicare Advantage — All Plans: $87.11 AmeriHealth Caritas PA Medicare Advantage — All Pl: $87.11 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $172.31 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $172.31 Coventry Health Care — Worker's Compensation: $131.08 Geisinger PA Medicare Advantage — All Plans: $87.94 Highmark PA — CHIP: $112.01 Humana Medicare Advantage — All Plans: $87.11 PA Health & Wellness Medicare Advantage — All Plan: $87.94
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$768	$384	$62.32 – $2,443
Emergency room visit (moderate): 10 of 51 insurance plan rates Aetna — Aetna: $616.49 Aetna — Better Health Mgd Medicaid: $104.59 Aetna Better Health PA — CHIP: $62.32 Aetna Better Health WV — CHIP: $104.59 Aetna Medicare Advantage — All Plans: $277.82 Alliance Coal — Alliance Coal: $463.03 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $98.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $277.82 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $549.55 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $549.55
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$686	$343	$62.32 – $2,443
Emergency room visit (moderate): 10 of 51 insurance plan rates Aetna — Aetna: $616.49 Aetna — Better Health Mgd Medicaid: $104.59 Aetna Better Health PA — CHIP: $62.32 Aetna Better Health WV — CHIP: $104.59 Aetna Medicare Advantage — All Plans: $277.82 Alliance Coal — Alliance Coal: $463.03 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $98.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $277.82 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $549.55 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $549.55
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$686	$343	$98.75 – $2,443
Emergency room visit (moderate): 10 of 38 insurance plan rates Aetna — Aetna: $616.49 Aetna Medicare Advantage — All Plans: $277.82 Alliance Coal — Alliance Coal: $463.03 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $98.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $277.82 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $549.55 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $549.55 Coventry Health Care — Worker's Compensation: $418.05 Geisinger PA Medicare Advantage — All Plans: $280.47 Highmark PA — CHIP: $357.25
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$1,244	$622	$104.86 – $3,705
Emergency room visit (moderately high): 10 of 51 insurance plan rates Aetna — Aetna: $942.35 Aetna — Better Health Mgd Medicaid: $205.23 Aetna Better Health PA — CHIP: $104.86 Aetna Better Health WV — CHIP: $205.23 Aetna Medicare Advantage — All Plans: $424.66 Alliance Coal — Alliance Coal: $707.77 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $153.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $424.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $840.02 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $840.02
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$1,111	$555.50	$104.86 – $3,705
Emergency room visit (moderately high): 10 of 51 insurance plan rates Aetna — Aetna: $942.35 Aetna — Better Health Mgd Medicaid: $205.23 Aetna Better Health PA — CHIP: $104.86 Aetna Better Health WV — CHIP: $205.23 Aetna Medicare Advantage — All Plans: $424.66 Alliance Coal — Alliance Coal: $707.77 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $153.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $424.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $840.02 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $840.02
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$1,111	$555.50	$153.75 – $3,705
Emergency room visit (moderately high): 10 of 38 insurance plan rates Aetna — Aetna: $942.35 Aetna Medicare Advantage — All Plans: $424.66 Alliance Coal — Alliance Coal: $707.77 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $153.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $424.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $840.02 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $840.02 Coventry Health Care — Worker's Compensation: $639.02 Geisinger PA Medicare Advantage — All Plans: $428.71 Highmark PA — CHIP: $546.07
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	$3,465	$1,732.50	$152.61 – $3,845
Emergency room visit (high): 10 of 51 insurance plan rates Aetna — Aetna: $1,344.92 Aetna — Better Health Mgd Medicaid: $620.92 Aetna Better Health PA — CHIP: $152.61 Aetna Better Health WV — CHIP: $620.92 Aetna Medicare Advantage — All Plans: $606.08 Alliance Coal — Alliance Coal: $1,010.14 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $241.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $606.08 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,198.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,198.89
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$3,094	$1,547	$152.61 – $3,845
Emergency room visit (high): 10 of 51 insurance plan rates Aetna — Aetna: $1,344.92 Aetna — Better Health Mgd Medicaid: $620.92 Aetna Better Health PA — CHIP: $152.61 Aetna Better Health WV — CHIP: $620.92 Aetna Medicare Advantage — All Plans: $606.08 Alliance Coal — Alliance Coal: $1,010.14 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $241.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $606.08 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,198.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,198.89
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$3,094	$1,547	$241.25 – $3,845
Emergency room visit (high): 10 of 38 insurance plan rates Aetna — Aetna: $1,344.92 Aetna Medicare Advantage — All Plans: $606.08 Alliance Coal — Alliance Coal: $1,010.14 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $241.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $606.08 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,198.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,198.89 Coventry Health Care — Worker's Compensation: $912.01 Geisinger PA Medicare Advantage — All Plans: $611.85 Highmark PA — CHIP: $779.36

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$78	$39	$7.99 – $171.55
Basic metabolic panel (blood test): 10 of 50 insurance plan rates Aetna — Aetna: $19.71 Aetna — Better Health Mgd Medicaid: $8.14 Aetna Better Health PA — CHIP: $10.30 Aetna Better Health WV — CHIP: $8.14 Aetna Medicare Advantage — All Plans: $8.88 Alliance Coal — Alliance Coal: $10.58 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $11.70 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.88 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $17.57 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $17.57
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$78	$39	$8.46 – $171.55
Basic metabolic panel (blood test): 10 of 36 insurance plan rates Aetna — Aetna: $19.71 Aetna Medicare Advantage — All Plans: $8.88 Alliance Coal — Alliance Coal: $10.58 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.88 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $17.57 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $17.57 Coventry Health Care — Worker's Compensation: $13.37 Geisinger PA Medicare Advantage — All Plans: $8.97 Highmark PA — CHIP: $11.42 Humana Medicare Advantage — All Plans: $8.88
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$78	$39	$8.46 – $171.55
Basic metabolic panel (blood test): 10 of 36 insurance plan rates Aetna — Aetna: $19.71 Aetna Medicare Advantage — All Plans: $8.88 Alliance Coal — Alliance Coal: $10.58 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.88 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $17.57 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $17.57 Coventry Health Care — Worker's Compensation: $13.37 Geisinger PA Medicare Advantage — All Plans: $8.97 Highmark PA — CHIP: $11.42 Humana Medicare Advantage — All Plans: $8.88
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$98	$49	$9.98 – $171.55
Comprehensive metabolic panel (blood test): 10 of 50 insurance plan rates Aetna — Aetna: $24.60 Aetna — Better Health Mgd Medicaid: $10.17 Aetna Better Health PA — CHIP: $12.86 Aetna Better Health WV — CHIP: $10.17 Aetna Medicare Advantage — All Plans: $11.09 Alliance Coal — Alliance Coal: $13.20 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $14.61 AmeriHealth Caritas PA Medicare Advantage — All Pl: $11.09 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $21.93 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $21.93
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$98	$49	$10.56 – $171.55
Comprehensive metabolic panel (blood test): 10 of 36 insurance plan rates Aetna — Aetna: $24.60 Aetna Medicare Advantage — All Plans: $11.09 Alliance Coal — Alliance Coal: $13.20 AmeriHealth Caritas PA Medicare Advantage — All Pl: $11.09 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $21.93 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $21.93 Coventry Health Care — Worker's Compensation: $16.68 Geisinger PA Medicare Advantage — All Plans: $11.19 Highmark PA — CHIP: $14.26 Humana Medicare Advantage — All Plans: $11.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$98	$49	$10.56 – $171.55
Comprehensive metabolic panel (blood test): 10 of 36 insurance plan rates Aetna — Aetna: $24.60 Aetna Medicare Advantage — All Plans: $11.09 Alliance Coal — Alliance Coal: $13.20 AmeriHealth Caritas PA Medicare Advantage — All Pl: $11.09 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $21.93 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $21.93 Coventry Health Care — Worker's Compensation: $16.68 Geisinger PA Medicare Advantage — All Plans: $11.19 Highmark PA — CHIP: $14.26 Humana Medicare Advantage — All Plans: $11.09
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$125	$62.50	$12.65 – $171.55
Cholesterol panel (lipid panel): 10 of 50 insurance plan rates Aetna — Aetna: $31.20 Aetna — Better Health Mgd Medicaid: $12.89 Aetna Better Health PA — CHIP: $15.40 Aetna Better Health WV — CHIP: $12.89 Aetna Medicare Advantage — All Plans: $14.06 Alliance Coal — Alliance Coal: $16.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $17.50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $14.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $27.81 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $27.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$41	$20.50	$12.65 – $171.55
Cholesterol panel (lipid panel): 10 of 50 insurance plan rates Aetna — Aetna: $31.20 Aetna — Better Health Mgd Medicaid: $12.89 Aetna Better Health PA — CHIP: $15.40 Aetna Better Health WV — CHIP: $12.89 Aetna Medicare Advantage — All Plans: $14.06 Alliance Coal — Alliance Coal: $16.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $17.50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $14.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $27.81 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $27.81
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$40	$20	$13.39 – $171.55
Cholesterol panel (lipid panel): 10 of 36 insurance plan rates Aetna — Aetna: $31.20 Aetna Medicare Advantage — All Plans: $14.06 Alliance Coal — Alliance Coal: $16.74 AmeriHealth Caritas PA Medicare Advantage — All Pl: $14.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $27.81 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $27.81 Coventry Health Care — Worker's Compensation: $21.16 Geisinger PA Medicare Advantage — All Plans: $14.19 Highmark PA — CHIP: $18.08 Humana Medicare Advantage — All Plans: $14.06
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$80	$40	$8.20 – $171.55
Kidney function panel: 10 of 50 insurance plan rates Aetna — Aetna: $20.22 Aetna — Better Health Mgd Medicaid: $8.36 Aetna Better Health PA — CHIP: $10.56 Aetna Better Health WV — CHIP: $8.36 Aetna Medicare Advantage — All Plans: $9.11 Alliance Coal — Alliance Coal: $10.85 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $12 AmeriHealth Caritas PA Medicare Advantage — All Pl: $9.11 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.03
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$76	$38	$7.72 – $171.55
Liver function panel: 10 of 50 insurance plan rates Aetna — Aetna: $19.04 Aetna — Better Health Mgd Medicaid: $7.86 Aetna Better Health PA — CHIP: $9.93 Aetna Better Health WV — CHIP: $7.86 Aetna Medicare Advantage — All Plans: $8.58 Alliance Coal — Alliance Coal: $10.21 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $11.29 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.58 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $16.97 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $16.97
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: LIVER FUNCTION BLOOD TEST PANEL	$76	$38	$8.17 – $171.55
Liver function panel: 10 of 36 insurance plan rates Aetna — Aetna: $19.04 Aetna Medicare Advantage — All Plans: $8.58 Alliance Coal — Alliance Coal: $10.21 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.58 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $16.97 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $16.97 Coventry Health Care — Worker's Compensation: $12.91 Geisinger PA Medicare Advantage — All Plans: $8.66 Highmark PA — CHIP: $11.03 Humana Medicare Advantage — All Plans: $8.58
