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Critical Access Hospital

UPMC Cole

Coudersport, Pennsylvania · Potter County · Emergency services listed

UPMC Cole is a critical access hospital at 1001 East Second Street, Coudersport, PA 16915. Phone: (814) 274-9301. It has an emergency department. Medicare overall rating: 4 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

UPMC Cole is a critical access hospital in Coudersport, Pennsylvania. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 42 services, specialties and programs. Medicare lists 166 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is a critical access hospital?

A small rural hospital with 24-hour emergency care, designated by Medicare to keep care available far from big cities. More about hospital types

Call(814) 274‑9301 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
166Doctors and clinicians
42Services listed

Quick answers

Does UPMC Cole have an emergency room?
Yes. Medicare (CMS) data lists emergency services at UPMC Cole. In a medical emergency, call 911.
Where is UPMC Cole?
1001 East Second Street, Coudersport, PA 16915, in Potter County, Pennsylvania.
What is the phone number of UPMC Cole?
(814) 274-9301, as listed by Medicare (CMS).
What is the Medicare star rating of UPMC Cole?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas[4]

Conditions treated[11]

  • Arterial ulcers
  • Diabetic ulcers
  • Minor burns
  • Pressure ulcers
  • Surgical dehiscence
  • Venous ulcers

Treatments[11]

  • Debridement
  • Advanced wound dressing technology
  • Platelet-derived growth factor therapy
  • Compression therapy
  • Vacuum-assisted closure (negative pressure wound therapy)
  • Bioengineered skin grafts
  • Pulsatile wound irrigation

Procedures[4][9]

Programs and centers[4][9]

  • Telemedicine
  • Wellness Center
  • Express Care
  • Hospitalist program

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

Emergency roomYes

Visiting and practical information

Patient portalMyUPMC

Recognition[4]

  • Accredited by The Joint Commission

Doctors and clinicians (166)

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

Main specialties

Doctors with a page on this site (166)

And 142 more: the button below opens the full list.

Other emergency rooms nearby

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

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Coudersport

Hospitals in Potter County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What UPMC Cole 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) 4 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well5 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff4 of 5 stars
Staff explained medicines4 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean5 of 5 stars
Restfulness of Environment4 of 5 stars
Care Coordination4 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1071%National average: 72%
Would definitely recommend the hospital64%National average: 71%
Nurses “always” communicated well84%National average: 80%
Doctors “always” communicated well81%National average: 80%
“Always” got help as soon as they wanted71%National average: 64%
Staff “always” explained medicines before giving them73%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean84%National average: 73%
Completed surveys171Response rate: 31%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 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.

Clostridioides difficile (C. diff) intestinal infections0.84No different from the national benchmark
Not reported to MedicareCentral line bloodstream infections (CLABSI); Catheter-associated urinary tract infections (CAUTI); Surgical site infections after colon surgery; Surgical site infections after abdominal hysterectomy; MRSA bloodstream infections

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 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 failure patients12.2%
Deaths within 30 days: pneumonia patients22.9%
Deaths within 30 days: COPD patients9.2%
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90); Complications after hip or knee replacement
Too few cases to reportDeaths within 30 days: heart attack patients; Deaths within 30 days: stroke patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 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)16.3%
Readmitted within 30 days: heart failure20.7%
Readmitted within 30 days: pneumonia17.1%
Readmitted within 30 days: COPD19.3%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to reportReadmitted within 30 days: heart attack

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 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)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)152 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)72%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 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 PennsylvaniaBest hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 66 common services exactly as UPMC Cole 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 →