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	$27	$13.50	$2.99 – $171.55
Urine test (automated, with microscope): 10 of 50 insurance plan rates Aetna — Aetna: $7.39 Aetna — Better Health Mgd Medicaid: $3.05 Aetna Better Health PA — CHIP: $3.30 Aetna Better Health WV — CHIP: $3.05 Aetna Medicare Advantage — All Plans: $3.33 Alliance Coal — Alliance Coal: $3.96 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $3.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3.33 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6.58
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$24	$12	$2.99 – $171.55
Urine test (automated, with microscope): 10 of 50 insurance plan rates Aetna — Aetna: $7.39 Aetna — Better Health Mgd Medicaid: $3.05 Aetna Better Health PA — CHIP: $3.30 Aetna Better Health WV — CHIP: $3.05 Aetna Medicare Advantage — All Plans: $3.33 Alliance Coal — Alliance Coal: $3.96 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $3.75 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3.33 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6.58
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$24	$12	$3.17 – $171.55
Urine test (automated, with microscope): 10 of 36 insurance plan rates Aetna — Aetna: $7.39 Aetna Medicare Advantage — All Plans: $3.33 Alliance Coal — Alliance Coal: $3.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3.33 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6.58 Coventry Health Care — Worker's Compensation: $5.01 Geisinger PA Medicare Advantage — All Plans: $3.36 Highmark PA — CHIP: $4.28 Humana Medicare Advantage — All Plans: $3.33
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS; MANUAL TEST	$28	$14	$3.29 – $171.55
Urine test (manual, without microscope): 10 of 50 insurance plan rates Aetna — Aetna: $8.11 Aetna — Better Health Mgd Medicaid: $3.35 Aetna Better Health PA — CHIP: $3.93 Aetna Better Health WV — CHIP: $3.35 Aetna Medicare Advantage — All Plans: $3.65 Alliance Coal — Alliance Coal: $4.35 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $4.46 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7.23
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$43	$21.50	$3.29 – $171.55
Urine test (manual, without microscope): 10 of 50 insurance plan rates Aetna — Aetna: $8.11 Aetna — Better Health Mgd Medicaid: $3.35 Aetna Better Health PA — CHIP: $3.93 Aetna Better Health WV — CHIP: $3.35 Aetna Medicare Advantage — All Plans: $3.65 Alliance Coal — Alliance Coal: $4.35 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $4.46 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7.23
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: URINALYSIS; MANUAL TEST	$28	$14	$3.48 – $171.55
Urine test (manual, without microscope): 10 of 36 insurance plan rates Aetna — Aetna: $8.11 Aetna Medicare Advantage — All Plans: $3.65 Alliance Coal — Alliance Coal: $4.35 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7.23 Coventry Health Care — Worker's Compensation: $5.50 Geisinger PA Medicare Advantage — All Plans: $3.69 Highmark PA — CHIP: $4.70 Humana Medicare Advantage — All Plans: $3.65
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$26	$13	$2.13 – $171.55
Urine test (automated, without microscope): 10 of 50 insurance plan rates Aetna — Aetna: $5.24 Aetna — Better Health Mgd Medicaid: $2.17 Aetna Better Health PA — CHIP: $3.41 Aetna Better Health WV — CHIP: $2.17 Aetna Medicare Advantage — All Plans: $2.36 Alliance Coal — Alliance Coal: $2.81 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $3.88 AmeriHealth Caritas PA Medicare Advantage — All Pl: $2.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4.67 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4.67
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$23	$11.50	$2.13 – $171.55
Urine test (automated, without microscope): 10 of 50 insurance plan rates Aetna — Aetna: $5.24 Aetna — Better Health Mgd Medicaid: $2.17 Aetna Better Health PA — CHIP: $3.41 Aetna Better Health WV — CHIP: $2.17 Aetna Medicare Advantage — All Plans: $2.36 Alliance Coal — Alliance Coal: $2.81 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $3.88 AmeriHealth Caritas PA Medicare Advantage — All Pl: $2.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4.67 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4.67
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: AUTOMATED URINALYSIS TEST	$23	$11.50	$2.25 – $171.55
Urine test (automated, without microscope): 10 of 36 insurance plan rates Aetna — Aetna: $5.24 Aetna Medicare Advantage — All Plans: $2.36 Alliance Coal — Alliance Coal: $2.81 AmeriHealth Caritas PA Medicare Advantage — All Pl: $2.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4.67 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4.67 Coventry Health Care — Worker's Compensation: $3.56 Geisinger PA Medicare Advantage — All Plans: $2.38 Highmark PA — CHIP: $3.04 Humana Medicare Advantage — All Plans: $2.36
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$61	$30.50	$17.38 – $171.55
PSA (prostate specific antigen) blood test: 10 of 50 insurance plan rates Aetna — Aetna: $42.85 Aetna — Better Health Mgd Medicaid: $17.71 Aetna Better Health PA — CHIP: $26.80 Aetna Better Health WV — CHIP: $17.71 Aetna Medicare Advantage — All Plans: $19.31 Alliance Coal — Alliance Coal: $22.99 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $30.45 AmeriHealth Caritas PA Medicare Advantage — All Pl: $19.31 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $38.20 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $38.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$51	$25.50	$17.38 – $171.55
PSA (prostate specific antigen) blood test: 10 of 50 insurance plan rates Aetna — Aetna: $42.85 Aetna — Better Health Mgd Medicaid: $17.71 Aetna Better Health PA — CHIP: $26.80 Aetna Better Health WV — CHIP: $17.71 Aetna Medicare Advantage — All Plans: $19.31 Alliance Coal — Alliance Coal: $22.99 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $30.45 AmeriHealth Caritas PA Medicare Advantage — All Pl: $19.31 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $38.20 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $38.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$215	$107.50	$18.39 – $171.55
PSA (prostate specific antigen) blood test: 10 of 36 insurance plan rates Aetna — Aetna: $42.85 Aetna Medicare Advantage — All Plans: $19.31 Alliance Coal — Alliance Coal: $22.99 AmeriHealth Caritas PA Medicare Advantage — All Pl: $19.31 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $38.20 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $38.20 Coventry Health Care — Worker's Compensation: $29.06 Geisinger PA Medicare Advantage — All Plans: $19.49 Highmark PA — CHIP: $24.83 Humana Medicare Advantage — All Plans: $19.31
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$324	$162	$15.88 – $171.55
Thyroid stimulating hormone (TSH) test: 10 of 50 insurance plan rates Aetna — Aetna: $39.14 Aetna — Better Health Mgd Medicaid: $16.18 Aetna Better Health PA — CHIP: $25.53 Aetna Better Health WV — CHIP: $16.18 Aetna Medicare Advantage — All Plans: $17.64 Alliance Coal — Alliance Coal: $21 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $29.01 AmeriHealth Caritas PA Medicare Advantage — All Pl: $17.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $34.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $34.89
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$289	$144.50	$15.88 – $171.55
Thyroid stimulating hormone (TSH) test: 10 of 49 insurance plan rates Aetna — Aetna: $39.14 Aetna — Better Health Mgd Medicaid: $16.18 Aetna Better Health PA — CHIP: $25.53 Aetna Better Health WV — CHIP: $16.18 Aetna Medicare Advantage — All Plans: $17.64 Alliance Coal — Alliance Coal: $21 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $29.01 AmeriHealth Caritas PA Medicare Advantage — All Pl: $17.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $34.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $34.89
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier Q1 In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$289	$144.50	$16.80 – $171.55
Thyroid stimulating hormone (TSH) test: 10 of 36 insurance plan rates Aetna — Aetna: $39.14 Aetna Medicare Advantage — All Plans: $17.64 Alliance Coal — Alliance Coal: $21 AmeriHealth Caritas PA Medicare Advantage — All Pl: $17.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $34.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $34.89 Coventry Health Care — Worker's Compensation: $26.54 Geisinger PA Medicare Advantage — All Plans: $17.81 Highmark PA — CHIP: $22.68 Humana Medicare Advantage — All Plans: $17.64
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$58	$29	$6.60 – $171.55
Complete blood count (CBC) with differential: 10 of 50 insurance plan rates Aetna — Aetna: $18.10 Aetna — Better Health Mgd Medicaid: $7.48 Aetna Better Health PA — CHIP: $6.60 Aetna Better Health WV — CHIP: $7.48 Aetna Medicare Advantage — All Plans: $8.16 Alliance Coal — Alliance Coal: $9.71 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $7.50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.16 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $16.14 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $16.14
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$52	$26	$6.60 – $171.55
Complete blood count (CBC) with differential: 10 of 50 insurance plan rates Aetna — Aetna: $18.10 Aetna — Better Health Mgd Medicaid: $7.48 Aetna Better Health PA — CHIP: $6.60 Aetna Better Health WV — CHIP: $7.48 Aetna Medicare Advantage — All Plans: $8.16 Alliance Coal — Alliance Coal: $9.71 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $7.50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.16 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $16.14 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $16.14
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$52	$26	$7.77 – $171.55
Complete blood count (CBC) with differential: 10 of 36 insurance plan rates Aetna — Aetna: $18.10 Aetna Medicare Advantage — All Plans: $8.16 Alliance Coal — Alliance Coal: $9.71 AmeriHealth Caritas PA Medicare Advantage — All Pl: $8.16 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $16.14 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $16.14 Coventry Health Care — Worker's Compensation: $12.28 Geisinger PA Medicare Advantage — All Plans: $8.24 Highmark PA — CHIP: $10.49 Humana Medicare Advantage — All Plans: $8.16
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$58	$29	$6.11 – $171.55
Complete blood count (CBC), automated: 10 of 50 insurance plan rates Aetna — Aetna: $15.08 Aetna — Better Health Mgd Medicaid: $6.23 Aetna Better Health PA — CHIP: $8.27 Aetna Better Health WV — CHIP: $6.23 Aetna Medicare Advantage — All Plans: $6.79 Alliance Coal — Alliance Coal: $8.09 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $9.40 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6.79 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.44 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.44
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$52	$26	$6.11 – $171.55
Complete blood count (CBC), automated: 10 of 50 insurance plan rates Aetna — Aetna: $15.08 Aetna — Better Health Mgd Medicaid: $6.23 Aetna Better Health PA — CHIP: $8.27 Aetna Better Health WV — CHIP: $6.23 Aetna Medicare Advantage — All Plans: $6.79 Alliance Coal — Alliance Coal: $8.09 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $9.40 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6.79 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.44 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.44
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$52	$26	$6.47 – $171.55
Complete blood count (CBC), automated: 10 of 36 insurance plan rates Aetna — Aetna: $15.08 Aetna Medicare Advantage — All Plans: $6.79 Alliance Coal — Alliance Coal: $8.09 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6.79 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.44 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.44 Coventry Health Care — Worker's Compensation: $10.22 Geisinger PA Medicare Advantage — All Plans: $6.86 Highmark PA — CHIP: $8.74 Humana Medicare Advantage — All Plans: $6.79
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$29	$14.50	$4.05 – $171.55
Blood clotting time test (prothrombin time, PT): 10 of 50 insurance plan rates Aetna — Aetna: $10 Aetna — Better Health Mgd Medicaid: $4.13 Aetna Better Health PA — CHIP: $4.40 Aetna Better Health WV — CHIP: $4.13 Aetna Medicare Advantage — All Plans: $4.50 Alliance Coal — Alliance Coal: $5.36 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $5 AmeriHealth Caritas PA Medicare Advantage — All Pl: $4.50 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $8.91 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $8.91
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$108.38	$54.19	$4.05 – $171.55
Blood clotting time test (prothrombin time, PT): 10 of 50 insurance plan rates Aetna — Aetna: $10 Aetna — Better Health Mgd Medicaid: $4.13 Aetna Better Health PA — CHIP: $4.40 Aetna Better Health WV — CHIP: $4.13 Aetna Medicare Advantage — All Plans: $4.50 Alliance Coal — Alliance Coal: $5.36 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $5 AmeriHealth Caritas PA Medicare Advantage — All Pl: $4.50 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $8.91 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $8.91
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: BLOOD TEST; CLOTTING TIME	$26	$13	$4.29 – $171.55
Blood clotting time test (prothrombin time, PT): 10 of 36 insurance plan rates Aetna — Aetna: $10 Aetna Medicare Advantage — All Plans: $4.50 Alliance Coal — Alliance Coal: $5.36 AmeriHealth Caritas PA Medicare Advantage — All Pl: $4.50 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $8.91 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $8.91 Coventry Health Care — Worker's Compensation: $6.78 Geisinger PA Medicare Advantage — All Plans: $4.55 Highmark PA — CHIP: $5.79 Humana Medicare Advantage — All Plans: $4.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$232	$116	$5.68 – $171.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 50 insurance plan rates Aetna — Aetna: $14 Aetna — Better Health Mgd Medicaid: $5.79 Aetna Better Health PA — CHIP: $8.25 Aetna Better Health WV — CHIP: $5.79 Aetna Medicare Advantage — All Plans: $6.31 Alliance Coal — Alliance Coal: $7.51 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $9.38 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6.31 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $12.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $12.48
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$207	$103.50	$5.68 – $171.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 50 insurance plan rates Aetna — Aetna: $14 Aetna — Better Health Mgd Medicaid: $5.79 Aetna Better Health PA — CHIP: $8.25 Aetna Better Health WV — CHIP: $5.79 Aetna Medicare Advantage — All Plans: $6.31 Alliance Coal — Alliance Coal: $7.51 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $9.38 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6.31 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $12.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $12.48
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$207	$103.50	$6.01 – $171.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 36 insurance plan rates Aetna — Aetna: $14 Aetna Medicare Advantage — All Plans: $6.31 Alliance Coal — Alliance Coal: $7.51 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6.31 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $12.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $12.48 Coventry Health Care — Worker's Compensation: $9.50 Geisinger PA Medicare Advantage — All Plans: $6.37 Highmark PA — CHIP: $8.11 Humana Medicare Advantage — All Plans: $6.31

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$620	$310	$30.11 – $236.10
CT scan of the head or brain, without contrast: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $30.69 Aetna Better Health PA — CHIP: $85.25 Aetna Better Health WV — CHIP: $30.69 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $96.88 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$554	$277	$30.11 – $236.10
CT scan of the head or brain, without contrast: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $30.69 Aetna Better Health PA — CHIP: $85.25 Aetna Better Health WV — CHIP: $30.69 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $96.88 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$554	$277	$101.33 – $236.10
CT scan of the head or brain, without contrast: 10 of 36 insurance plan rates Aetna — Aetna: $236.10 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46 Coventry Health Care — Worker's Compensation: $160.10 Geisinger PA Medicare Advantage — All Plans: $107.41 Highmark PA — CHIP: $136.82 Humana Medicare Advantage — All Plans: $106.40
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$2,264	$1,132	$81.59 – $787.87
MRI of the brain, before and after contrast: 10 of 50 insurance plan rates Aetna — Aetna: $787.87 Aetna — Better Health Mgd Medicaid: $83.14 Aetna Better Health PA — CHIP: $295.90 Aetna Better Health WV — CHIP: $83.14 Aetna Medicare Advantage — All Plans: $355.05 Alliance Coal — Alliance Coal: $591.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $336.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $355.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $702.32 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $702.32
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,021	$1,010.50	$81.59 – $787.87
MRI of the brain, before and after contrast: 10 of 50 insurance plan rates Aetna — Aetna: $787.87 Aetna — Better Health Mgd Medicaid: $83.14 Aetna Better Health PA — CHIP: $295.90 Aetna Better Health WV — CHIP: $83.14 Aetna Medicare Advantage — All Plans: $355.05 Alliance Coal — Alliance Coal: $591.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $336.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $355.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $702.32 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $702.32
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,021	$1,010.50	$171.55 – $787.87
MRI of the brain, before and after contrast: 10 of 36 insurance plan rates Aetna — Aetna: $787.87 Aetna Medicare Advantage — All Plans: $355.05 Alliance Coal — Alliance Coal: $591.74 AmeriHealth Caritas PA Medicare Advantage — All Pl: $355.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $702.32 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $702.32 Coventry Health Care — Worker's Compensation: $534.26 Geisinger PA Medicare Advantage — All Plans: $358.43 Highmark PA — CHIP: $456.56 Humana Medicare Advantage — All Plans: $355.05
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	$328	$164	$7.72 – $196.54
Chest X-ray, 2 views: 10 of 50 insurance plan rates Aetna — Aetna: $196.54 Aetna — Better Health Mgd Medicaid: $7.86 Aetna Better Health PA — CHIP: $16.34 Aetna Better Health WV — CHIP: $7.86 Aetna Medicare Advantage — All Plans: $88.57 Alliance Coal — Alliance Coal: $147.61 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $18.56 AmeriHealth Caritas PA Medicare Advantage — All Pl: $88.57 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $175.19 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $175.19
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_PO_TC In the file: X-RAY OF CHEST; 2 VIEWS	$293	$146.50	$84.35 – $196.54
Chest X-ray, 2 views: 10 of 36 insurance plan rates Aetna — Aetna: $196.54 Aetna Medicare Advantage — All Plans: $88.57 Alliance Coal — Alliance Coal: $147.61 AmeriHealth Caritas PA Medicare Advantage — All Pl: $88.57 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $175.19 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $175.19 Coventry Health Care — Worker's Compensation: $133.27 Geisinger PA Medicare Advantage — All Plans: $89.41 Highmark PA — CHIP: $113.89 Humana Medicare Advantage — All Plans: $88.57
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_TC In the file: X-RAY OF CHEST; 2 VIEWS	$293	$146.50	$84.35 – $196.54
Chest X-ray, 2 views: 10 of 36 insurance plan rates Aetna — Aetna: $196.54 Aetna Medicare Advantage — All Plans: $88.57 Alliance Coal — Alliance Coal: $147.61 AmeriHealth Caritas PA Medicare Advantage — All Pl: $88.57 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $175.19 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $175.19 Coventry Health Care — Worker's Compensation: $133.27 Geisinger PA Medicare Advantage — All Plans: $89.41 Highmark PA — CHIP: $113.89 Humana Medicare Advantage — All Plans: $88.57
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$325	$162.50	$9.26 – $236.10
X-ray of the lower spine, at least 4 views: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $9.44 Aetna Better Health PA — CHIP: $24.75 Aetna Better Health WV — CHIP: $9.44 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $28.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$290	$145	$101.33 – $236.10
X-ray of the lower spine, at least 4 views: 10 of 36 insurance plan rates Aetna — Aetna: $236.10 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46 Coventry Health Care — Worker's Compensation: $160.10 Geisinger PA Medicare Advantage — All Plans: $107.41 Highmark PA — CHIP: $136.82 Humana Medicare Advantage — All Plans: $106.40
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$290	$145	$101.33 – $236.10
X-ray of the lower spine, at least 4 views: 10 of 36 insurance plan rates Aetna — Aetna: $236.10 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46 Coventry Health Care — Worker's Compensation: $160.10 Geisinger PA Medicare Advantage — All Plans: $107.41 Highmark PA — CHIP: $136.82 Humana Medicare Advantage — All Plans: $106.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$1,415	$707.50	$52.50 – $538.86
MRI of the lower back (lumbar spine), without contrast: 10 of 50 insurance plan rates Aetna — Aetna: $538.86 Aetna — Better Health Mgd Medicaid: $53.50 Aetna Better Health PA — CHIP: $205.92 Aetna Better Health WV — CHIP: $53.50 Aetna Medicare Advantage — All Plans: $242.83 Alliance Coal — Alliance Coal: $404.72 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $234 AmeriHealth Caritas PA Medicare Advantage — All Pl: $242.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $480.35 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $480.35
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,263	$631.50	$52.50 – $538.86
MRI of the lower back (lumbar spine), without contrast: 10 of 50 insurance plan rates Aetna — Aetna: $538.86 Aetna — Better Health Mgd Medicaid: $53.50 Aetna Better Health PA — CHIP: $205.92 Aetna Better Health WV — CHIP: $53.50 Aetna Medicare Advantage — All Plans: $242.83 Alliance Coal — Alliance Coal: $404.72 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $234 AmeriHealth Caritas PA Medicare Advantage — All Pl: $242.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $480.35 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $480.35
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,263	$631.50	$171.55 – $538.86
MRI of the lower back (lumbar spine), without contrast: 10 of 36 insurance plan rates Aetna — Aetna: $538.86 Aetna Medicare Advantage — All Plans: $242.83 Alliance Coal — Alliance Coal: $404.72 AmeriHealth Caritas PA Medicare Advantage — All Pl: $242.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $480.35 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $480.35 Coventry Health Care — Worker's Compensation: $365.41 Geisinger PA Medicare Advantage — All Plans: $245.15 Highmark PA — CHIP: $312.26 Humana Medicare Advantage — All Plans: $242.83
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$1,216	$608	$40.92 – $396.12
CT scan of the pelvis, with contrast: 10 of 50 insurance plan rates Aetna — Aetna: $396.12 Aetna — Better Health Mgd Medicaid: $41.70 Aetna Better Health PA — CHIP: $95.15 Aetna Better Health WV — CHIP: $41.70 Aetna Medicare Advantage — All Plans: $178.51 Alliance Coal — Alliance Coal: $297.52 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $108.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $178.51 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $353.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $353.11
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST	$1,086	$543	$40.92 – $396.12
CT scan of the pelvis, with contrast: 10 of 50 insurance plan rates Aetna — Aetna: $396.12 Aetna — Better Health Mgd Medicaid: $41.70 Aetna Better Health PA — CHIP: $95.15 Aetna Better Health WV — CHIP: $41.70 Aetna Medicare Advantage — All Plans: $178.51 Alliance Coal — Alliance Coal: $297.52 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $108.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $178.51 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $353.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $353.11
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF PELVIS WITH CONTRAST	$1,086	$543	$170.01 – $396.12
CT scan of the pelvis, with contrast: 10 of 36 insurance plan rates Aetna — Aetna: $396.12 Aetna Medicare Advantage — All Plans: $178.51 Alliance Coal — Alliance Coal: $297.52 AmeriHealth Caritas PA Medicare Advantage — All Pl: $178.51 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $353.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $353.11 Coventry Health Care — Worker's Compensation: $268.62 Geisinger PA Medicare Advantage — All Plans: $180.21 Highmark PA — CHIP: $229.55 Humana Medicare Advantage — All Plans: $178.51
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$1,268	$634	$47.87 – $538.86