Show the prices of 66 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OFFICE VISIT; LEVEL 3 $453 $271.80 $56.06 – $371.46
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $56.96
  • Aetna — Commercial: $371.46
  • Aetna — Medicare: $138.16
  • AmeriHealth Caritas — Community HealthChoices (CHC): $130.01
  • AmeriHealth Caritas — Medicaid: $130.01
  • AmeriHealth Caritas — Medicare: $126.84
  • BCBS of Western NY — Medicare Advantage: $112.11
  • Cigna — Medicare: $133.18
  • Galaxy Health Plan — Commercial: $362.40
  • Geisinger — Commercial: $362.40
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEW PT OFFICE VISIT; LEVEL 3 $453 $271.80 $339.75 – $362.40
New patient office visit (about 30–44 minutes): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $362.40
  • Geisinger — Commercial: $339.75
  • Humana — Commercial: $362.40
  • InterGroup — PPO: $362.40
  • Multiplan — PPO/Auto: $362.40
  • Multiplan — Worker's Compensation: $362.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OFFICE VISIT; LEVEL 4 $700 $420 $61.30 – $574
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $94.89
  • Aetna — Commercial: $574
  • Aetna — Medicare: $213.50
  • AmeriHealth Caritas — Community HealthChoices (CHC): $200.90
  • AmeriHealth Caritas — Medicaid: $200.90
  • AmeriHealth Caritas — Medicare: $196
  • BCBS of Western NY — Medicare Advantage: $171.51
  • Cigna — Medicare: $205.80
  • Galaxy Health Plan — Commercial: $560
  • Geisinger — Commercial: $560
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEW PT OFFICE VISIT; LEVEL 4 $700 $420 $525 – $560
New patient office visit (about 45–59 minutes): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $560
  • Geisinger — Commercial: $525
  • Humana — Commercial: $560
  • InterGroup — PPO: $560
  • Multiplan — PPO/Auto: $560
  • Multiplan — Worker's Compensation: $560
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OFFICE VISIT; LEVEL 5 $877 $526.20 $65.78 – $719.14
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $123.42
  • Aetna — Commercial: $719.14
  • Aetna — Medicare: $267.49
  • AmeriHealth Caritas — Community HealthChoices (CHC): $251.70
  • AmeriHealth Caritas — Medicaid: $251.70
  • AmeriHealth Caritas — Medicare: $245.56
  • BCBS of Western NY — Medicare Advantage: $216.84
  • Cigna — Medicare: $257.84
  • Galaxy Health Plan — Commercial: $701.60
  • Geisinger — Commercial: $701.60
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEW PT OFFICE VISIT; LEVEL 5 $877 $526.20 $657.75 – $701.60
New patient office visit (about 60–74 minutes): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $701.60
  • Geisinger — Commercial: $657.75
  • Humana — Commercial: $701.60
  • InterGroup — PPO: $701.60
  • Multiplan — PPO/Auto: $701.60
  • Multiplan — Worker's Compensation: $701.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTAB PT OFFICE VISIT; LEVEL 3 $305 $183 $36.75 – $250.10
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $36.75
  • Aetna — Commercial: $250.10
  • Aetna — Medicare: $93.03
  • AmeriHealth Caritas — Community HealthChoices (CHC): $87.53
  • AmeriHealth Caritas — Medicaid: $87.53
  • AmeriHealth Caritas — Medicare: $85.40
  • BCBS of Western NY — Medicare Advantage: $74.82
  • Cigna — Medicare: $89.67
  • Galaxy Health Plan — Commercial: $244
  • Geisinger — Commercial: $244
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ESTAB PT OFFICE VISIT; LEVEL 3 $305 $183 $228.75 – $244
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $244
  • Geisinger — Commercial: $228.75
  • Humana — Commercial: $244
  • InterGroup — PPO: $244
  • Multiplan — PPO/Auto: $244
  • Multiplan — Worker's Compensation: $244
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTAB PT OFFICE VISIT; LEVEL 4 $455 $273 $51.57 – $373.10
Established patient office visit (about 30–39 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $57.14
  • Aetna — Commercial: $373.10
  • Aetna — Medicare: $138.78
  • AmeriHealth Caritas — Community HealthChoices (CHC): $130.59
  • AmeriHealth Caritas — Medicaid: $130.59
  • AmeriHealth Caritas — Medicare: $127.40
  • BCBS of Western NY — Medicare Advantage: $110.60
  • Cigna — Medicare: $133.77
  • Galaxy Health Plan — Commercial: $364
  • Geisinger — Commercial: $364
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ESTAB PT OFFICE VISIT; LEVEL 4 $455 $273 $341.25 – $364
Established patient office visit (about 30–39 minutes): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $364
  • Geisinger — Commercial: $341.25
  • Humana — Commercial: $364
  • InterGroup — PPO: $364
  • Multiplan — PPO/Auto: $364
  • Multiplan — Worker's Compensation: $364
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION $599 $359.40 $128.83 – $564.28
Office consultation with a specialist (moderate): 10 of 31 insurance plan rates
  • Aetna — Commercial: $491.18