MRI of a leg joint (such as the knee), without contrast: 10 of 50 insurance plan rates Aetna — Aetna: $538.86 Aetna — Better Health Mgd Medicaid: $48.78 Aetna Better Health PA — CHIP: $295.90 Aetna Better Health WV — CHIP: $48.78 Aetna Medicare Advantage — All Plans: $242.83 Alliance Coal — Alliance Coal: $404.72 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $336.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $242.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $480.35 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $480.35
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,132	$566	$171.55 – $538.86
MRI of a leg joint (such as the knee), without contrast: 10 of 36 insurance plan rates Aetna — Aetna: $538.86 Aetna Medicare Advantage — All Plans: $242.83 Alliance Coal — Alliance Coal: $404.72 AmeriHealth Caritas PA Medicare Advantage — All Pl: $242.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $480.35 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $480.35 Coventry Health Care — Worker's Compensation: $365.41 Geisinger PA Medicare Advantage — All Plans: $245.15 Highmark PA — CHIP: $312.26 Humana Medicare Advantage — All Plans: $242.83
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,132	$566	$171.55 – $538.86
MRI of a leg joint (such as the knee), without contrast: 10 of 36 insurance plan rates Aetna — Aetna: $538.86 Aetna Medicare Advantage — All Plans: $242.83 Alliance Coal — Alliance Coal: $404.72 AmeriHealth Caritas PA Medicare Advantage — All Pl: $242.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $480.35 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $480.35 Coventry Health Care — Worker's Compensation: $365.41 Geisinger PA Medicare Advantage — All Plans: $245.15 Highmark PA — CHIP: $312.26 Humana Medicare Advantage — All Plans: $242.83
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$2,028	$1,014	$64.86 – $787.87
CT scan of the abdomen and pelvis, with contrast: 10 of 50 insurance plan rates Aetna — Aetna: $787.87 Aetna — Better Health Mgd Medicaid: $66.09 Aetna Better Health PA — CHIP: $212 Aetna Better Health WV — CHIP: $66.09 Aetna Medicare Advantage — All Plans: $355.05 Alliance Coal — Alliance Coal: $591.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $240.91 AmeriHealth Caritas PA Medicare Advantage — All Pl: $355.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $702.32 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $702.32
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$1,811	$905.50	$64.86 – $787.87
CT scan of the abdomen and pelvis, with contrast: 10 of 50 insurance plan rates Aetna — Aetna: $787.87 Aetna — Better Health Mgd Medicaid: $66.09 Aetna Better Health PA — CHIP: $212 Aetna Better Health WV — CHIP: $66.09 Aetna Medicare Advantage — All Plans: $355.05 Alliance Coal — Alliance Coal: $591.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $240.91 AmeriHealth Caritas PA Medicare Advantage — All Pl: $355.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $702.32 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $702.32
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$1,811	$905.50	$171.55 – $787.87
CT scan of the abdomen and pelvis, with contrast: 10 of 36 insurance plan rates Aetna — Aetna: $787.87 Aetna Medicare Advantage — All Plans: $355.05 Alliance Coal — Alliance Coal: $591.74 AmeriHealth Caritas PA Medicare Advantage — All Pl: $355.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $702.32 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $702.32 Coventry Health Care — Worker's Compensation: $534.26 Geisinger PA Medicare Advantage — All Plans: $358.43 Highmark PA — CHIP: $456.56 Humana Medicare Advantage — All Plans: $355.05
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$559	$279.50	$28.57 – $236.10
Ultrasound of the abdomen, complete: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $63.25 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $71.88 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$499	$249.50	$28.57 – $236.10
Ultrasound of the abdomen, complete: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $63.25 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $71.88 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$499	$249.50	$101.33 – $236.10
Ultrasound of the abdomen, complete: 10 of 36 insurance plan rates Aetna — Aetna: $236.10 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46 Coventry Health Care — Worker's Compensation: $160.10 Geisinger PA Medicare Advantage — All Plans: $107.41 Highmark PA — CHIP: $136.82 Humana Medicare Advantage — All Plans: $106.40
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS	$559	$279.50	$35.26 – $236.10
Pregnancy ultrasound (after the first trimester): 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $35.93 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $35.93 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $58.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$499	$249.50	$35.26 – $236.10
Pregnancy ultrasound (after the first trimester): 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $35.93 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $35.93 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $58.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$499	$249.50	$101.33 – $236.10
Pregnancy ultrasound (after the first trimester): 10 of 36 insurance plan rates Aetna — Aetna: $236.10 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46 Coventry Health Care — Worker's Compensation: $160.10 Geisinger PA Medicare Advantage — All Plans: $107.41 Highmark PA — CHIP: $136.82 Humana Medicare Advantage — All Plans: $106.40
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	$559	$279.50	$24.44 – $236.10
Transvaginal ultrasound: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $24.91 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $24.91 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $58.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$499	$249.50	$24.44 – $236.10
Transvaginal ultrasound: 10 of 50 insurance plan rates Aetna — Aetna: $236.10 Aetna — Better Health Mgd Medicaid: $24.91 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $24.91 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $58.13 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$499	$249.50	$101.33 – $236.10
Transvaginal ultrasound: 10 of 36 insurance plan rates Aetna — Aetna: $236.10 Aetna Medicare Advantage — All Plans: $106.40 Alliance Coal — Alliance Coal: $177.33 AmeriHealth Caritas PA Medicare Advantage — All Pl: $106.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $210.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $210.46 Coventry Health Care — Worker's Compensation: $160.10 Geisinger PA Medicare Advantage — All Plans: $107.41 Highmark PA — CHIP: $136.82 Humana Medicare Advantage — All Plans: $106.40
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	$517	$258.50	$28.57 – $171.55
Diagnostic mammogram, one breast: 10 of 50 insurance plan rates Aetna — Aetna: $85.86 Aetna — Better Health Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $78.11 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $38.69 Alliance Coal — Alliance Coal: $64.49 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $88.76 AmeriHealth Caritas PA Medicare Advantage — All Pl: $38.69 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76.54 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76.54
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$462	$231	$28.57 – $171.55
Diagnostic mammogram, one breast: 10 of 50 insurance plan rates Aetna — Aetna: $85.86 Aetna — Better Health Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $78.11 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $38.69 Alliance Coal — Alliance Coal: $64.49 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $88.76 AmeriHealth Caritas PA Medicare Advantage — All Pl: $38.69 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76.54 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76.54
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_RT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$462	$231	$36.85 – $171.55
Diagnostic mammogram, one breast: 10 of 36 insurance plan rates Aetna — Aetna: $85.86 Aetna Medicare Advantage — All Plans: $38.69 Alliance Coal — Alliance Coal: $64.49 AmeriHealth Caritas PA Medicare Advantage — All Pl: $38.69 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76.54 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76.54 Coventry Health Care — Worker's Compensation: $58.22 Geisinger PA Medicare Advantage — All Plans: $39.06 Highmark PA — CHIP: $49.75 Humana Medicare Advantage — All Plans: $38.69
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	$659	$329.50	$35 – $171.55
Diagnostic mammogram, both breasts: 10 of 50 insurance plan rates Aetna — Aetna: $105.69 Aetna — Better Health Mgd Medicaid: $35.66 Aetna Better Health PA — CHIP: $99.91 Aetna Better Health WV — CHIP: $35.66 Aetna Medicare Advantage — All Plans: $47.63 Alliance Coal — Alliance Coal: $79.38 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $113.54 AmeriHealth Caritas PA Medicare Advantage — All Pl: $47.63 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $94.21 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $94.21
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$588	$294	$35 – $171.55
Diagnostic mammogram, both breasts: 10 of 50 insurance plan rates Aetna — Aetna: $105.69 Aetna — Better Health Mgd Medicaid: $35.66 Aetna Better Health PA — CHIP: $99.91 Aetna Better Health WV — CHIP: $35.66 Aetna Medicare Advantage — All Plans: $47.63 Alliance Coal — Alliance Coal: $79.38 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $113.54 AmeriHealth Caritas PA Medicare Advantage — All Pl: $47.63 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $94.21 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $94.21
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$588	$294	$45.36 – $171.55
Diagnostic mammogram, both breasts: 10 of 36 insurance plan rates Aetna — Aetna: $105.69 Aetna Medicare Advantage — All Plans: $47.63 Alliance Coal — Alliance Coal: $79.38 AmeriHealth Caritas PA Medicare Advantage — All Pl: $47.63 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $94.21 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $94.21 Coventry Health Care — Worker's Compensation: $71.67 Geisinger PA Medicare Advantage — All Plans: $48.08 Highmark PA — CHIP: $61.25 Humana Medicare Advantage — All Plans: $47.63
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY	$545	$272.50	$27.03 – $171.55
Screening mammogram, both breasts: 10 of 50 insurance plan rates Aetna — Aetna: $79.83 Aetna — Better Health Mgd Medicaid: $27.54 Aetna Better Health PA — CHIP: $82.52 Aetna Better Health WV — CHIP: $27.54 Aetna Medicare Advantage — All Plans: $35.97 Alliance Coal — Alliance Coal: $59.95 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $93.78 AmeriHealth Caritas PA Medicare Advantage — All Pl: $35.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $71.16 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $71.16
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	$273	$136.50	$27.03 – $171.55
Screening mammogram, both breasts: 10 of 50 insurance plan rates Aetna — Aetna: $79.83 Aetna — Better Health Mgd Medicaid: $27.54 Aetna Better Health PA — CHIP: $82.52 Aetna Better Health WV — CHIP: $27.54 Aetna Medicare Advantage — All Plans: $35.97 Alliance Coal — Alliance Coal: $59.96 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $93.78 AmeriHealth Caritas PA Medicare Advantage — All Pl: $35.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $71.16 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $71.16
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_LT_PO_TC In the file: SCREENING MAMMOGRAPHY	$244	$122	$34.26 – $171.55
Screening mammogram, both breasts: 10 of 36 insurance plan rates Aetna — Aetna: $79.83 Aetna Medicare Advantage — All Plans: $35.97 Alliance Coal — Alliance Coal: $59.95 AmeriHealth Caritas PA Medicare Advantage — All Pl: $35.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $71.16 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $71.16 Coventry Health Care — Worker's Compensation: $54.13 Geisinger PA Medicare Advantage — All Plans: $36.32 Highmark PA — CHIP: $46.26 Humana Medicare Advantage — All Plans: $35.97

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	$6,472	$3,236	$171.55 – $7,321.49
Left heart catheterization (diagnostic): 10 of 51 insurance plan rates Aetna — Aetna: $7,321.49 Aetna — Better Health Mgd Medicaid: $182.26 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $182.26 Aetna Medicare Advantage — All Plans: $3,299.38 Alliance Coal — Alliance Coal: $5,498.97 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $970 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,299.38 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,526.49 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,526.49
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM	$7,197	$3,598.50	$86.98 – $1,939.35
Sleep study (overnight, in a sleep lab): 10 of 50 insurance plan rates Aetna — Aetna: $1,939.35 Aetna — Better Health Mgd Medicaid: $88.64 Aetna Better Health PA — CHIP: $297.35 Aetna Better Health WV — CHIP: $88.64 Aetna Medicare Advantage — All Plans: $873.96 Alliance Coal — Alliance Coal: $1,456.60 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $337.90 AmeriHealth Caritas PA Medicare Advantage — All Pl: $873.96 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,728.77 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,728.77
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$6,426	$3,213	$86.98 – $1,939.35
Sleep study (overnight, in a sleep lab): 10 of 50 insurance plan rates Aetna — Aetna: $1,939.35 Aetna — Better Health Mgd Medicaid: $88.64 Aetna Better Health PA — CHIP: $297.35 Aetna Better Health WV — CHIP: $88.64 Aetna Medicare Advantage — All Plans: $873.96 Alliance Coal — Alliance Coal: $1,456.60 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $337.90 AmeriHealth Caritas PA Medicare Advantage — All Pl: $873.96 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,728.77 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,728.77
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$4,282	$2,141	$171.55 – $969.68
Sleep study (overnight, in a sleep lab): 10 of 36 insurance plan rates Aetna — Aetna: $969.68 Aetna Medicare Advantage — All Plans: $436.98 Alliance Coal — Alliance Coal: $728.30 AmeriHealth Caritas PA Medicare Advantage — All Pl: $436.98 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $864.39 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $864.39 Coventry Health Care — Worker's Compensation: $657.55 Geisinger PA Medicare Advantage — All Plans: $441.14 Highmark PA — CHIP: $561.91 Humana Medicare Advantage — All Plans: $436.98

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	$172	$86	$21.36 – $171.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 46 insurance plan rates Aetna — Aetna: $65.05 Aetna — Better Health Mgd Medicaid: $21.76 Aetna Better Health WV — CHIP: $21.76 Aetna Medicare Advantage — All Plans: $29.32 Alliance Coal — Alliance Coal: $37.69 AmeriHealth Caritas PA Medicare Advantage — All Pl: $29.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $57.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $57.99 Coventry Health Care — Worker's Compensation: $44.11 Geisinger PA Medicare Advantage — All Plans: $29.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_CQ_GP_GZ In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$164	$82	$27.92 – $171.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates Aetna — Aetna: $65.05 Aetna Medicare Advantage — All Plans: $29.32 Alliance Coal — Alliance Coal: $37.69 AmeriHealth Caritas PA Medicare Advantage — All Pl: $29.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $57.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $57.99 Coventry Health Care — Worker's Compensation: $44.11 Geisinger PA Medicare Advantage — All Plans: $29.60 Highmark PA — CHIP: $37.70 Humana Medicare Advantage — All Plans: $29.32
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$164	$82	$27.92 – $171.55
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates Aetna — Aetna: $65.05 Aetna Medicare Advantage — All Plans: $29.32 Alliance Coal — Alliance Coal: $37.69 AmeriHealth Caritas PA Medicare Advantage — All Pl: $29.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $57.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $57.99 Coventry Health Care — Worker's Compensation: $44.11 Geisinger PA Medicare Advantage — All Plans: $29.60 Highmark PA — CHIP: $37.70 Humana Medicare Advantage — All Plans: $29.32
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	$452	$226	$69.97 – $219.16
Physical therapy evaluation (low complexity): 10 of 51 insurance plan rates Aetna — Aetna: $219.16 Aetna — Better Health Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $69.97 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $79.51 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$430	$215	$94.06 – $219.16
Physical therapy evaluation (low complexity): 10 of 37 insurance plan rates Aetna — Aetna: $219.16 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36 Coventry Health Care — Worker's Compensation: $148.61 Geisinger PA Medicare Advantage — All Plans: $99.70 Highmark PA — CHIP: $127 Humana Medicare Advantage — All Plans: $98.76
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_U8 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$430	$215	$94.06 – $219.16
Physical therapy evaluation (low complexity): 10 of 37 insurance plan rates Aetna — Aetna: $219.16 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36 Coventry Health Care — Worker's Compensation: $148.61 Geisinger PA Medicare Advantage — All Plans: $99.70 Highmark PA — CHIP: $127 Humana Medicare Advantage — All Plans: $98.76
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	$452	$226	$69.97 – $219.16
Physical therapy evaluation (moderate complexity): 10 of 51 insurance plan rates Aetna — Aetna: $219.16 Aetna — Better Health Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $69.97 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $79.51 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$430	$215	$94.06 – $219.16
Physical therapy evaluation (moderate complexity): 10 of 37 insurance plan rates Aetna — Aetna: $219.16 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36 Coventry Health Care — Worker's Compensation: $148.61 Geisinger PA Medicare Advantage — All Plans: $99.70 Highmark PA — CHIP: $127 Humana Medicare Advantage — All Plans: $98.76
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$430	$215	$94.06 – $219.16
Physical therapy evaluation (moderate complexity): 10 of 37 insurance plan rates Aetna — Aetna: $219.16 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36 Coventry Health Care — Worker's Compensation: $148.61 Geisinger PA Medicare Advantage — All Plans: $99.70 Highmark PA — CHIP: $127 Humana Medicare Advantage — All Plans: $98.76
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	$610	$305	$69.97 – $219.16
Physical therapy evaluation (high complexity): 10 of 51 insurance plan rates Aetna — Aetna: $219.16 Aetna — Better Health Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $69.97 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $79.51 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_U8 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$581	$290.50	$94.06 – $219.16
Physical therapy evaluation (high complexity): 10 of 37 insurance plan rates Aetna — Aetna: $219.16 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36 Coventry Health Care — Worker's Compensation: $148.61 Geisinger PA Medicare Advantage — All Plans: $99.70 Highmark PA — CHIP: $127 Humana Medicare Advantage — All Plans: $98.76
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$610	$305	$94.06 – $219.16
Physical therapy evaluation (high complexity): 10 of 37 insurance plan rates Aetna — Aetna: $219.16 Aetna Medicare Advantage — All Plans: $98.76 Alliance Coal — Alliance Coal: $126.98 AmeriHealth Caritas PA Medicare Advantage — All Pl: $98.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $195.36 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $195.36 Coventry Health Care — Worker's Compensation: $148.61 Geisinger PA Medicare Advantage — All Plans: $99.70 Highmark PA — CHIP: $127 Humana Medicare Advantage — All Plans: $98.76
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	$411	$205.50	$106.29 – $400.85
Psychotherapy, 60 minutes: 10 of 45 insurance plan rates Aetna — Aetna: $400.85 Aetna — Better Health Mgd Medicaid: $108.32 Aetna Better Health WV — CHIP: $108.32 Aetna Medicare Advantage — All Plans: $180.64 Alliance Coal — Alliance Coal: $301.07 AmeriHealth Caritas PA Medicare Advantage — All Pl: $180.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $357.33 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $357.33 Coventry Health Care — Worker's Compensation: $271.82 Geisinger PA Medicare Advantage — All Plans: $182.36
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/PT 50 MIN	$411	$205.50	$80.81 – $400.85
Family psychotherapy, with the patient: 10 of 45 insurance plan rates Aetna — Aetna: $400.85 Aetna — Better Health Mgd Medicaid: $82.35 Aetna Better Health WV — CHIP: $82.35 Aetna Medicare Advantage — All Plans: $180.64 Alliance Coal — Alliance Coal: $301.07 AmeriHealth Caritas PA Medicare Advantage — All Pl: $180.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $357.33 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $357.33 Coventry Health Care — Worker's Compensation: $271.82 Geisinger PA Medicare Advantage — All Plans: $182.36

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_SG In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$2,141	$1,070.50	$171.55 – $8,842.49
Removal of breast growth (open surgery): 10 of 37 insurance plan rates Aetna — Aetna: $8,842.49 Aetna Medicare Advantage — All Plans: $3,984.81 Alliance Coal — Alliance Coal: $6,641.36 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,984.81 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,882.34 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,882.34 Coventry Health Care — Worker's Compensation: $5,996.19 Geisinger PA Medicare Advantage — All Plans: $4,022.76 Highmark PA — CHIP: $5,124.09 Humana Medicare Advantage — All Plans: $3,984.81
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$2,960	$1,480	$171.55 – $8,842.49
Removal of breast growth (open surgery): 10 of 37 insurance plan rates Aetna — Aetna: $8,842.49 Aetna Medicare Advantage — All Plans: $3,984.81 Alliance Coal — Alliance Coal: $6,641.36 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,984.81 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,882.34 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,882.34 Coventry Health Care — Worker's Compensation: $5,996.19 Geisinger PA Medicare Advantage — All Plans: $4,022.76 Highmark PA — CHIP: $5,124.09 Humana Medicare Advantage — All Plans: $3,984.81
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$2,078	$1,039	$171.55 – $8,842.49
Removal of breast growth (open surgery): 10 of 37 insurance plan rates Aetna — Aetna: $8,842.49 Aetna Medicare Advantage — All Plans: $3,984.81 Alliance Coal — Alliance Coal: $6,641.35 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,984.81 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,882.34 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,882.34 Coventry Health Care — Worker's Compensation: $5,996.19 Geisinger PA Medicare Advantage — All Plans: $4,022.76 Highmark PA — CHIP: $5,124.09 Humana Medicare Advantage — All Plans: $3,984.81
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 22_RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$17,684	$8,842	$171.55 – $28,994.47
Total hip replacement: 10 of 37 insurance plan rates Aetna — Aetna: $28,994.47 Aetna Medicare Advantage — All Plans: $13,066.18 Alliance Coal — Alliance Coal: $21,776.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $13,066.18 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25,846.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25,846.15 Coventry Health Care — Worker's Compensation: $19,661.49 Geisinger PA Medicare Advantage — All Plans: $13,190.62 Highmark PA — CHIP: $16,801.86 Humana Medicare Advantage — All Plans: $13,066.18
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$31,454	$15,727	$171.55 – $28,994.47
Total hip replacement: 10 of 37 insurance plan rates Aetna — Aetna: $28,994.47 Aetna Medicare Advantage — All Plans: $13,066.18 Alliance Coal — Alliance Coal: $21,776.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $13,066.18 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25,846.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25,846.15 Coventry Health Care — Worker's Compensation: $19,661.49 Geisinger PA Medicare Advantage — All Plans: $13,190.62 Highmark PA — CHIP: $16,801.86 Humana Medicare Advantage — All Plans: $13,066.18
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$16,469	$8,234.50	$171.55 – $28,994.47
Total hip replacement: 10 of 37 insurance plan rates Aetna — Aetna: $28,994.47 Aetna Medicare Advantage — All Plans: $13,066.18 Alliance Coal — Alliance Coal: $21,776.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $13,066.18 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25,846.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25,846.15 Coventry Health Care — Worker's Compensation: $19,661.49 Geisinger PA Medicare Advantage — All Plans: $13,190.62 Highmark PA — CHIP: $16,801.86 Humana Medicare Advantage — All Plans: $13,066.18
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$33,344	$16,672	$171.55 – $28,994.47
Total knee replacement: 10 of 37 insurance plan rates Aetna — Aetna: $28,994.47 Aetna Medicare Advantage — All Plans: $13,066.18 Alliance Coal — Alliance Coal: $21,776.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $13,066.18 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25,846.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25,846.15 Coventry Health Care — Worker's Compensation: $19,661.49 Geisinger PA Medicare Advantage — All Plans: $13,190.62 Highmark PA — CHIP: $16,801.86 Humana Medicare Advantage — All Plans: $13,066.18
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$32,669	$16,334.50	$171.55 – $28,994.47
Total knee replacement: 10 of 37 insurance plan rates Aetna — Aetna: $28,994.47 Aetna Medicare Advantage — All Plans: $13,066.18 Alliance Coal — Alliance Coal: $21,776.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $13,066.18 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25,846.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25,846.15 Coventry Health Care — Worker's Compensation: $19,661.49 Geisinger PA Medicare Advantage — All Plans: $13,190.62 Highmark PA — CHIP: $16,801.86 Humana Medicare Advantage — All Plans: $13,066.18
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier SG In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$25,379	$12,689.50	$171.55 – $28,994.47
Total knee replacement: 10 of 37 insurance plan rates Aetna — Aetna: $28,994.47 Aetna Medicare Advantage — All Plans: $13,066.18 Alliance Coal — Alliance Coal: $21,776.96 AmeriHealth Caritas PA Medicare Advantage — All Pl: $13,066.18 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $25,846.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $25,846.15 Coventry Health Care — Worker's Compensation: $19,661.49 Geisinger PA Medicare Advantage — All Plans: $13,190.62 Highmark PA — CHIP: $16,801.86 Humana Medicare Advantage — All Plans: $13,066.18
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_SG In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$2,272.33	$1,136.17	$144.07 – $335.68
Shoulder arthroscopy: shaving of shoulder bone: 10 of 37 insurance plan rates Aetna — Aetna: $335.68 Aetna Medicare Advantage — All Plans: $151.27 Alliance Coal — Alliance Coal: $252.12 AmeriHealth Caritas PA Medicare Advantage — All Pl: $151.27 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $299.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $299.23 Coventry Health Care — Worker's Compensation: $227.63 Geisinger PA Medicare Advantage — All Plans: $152.71 Highmark PA — CHIP: $194.52 Humana Medicare Advantage — All Plans: $151.27
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$3,194.66	$1,597.33	$144.07 – $335.68
Shoulder arthroscopy: shaving of shoulder bone: 10 of 37 insurance plan rates Aetna — Aetna: $335.68 Aetna Medicare Advantage — All Plans: $151.27 Alliance Coal — Alliance Coal: $252.12 AmeriHealth Caritas PA Medicare Advantage — All Pl: $151.27 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $299.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $299.23 Coventry Health Care — Worker's Compensation: $227.63 Geisinger PA Medicare Advantage — All Plans: $152.71 Highmark PA — CHIP: $194.52 Humana Medicare Advantage — All Plans: $151.27
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$2,947.33	$1,473.67	$144.07 – $335.68
Shoulder arthroscopy: shaving of shoulder bone: 10 of 37 insurance plan rates Aetna — Aetna: $335.68 Aetna Medicare Advantage — All Plans: $151.27 Alliance Coal — Alliance Coal: $252.12 AmeriHealth Caritas PA Medicare Advantage — All Pl: $151.27 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $299.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $299.23 Coventry Health Care — Worker's Compensation: $227.63 Geisinger PA Medicare Advantage — All Plans: $152.71 Highmark PA — CHIP: $194.52 Humana Medicare Advantage — All Plans: $151.27
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_SG In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$5,134	$2,567	$171.55 – $7,389.39
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 37 insurance plan rates Aetna — Aetna: $7,389.39 Aetna Medicare Advantage — All Plans: $3,329.98 Alliance Coal — Alliance Coal: $5,549.97 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,329.98 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,587.02 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,587.02 Coventry Health Care — Worker's Compensation: $5,010.83 Geisinger PA Medicare Advantage — All Plans: $3,361.69 Highmark PA — CHIP: $4,282.04 Humana Medicare Advantage — All Plans: $3,329.98
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_XS In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$5,872.25	$2,936.13	$171.55 – $7,389.39
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 37 insurance plan rates Aetna — Aetna: $7,389.39 Aetna Medicare Advantage — All Plans: $3,329.98 Alliance Coal — Alliance Coal: $5,549.97 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,329.98 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,587.02 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,587.02 Coventry Health Care — Worker's Compensation: $5,010.83 Geisinger PA Medicare Advantage — All Plans: $3,361.69 Highmark PA — CHIP: $4,282.04 Humana Medicare Advantage — All Plans: $3,329.98
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_XU In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$6,243.50	$3,121.75	$171.55 – $7,389.39
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 37 insurance plan rates Aetna — Aetna: $7,389.39 Aetna Medicare Advantage — All Plans: $3,329.98 Alliance Coal — Alliance Coal: $5,549.97 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,329.98 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,587.02 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,587.02 Coventry Health Care — Worker's Compensation: $5,010.83 Geisinger PA Medicare Advantage — All Plans: $3,361.69 Highmark PA — CHIP: $4,282.04 Humana Medicare Advantage — All Plans: $3,329.98
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$2,771.34	$1,385.67	$171.55 – $13,369.17
Removal of tonsils and adenoids (under age 12): 10 of 51 insurance plan rates Aetna — Aetna: $13,369.17 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $763.40 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $6,024.73 Alliance Coal — Alliance Coal: $10,041.22 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $867.50 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6,024.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $11,917.49 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $11,917.49
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GC In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$3,779	$1,889.50	$171.55 – $13,369.17
Removal of tonsils and adenoids (under age 12): 10 of 37 insurance plan rates Aetna — Aetna: $13,369.17 Aetna Medicare Advantage — All Plans: $6,024.73 Alliance Coal — Alliance Coal: $10,041.22 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6,024.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $11,917.49 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $11,917.49 Coventry Health Care — Worker's Compensation: $9,065.79 Geisinger PA Medicare Advantage — All Plans: $6,082.11 Highmark PA — CHIP: $7,747.23 Humana Medicare Advantage — All Plans: $6,024.73
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier SG In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$3,716	$1,858	$171.55 – $13,369.17
Removal of tonsils and adenoids (under age 12): 10 of 37 insurance plan rates Aetna — Aetna: $13,369.17 Aetna Medicare Advantage — All Plans: $6,024.73 Alliance Coal — Alliance Coal: $10,041.22 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6,024.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $11,917.49 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $11,917.49 Coventry Health Care — Worker's Compensation: $9,065.79 Geisinger PA Medicare Advantage — All Plans: $6,082.11 Highmark PA — CHIP: $7,747.23 Humana Medicare Advantage — All Plans: $6,024.73
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$459	$229.50	$105 – $2,048.30
Upper GI endoscopy (diagnostic): 10 of 51 insurance plan rates Aetna — Aetna: $2,048.30 Aetna — Better Health Mgd Medicaid: $107 Aetna Better Health PA — CHIP: $137.74 Aetna Better Health WV — CHIP: $107 Aetna Medicare Advantage — All Plans: $923.06 Alliance Coal — Alliance Coal: $1,538.42 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $156.53 AmeriHealth Caritas PA Medicare Advantage — All Pl: $923.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,825.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,825.89
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,096	$1,048	$171.55 – $2,048.30
Upper GI endoscopy (diagnostic): 10 of 37 insurance plan rates Aetna — Aetna: $2,048.30 Aetna Medicare Advantage — All Plans: $923.06 Alliance Coal — Alliance Coal: $1,538.42 AmeriHealth Caritas PA Medicare Advantage — All Pl: $923.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,825.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,825.89 Coventry Health Care — Worker's Compensation: $1,388.98 Geisinger PA Medicare Advantage — All Plans: $931.85 Highmark PA — CHIP: $1,186.96 Humana Medicare Advantage — All Plans: $923.06
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$585	$292.50	$171.55 – $2,048.30
Upper GI endoscopy (diagnostic): 10 of 37 insurance plan rates Aetna — Aetna: $2,048.30 Aetna Medicare Advantage — All Plans: $923.06 Alliance Coal — Alliance Coal: $1,538.42 AmeriHealth Caritas PA Medicare Advantage — All Pl: $923.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,825.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,825.89 Coventry Health Care — Worker's Compensation: $1,388.98 Geisinger PA Medicare Advantage — All Plans: $931.85 Highmark PA — CHIP: $1,186.96 Humana Medicare Advantage — All Plans: $923.06
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$543	$271.50	$163.44 – $2,048.30
Upper GI endoscopy with biopsy: 10 of 51 insurance plan rates Aetna — Aetna: $2,048.30 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $163.44 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $923.06 Alliance Coal — Alliance Coal: $1,538.42 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $185.73 AmeriHealth Caritas PA Medicare Advantage — All Pl: $923.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,825.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,825.89
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	$2,453	$1,226.50	$163.44 – $2,048.30
Upper GI endoscopy with biopsy: 10 of 50 insurance plan rates Aetna — Aetna: $2,048.30 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $163.44 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $923.05 Alliance Coal — Alliance Coal: $1,538.42 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $185.73 AmeriHealth Caritas PA Medicare Advantage — All Pl: $923.05 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,825.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,825.89
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_SG In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$795	$397.50	$171.55 – $2,048.30
Upper GI endoscopy with biopsy: 10 of 37 insurance plan rates Aetna — Aetna: $2,048.30 Aetna Medicare Advantage — All Plans: $923.06 Alliance Coal — Alliance Coal: $1,538.42 AmeriHealth Caritas PA Medicare Advantage — All Pl: $923.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,825.89 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,825.89 Coventry Health Care — Worker's Compensation: $1,388.98 Geisinger PA Medicare Advantage — All Plans: $931.85 Highmark PA — CHIP: $1,186.96 Humana Medicare Advantage — All Plans: $923.06
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$363	$181.50	$105 – $2,100.19
Colonoscopy (diagnostic): 10 of 51 insurance plan rates Aetna — Aetna: $2,100.19 Aetna — Better Health Mgd Medicaid: $107 Aetna Better Health PA — CHIP: $198.55 Aetna Better Health WV — CHIP: $107 Aetna Medicare Advantage — All Plans: $946.44 Alliance Coal — Alliance Coal: $1,577.40 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $225.63 AmeriHealth Caritas PA Medicare Advantage — All Pl: $946.44 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,872.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,872.15
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	$2,468	$1,234	$105 – $2,100.19
Colonoscopy (diagnostic): 10 of 50 insurance plan rates Aetna — Aetna: $2,100.19 Aetna — Better Health Mgd Medicaid: $107 Aetna Better Health PA — CHIP: $198.55 Aetna Better Health WV — CHIP: $107 Aetna Medicare Advantage — All Plans: $946.44 Alliance Coal — Alliance Coal: $1,577.40 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $225.63 AmeriHealth Caritas PA Medicare Advantage — All Pl: $946.44 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,872.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,872.15
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_74 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$375	$187.50	$171.55 – $2,100.19
Colonoscopy (diagnostic): 10 of 37 insurance plan rates Aetna — Aetna: $2,100.19 Aetna Medicare Advantage — All Plans: $946.44 Alliance Coal — Alliance Coal: $1,577.40 AmeriHealth Caritas PA Medicare Advantage — All Pl: $946.44 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,872.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,872.15 Coventry Health Care — Worker's Compensation: $1,424.16 Geisinger PA Medicare Advantage — All Plans: $955.45 Highmark PA — CHIP: $1,217.03 Humana Medicare Advantage — All Plans: $946.44
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,055	$1,027.50	$171.55 – $2,702.45
Colonoscopy with biopsy: 10 of 51 insurance plan rates Aetna — Aetna: $2,702.45 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $247.96 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,217.84 Alliance Coal — Alliance Coal: $2,029.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $281.78 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,217.84 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,409.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,409.01
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_XU In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$685	$342.50	$171.55 – $2,702.45
Colonoscopy with biopsy: 10 of 37 insurance plan rates Aetna — Aetna: $2,702.45 Aetna Medicare Advantage — All Plans: $1,217.84 Alliance Coal — Alliance Coal: $2,029.74 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,217.84 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,409.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,409.01 Coventry Health Care — Worker's Compensation: $1,832.56 Geisinger PA Medicare Advantage — All Plans: $1,229.44 Highmark PA — CHIP: $1,566.03 Humana Medicare Advantage — All Plans: $1,217.84
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX_PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,047	$523.50	$171.55 – $2,702.45
Colonoscopy with biopsy: 10 of 37 insurance plan rates Aetna — Aetna: $2,702.45 Aetna Medicare Advantage — All Plans: $1,217.84 Alliance Coal — Alliance Coal: $2,029.74 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,217.84 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,409.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,409.01 Coventry Health Care — Worker's Compensation: $1,832.56 Geisinger PA Medicare Advantage — All Plans: $1,229.44 Highmark PA — CHIP: $1,566.03 Humana Medicare Advantage — All Plans: $1,217.84
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	$2,751	$1,375.50	$171.55 – $2,702.45
Colonoscopy with removal of polyps (snare): 10 of 51 insurance plan rates Aetna — Aetna: $2,702.45 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $294.89 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,217.84 Alliance Coal — Alliance Coal: $2,029.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $335.10 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,217.84 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,409.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,409.01
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,622	$811	$171.55 – $2,702.45
Colonoscopy with removal of polyps (snare): 10 of 51 insurance plan rates Aetna — Aetna: $2,702.45 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $294.89 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,217.84 Alliance Coal — Alliance Coal: $2,029.74 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $335.10 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,217.84 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,409.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,409.01
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX_PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,803	$901.50	$171.55 – $2,702.45
Colonoscopy with removal of polyps (snare): 10 of 37 insurance plan rates Aetna — Aetna: $2,702.45 Aetna Medicare Advantage — All Plans: $1,217.84 Alliance Coal — Alliance Coal: $2,029.74 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,217.84 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,409.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,409.01 Coventry Health Care — Worker's Compensation: $1,832.56 Geisinger PA Medicare Advantage — All Plans: $1,229.44 Highmark PA — CHIP: $1,566.03 Humana Medicare Advantage — All Plans: $1,217.84
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,005	$502.50	$138.72 – $2,100.19
Screening colonoscopy (not high risk): 10 of 46 insurance plan rates Aetna — Aetna: $2,100.19 Aetna — Better Health Mgd Medicaid: $141.36 Aetna Better Health WV — CHIP: $141.36 Aetna Medicare Advantage — All Plans: $946.44 Alliance Coal — Alliance Coal: $1,577.40 AmeriHealth Caritas PA Medicare Advantage — All Pl: $946.44 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,872.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,872.15 Coventry Health Care — Worker's Compensation: $1,424.16 Geisinger PA Medicare Advantage — All Plans: $955.45
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$501	$250.50	$171.55 – $2,100.19
Screening colonoscopy (not high risk): 10 of 37 insurance plan rates Aetna — Aetna: $2,100.19 Aetna Medicare Advantage — All Plans: $946.44 Alliance Coal — Alliance Coal: $1,577.40 AmeriHealth Caritas PA Medicare Advantage — All Pl: $946.44 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,872.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,872.15 Coventry Health Care — Worker's Compensation: $1,424.16 Geisinger PA Medicare Advantage — All Plans: $955.45 Highmark PA — CHIP: $1,217.03 Humana Medicare Advantage — All Plans: $946.44
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,089	$544.50	$171.55 – $2,100.19
Screening colonoscopy (not high risk): 10 of 37 insurance plan rates Aetna — Aetna: $2,100.19 Aetna Medicare Advantage — All Plans: $946.44 Alliance Coal — Alliance Coal: $1,577.40 AmeriHealth Caritas PA Medicare Advantage — All Pl: $946.44 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,872.15 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,872.15 Coventry Health Care — Worker's Compensation: $1,424.16 Geisinger PA Medicare Advantage — All Plans: $955.45 Highmark PA — CHIP: $1,217.03 Humana Medicare Advantage — All Plans: $946.44
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$4,265	$2,132.50	$171.55 – $13,653.03
Gallbladder removal by laparoscope: 10 of 51 insurance plan rates Aetna — Aetna: $13,653.03 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $6,152.65 Alliance Coal — Alliance Coal: $10,254.42 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $970 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6,152.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $12,170.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $12,170.53
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$1,767	$883.50	$171.55 – $13,653.03
Gallbladder removal by laparoscope: 10 of 37 insurance plan rates Aetna — Aetna: $13,653.03 Aetna Medicare Advantage — All Plans: $6,152.65 Alliance Coal — Alliance Coal: $10,254.42 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6,152.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $12,170.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $12,170.53 Coventry Health Care — Worker's Compensation: $9,258.28 Geisinger PA Medicare Advantage — All Plans: $6,211.25 Highmark PA — CHIP: $7,911.73 Humana Medicare Advantage — All Plans: $6,152.65
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier SG In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$6,793	$3,396.50	$171.55 – $13,653.03
Gallbladder removal by laparoscope: 10 of 37 insurance plan rates Aetna — Aetna: $13,653.03 Aetna Medicare Advantage — All Plans: $6,152.65 Alliance Coal — Alliance Coal: $10,254.42 AmeriHealth Caritas PA Medicare Advantage — All Pl: $6,152.65 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $12,170.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $12,170.53 Coventry Health Care — Worker's Compensation: $9,258.28 Geisinger PA Medicare Advantage — All Plans: $6,211.25 Highmark PA — CHIP: $7,911.73 Humana Medicare Advantage — All Plans: $6,152.65
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$4,472	$2,236	$69.85 – $8,085.87
Groin (inguinal) hernia repair, age 5 or older: 10 of 51 insurance plan rates Aetna — Aetna: $8,085.87 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $69.85 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $3,643.85 Alliance Coal — Alliance Coal: $6,073.08 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $79.38 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,643.85 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,207.88 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,207.88
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$3,905	$1,952.50	$171.55 – $8,085.87
Groin (inguinal) hernia repair, age 5 or older: 10 of 37 insurance plan rates Aetna — Aetna: $8,085.87 Aetna Medicare Advantage — All Plans: $3,643.85 Alliance Coal — Alliance Coal: $6,073.08 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,643.85 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,207.88 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,207.88 Coventry Health Care — Worker's Compensation: $5,483.12 Geisinger PA Medicare Advantage — All Plans: $3,678.55 Highmark PA — CHIP: $4,685.64 Humana Medicare Advantage — All Plans: $3,643.85
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_SG In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$4,157	$2,078.50	$171.55 – $8,085.87
Groin (inguinal) hernia repair, age 5 or older: 10 of 37 insurance plan rates Aetna — Aetna: $8,085.87 Aetna Medicare Advantage — All Plans: $3,643.85 Alliance Coal — Alliance Coal: $6,073.08 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,643.85 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,207.88 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,207.88 Coventry Health Care — Worker's Compensation: $5,483.12 Geisinger PA Medicare Advantage — All Plans: $3,678.55 Highmark PA — CHIP: $4,685.64 Humana Medicare Advantage — All Plans: $3,643.85
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND	$3,246	$1,623	$98.45 – $225.40
Prostate biopsy: 10 of 32 insurance plan rates Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $98.45 Aetna Better Health WV — CHIP: $209.72 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $111.88 Geisinger Pennsylvania — Mgd Medicaid: $107.40 Highmark Health Options — CHIP: $205.80 Highmark Health Options West VA — Mgd MCaid: $205.80 Highmark WholeCare Pennsylvania Medicaid — Highmark WholeCare Pennsylvania Medicaid: $225.40 Pennsylvania Health & Wellness — Medicaid: $111.88 The Health Plan WV — CHIP: $209.72
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier SG In the file: BIOPSY OF PROSTATE GLAND	$1,574	$787	$171.55
Prostate biopsy: 10 of 18 insurance plan rates UPMC — Commercial: $171.55 4 Most Zelis Stratose — 4 Most Zelis Stratose: 95% (a percentage in the contract, not a dollar amount) Aetna — Better Health: 60% (a percentage in the contract, not a dollar amount) Aetna Rental — First Health: 95% (a percentage in the contract, not a dollar amount) American Correctional Healthcare, Inc. — FBOP: 100% (a percentage in the contract, not a dollar amount) AMPS — Direct Agreements: 95% (a percentage in the contract, not a dollar amount) BRMS — Direct Agreements: 94% (a percentage in the contract, not a dollar amount) CareSource — CareSource: 90% (a percentage in the contract, not a dollar amount) Cigna — Cigna: 89.2% (a percentage in the contract, not a dollar amount) Geisinger Pennsylvania — Mgd Medicaid: 24% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$2,330	$1,165	$171.55 – $7,310.63
Hysteroscopy with biopsy of the uterus lining: 10 of 51 insurance plan rates Aetna — Aetna: $7,310.63 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $3,294.49 Alliance Coal — Alliance Coal: $5,490.82 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $970 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,294.49 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,516.82 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,516.82
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	$7,441	$3,720.50	$171.55 – $7,310.63
Hysteroscopy with biopsy of the uterus lining: 10 of 50 insurance plan rates Aetna — Aetna: $7,310.63 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $3,294.49 Alliance Coal — Alliance Coal: $5,490.82 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $970 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,294.49 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,516.82 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,516.82
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$1,357	$678.50	$171.55 – $7,310.63
Hysteroscopy with biopsy of the uterus lining: 10 of 37 insurance plan rates Aetna — Aetna: $7,310.63 Aetna Medicare Advantage — All Plans: $3,294.49 Alliance Coal — Alliance Coal: $5,490.82 AmeriHealth Caritas PA Medicare Advantage — All Pl: $3,294.49 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $6,516.82 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $6,516.82 Coventry Health Care — Worker's Compensation: $4,957.42 Geisinger PA Medicare Advantage — All Plans: $3,325.87 Highmark PA — CHIP: $4,236.40 Humana Medicare Advantage — All Plans: $3,294.49
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,755	$877.50	$74.37 – $1,594.14
Spinal injection, lower back (epidural), with imaging guidance: 10 of 51 insurance plan rates Aetna — Aetna: $1,594.14 Aetna — Better Health Mgd Medicaid: $75.79 Aetna Better Health PA — CHIP: $89.45 Aetna Better Health WV — CHIP: $75.79 Aetna Medicare Advantage — All Plans: $718.39 Alliance Coal — Alliance Coal: $1,197.31 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $101.65 AmeriHealth Caritas PA Medicare Advantage — All Pl: $718.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,421.04 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,421.04
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	$1,623	$811.50	$74.37 – $1,594.14
Spinal injection, lower back (epidural), with imaging guidance: 10 of 50 insurance plan rates Aetna — Aetna: $1,594.14 Aetna — Better Health Mgd Medicaid: $75.79 Aetna Better Health PA — CHIP: $89.45 Aetna Better Health WV — CHIP: $75.79 Aetna Medicare Advantage — All Plans: $718.39 Alliance Coal — Alliance Coal: $1,197.31 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $101.65 AmeriHealth Caritas PA Medicare Advantage — All Pl: $718.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,421.04 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,421.04
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,623	$811.50	$171.55 – $1,594.14
Spinal injection, lower back (epidural), with imaging guidance: 10 of 36 insurance plan rates Aetna — Aetna: $1,594.14 Aetna Medicare Advantage — All Plans: $718.39 Alliance Coal — Alliance Coal: $1,197.31 AmeriHealth Caritas PA Medicare Advantage — All Pl: $718.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,421.04 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,421.04 Coventry Health Care — Worker's Compensation: $1,081 Geisinger PA Medicare Advantage — All Plans: $725.23 Highmark PA — CHIP: $923.78 Humana Medicare Advantage — All Plans: $718.39
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$2,742	$1,371	$104.54 – $1,997.46
Nerve root injection, lower back, with imaging guidance: 10 of 50 insurance plan rates Aetna — Aetna: $1,997.46 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $104.54 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $900.14 Alliance Coal — Alliance Coal: $1,500.24 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $118.80 AmeriHealth Caritas PA Medicare Advantage — All Pl: $900.14 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,780.57 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,780.57
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$2,742	$1,371	$171.55 – $1,997.46
Nerve root injection, lower back, with imaging guidance: 10 of 37 insurance plan rates Aetna — Aetna: $1,997.46 Aetna Medicare Advantage — All Plans: $900.14 Alliance Coal — Alliance Coal: $1,500.24 AmeriHealth Caritas PA Medicare Advantage — All Pl: $900.14 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,780.57 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,780.57 Coventry Health Care — Worker's Compensation: $1,354.50 Geisinger PA Medicare Advantage — All Plans: $908.72 Highmark PA — CHIP: $1,157.50 Humana Medicare Advantage — All Plans: $900.14
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$2,742	$1,371	$171.55 – $1,997.46
Nerve root injection, lower back, with imaging guidance: 10 of 37 insurance plan rates Aetna — Aetna: $1,997.46 Aetna Medicare Advantage — All Plans: $900.14 Alliance Coal — Alliance Coal: $1,500.24 AmeriHealth Caritas PA Medicare Advantage — All Pl: $900.14 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,780.57 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,780.57 Coventry Health Care — Worker's Compensation: $1,354.50 Geisinger PA Medicare Advantage — All Plans: $908.72 Highmark PA — CHIP: $1,157.50 Humana Medicare Advantage — All Plans: $900.14
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$4,157	$2,078.50	$171.55 – $4,409.97
Carpal tunnel release: 10 of 51 insurance plan rates Aetna — Aetna: $4,409.97 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $330 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,987.32 Alliance Coal — Alliance Coal: $3,312.21 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $375 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,987.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,931.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,931.12
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	$4,489	$2,244.50	$171.55 – $4,409.97
Carpal tunnel release: 10 of 50 insurance plan rates Aetna — Aetna: $4,409.97 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $330 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,987.32 Alliance Coal — Alliance Coal: $3,312.21 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $375 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,987.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,931.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,931.12
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 79_LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$3,023	$1,511.50	$171.55 – $4,409.97
Carpal tunnel release: 10 of 37 insurance plan rates Aetna — Aetna: $4,409.97 Aetna Medicare Advantage — All Plans: $1,987.32 Alliance Coal — Alliance Coal: $3,312.21 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,987.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,931.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,931.12 Coventry Health Care — Worker's Compensation: $2,990.45 Geisinger PA Medicare Advantage — All Plans: $2,006.25 Highmark PA — CHIP: $2,555.51 Humana Medicare Advantage — All Plans: $1,987.32
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	$1,598	$799	$171.55 – $1,242.10
Laser treatment of clouding after cataract surgery: 10 of 50 insurance plan rates Aetna — Aetna: $1,242.10 Aetna — Better Health Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $238.16 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $559.74 Alliance Coal — Alliance Coal: $932.91 AmeriHealth Caritas PA Medicaid — AmeriHealth Caritas PA Medicaid: $270.64 AmeriHealth Caritas PA Medicare Advantage — All Pl: $559.74 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,107.23 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,107.23
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 73_LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$631	$315.50	$171.55 – $2,605.94
Cataract removal with lens implant: 10 of 37 insurance plan rates Aetna — Aetna: $2,605.94 Aetna Medicare Advantage — All Plans: $1,174.35 Alliance Coal — Alliance Coal: $1,957.25 AmeriHealth Caritas PA Medicare Advantage — All Pl: $1,174.35 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,322.98 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,322.98 Coventry Health Care — Worker's Compensation: $1,767.12 Geisinger PA Medicare Advantage — All Plans: $1,185.54 Highmark PA — CHIP: $1,510.10 Humana Medicare Advantage — All Plans: $1,174.35
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,767	$883.50	$171.55 – $5,211.93
Cataract removal with lens implant: 10 of 37 insurance plan rates Aetna — Aetna: $5,211.93 Aetna Medicare Advantage — All Plans: $2,348.72 Alliance Coal — Alliance Coal: $3,914.54 AmeriHealth Caritas PA Medicare Advantage — All Pl: $2,348.72 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,646 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,646 Coventry Health Care — Worker's Compensation: $3,534.27 Geisinger PA Medicare Advantage — All Plans: $2,371.09 Highmark PA — CHIP: $3,020.24 Humana Medicare Advantage — All Plans: $2,348.72
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,527	$1,263.50	$171.55 – $5,211.93
Cataract removal with lens implant: 10 of 37 insurance plan rates Aetna — Aetna: $5,211.93 Aetna Medicare Advantage — All Plans: $2,348.72 Alliance Coal — Alliance Coal: $3,914.54 AmeriHealth Caritas PA Medicare Advantage — All Pl: $2,348.72 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,646 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,646 Coventry Health Care — Worker's Compensation: $3,534.27 Geisinger PA Medicare Advantage — All Plans: $2,371.09 Highmark PA — CHIP: $3,020.24 Humana Medicare Advantage — All Plans: $2,348.72

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$12,172 – $229,190.66
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 45 insurance plan rates Aetna — Aetna: $148,546.88 Aetna — Better Health Mgd Medicaid: $47,291.42 Aetna Better Health PA — CHIP: $77,197.15 Aetna Better Health WV — CHIP: $47,291.42 Aetna Medicare Advantage — All Plans: $72,885.15 Alliance Coal — Alliance Coal: $12,172 AmeriHealth Caritas PA Medicare Advantage — All Pl: $72,885.15 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $127,705.77 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $127,705.77 Coventry Health Care — Worker's Compensation: $109,674.80
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT COMORBITY	Not listed in the file	Not listed in the file	$12,172 – $86,381.31
Spinal fusion (not neck), without major complications: 10 of 18 insurance plan rates Alliance Coal — Alliance Coal: $12,172 United HealthCare — United HealthCare: $86,381.31 UPMC — Commercial: $40,061.91 4 Most Zelis Stratose — 4 Most Zelis Stratose: 95% (a percentage in the contract, not a dollar amount) Aetna — Better Health: 60% (a percentage in the contract, not a dollar amount) Aetna Rental — First Health: 95% (a percentage in the contract, not a dollar amount) American Correctional Healthcare, Inc. — FBOP: 100% (a percentage in the contract, not a dollar amount) AMPS — Direct Agreements: 95% (a percentage in the contract, not a dollar amount) BRMS — Direct Agreements: 94% (a percentage in the contract, not a dollar amount) CareSource — CareSource: 90% (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 COMORBITY	Not listed in the file	Not listed in the file	$9,150.28 – $44,436.35
Hip or knee replacement (major joint of the leg), without major complications: 10 of 45 insurance plan rates Aetna — Aetna: $30,183.80 Aetna — Better Health Mgd Medicaid: $9,324.57 Aetna Better Health PA — CHIP: $15,221.16 Aetna Better Health WV — CHIP: $9,324.57 Aetna Medicare Advantage — All Plans: $14,809.81 Alliance Coal — Alliance Coal: $12,172 AmeriHealth Caritas PA Medicare Advantage — All Pl: $14,809.81 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $22,457.44 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $22,457.44 Coventry Health Care — Worker's Compensation: $22,285.24
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$11,580.99 – $58,107.07
Neck (cervical) spinal fusion, without complications: 10 of 45 insurance plan rates Aetna — Aetna: $37,905.97 Aetna — Better Health Mgd Medicaid: $11,801.59 Aetna Better Health PA — CHIP: $19,264.57 Aetna Better Health WV — CHIP: $11,801.59 Aetna Medicare Advantage — All Plans: $18,598.72 Alliance Coal — Alliance Coal: $12,172 AmeriHealth Caritas PA Medicare Advantage — All Pl: $18,598.72 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $28,900.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $28,900.46 Coventry Health Care — Worker's Compensation: $27,986.65
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	$5,885.61 – $27,440.63
Uterus and ovary surgery (not for cancer), without complications: 10 of 45 insurance plan rates Aetna — Aetna: $19,812.18 Aetna — Better Health Mgd Medicaid: $5,997.72 Aetna Better Health PA — CHIP: $9,790.50 Aetna Better Health WV — CHIP: $5,997.72 Aetna Medicare Advantage — All Plans: $9,720.93 Alliance Coal — Alliance Coal: $12,172 AmeriHealth Caritas PA Medicare Advantage — All Pl: $9,720.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $16,256.51 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $16,256.51 Coventry Health Care — Worker's Compensation: $14,627.69

Source: Uniontown Hospital’s standard charges file (wvumedicine.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 9, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	500 West Berkeley Street, Uniontown, PA 15401
County	Fayette County
State	Pennsylvania
Phone	(724) 430‑5000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
CMS Certification Number	390041
Name in Medicare records	UNIONTOWN HOSPITAL
Profile level	Medicare data + hospital website
Official website	wvumedicine.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

Uniontown Hospital (WVU Medicine) — wvumedicine.org
Patients and Visitors | Uniontown Hospital — wvumedicine.org
Before Your Visit | Uniontown Hospital — wvumedicine.org
After Your Visit | Uniontown Hospital — wvumedicine.org
Visitation Guidelines | Uniontown Hospital — wvumedicine.org
Recognized for Excellence | Uniontown Hospital — wvumedicine.org
About | Uniontown Hospital — wvumedicine.org
Our Growth | Uniontown Hospital — wvumedicine.org

Uniontown Hospital

Summary

Profile from official sources

At a glance