  • Aetna — Medicare: $182.69
  • AmeriHealth Caritas — Community HealthChoices (CHC): $171.91
  • AmeriHealth Caritas — Medicaid: $171.91
  • AmeriHealth Caritas — Medicare: $167.72
  • BCBS of Western NY — Medicare Advantage: $128.83
  • Cigna — Medicare: $176.11
  • Galaxy Health Plan — Commercial: $479.20
  • Geisinger — Commercial: $479.20
  • Geisinger — Medicaid: $329.45
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION $599 $359.40 $449.25 – $479.20
Office consultation with a specialist (moderate): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $479.20
  • Geisinger — Commercial: $449.25
  • Humana — Commercial: $479.20
  • InterGroup — PPO: $479.20
  • Multiplan — PPO/Auto: $479.20
  • Multiplan — Worker's Compensation: $479.20
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION $895 $537 $168 – $808.36
Office consultation with a specialist (moderate to high): 10 of 31 insurance plan rates
  • Aetna — Commercial: $733.90
  • Aetna — Medicare: $272.98
  • AmeriHealth Caritas — Community HealthChoices (CHC): $256.87
  • AmeriHealth Caritas — Medicaid: $256.87
  • AmeriHealth Caritas — Medicare: $250.60
  • BCBS of Western NY — Medicare Advantage: $193.20
  • Cigna — Medicare: $263.13
  • Galaxy Health Plan — Commercial: $716
  • Geisinger — Commercial: $716
  • Geisinger — Medicaid: $492.25
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE CONSULTATION $895 $537 $671.25 – $716
Office consultation with a specialist (moderate to high): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $716
  • Geisinger — Commercial: $671.25
  • Humana — Commercial: $716
  • InterGroup — PPO: $716
  • Multiplan — PPO/Auto: $716
  • Multiplan — Worker's Compensation: $716
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL III EMERGENCY RM VISIT $457 $274.20 $39.46 – $781
Emergency room visit (moderate): 10 of 35 insurance plan rates
  • Aetna — CHIP/Medicaid: $59.48
  • Aetna — Commercial: $781
  • Aetna — Medicare: $139.38
  • AmeriHealth Caritas — Community HealthChoices (CHC): $39.46
  • AmeriHealth Caritas — Medicaid: $39.46
  • AmeriHealth Caritas — Medicare: $127.96
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $272.94
  • BCBS of Western NY — Commercial/Medicaid: $374.89
  • BCBS of Western NY — Medicare Advantage: $374.89
  • Cigna — Medicare: $134.36
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT LEVEL 3 $223 $133.80 $39.46 – $781
Emergency room visit (moderate): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $59.48
  • Aetna — Commercial: $781
  • Aetna — Medicare: $68.02
  • AmeriHealth Caritas — Community HealthChoices (CHC): $39.46
  • AmeriHealth Caritas — Medicaid: $39.46
  • AmeriHealth Caritas — Medicare: $62.44
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $272.94
  • BCBS of Western NY — Commercial/Medicaid: $374.89
  • BCBS of Western NY — Medicare Advantage: $374.89
  • Cigna — Medicare: $65.56
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED;DETAILED $223 $133.80 $39.46 – $781
Emergency room visit (moderate): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $59.48
  • Aetna — Commercial: $781
  • Aetna — Medicare: $68.02
  • AmeriHealth Caritas — Community HealthChoices (CHC): $39.46
  • AmeriHealth Caritas — Medicaid: $39.46
  • AmeriHealth Caritas — Medicare: $62.44
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $272.94
  • BCBS of Western NY — Commercial/Medicaid: $374.89
  • BCBS of Western NY — Medicare Advantage: $374.89
  • Cigna — Medicare: $65.56
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL IV EMERGENCY RM VISIT $595 $357 $56.38 – $909
Emergency room visit (moderately high): 10 of 35 insurance plan rates
  • Aetna — CHIP/Medicaid: $100.10
  • Aetna — Commercial: $909
  • Aetna — Medicare: $181.47
  • AmeriHealth Caritas — Community HealthChoices (CHC): $56.38
  • AmeriHealth Caritas — Medicaid: $56.38
  • AmeriHealth Caritas — Medicare: $166.60
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $432.27
  • BCBS of Western NY — Commercial/Medicaid: $593.73
  • BCBS of Western NY — Medicare Advantage: $593.73
  • Cigna — Medicare: $174.93
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED;COMPREHENSIVE $377 $226.20 $56.38 – $909
Emergency room visit (moderately high): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $100.10
  • Aetna — Commercial: $909
  • Aetna — Medicare: $114.98
  • AmeriHealth Caritas — Community HealthChoices (CHC): $56.38
  • AmeriHealth Caritas — Medicaid: $56.38
  • AmeriHealth Caritas — Medicare: $105.56
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $432.27
  • BCBS of Western NY — Commercial/Medicaid: $593.73
  • BCBS of Western NY — Medicare Advantage: $593.73
  • Cigna — Medicare: $110.84
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT LEVEL 4 $377 $226.20 $56.38 – $909
Emergency room visit (moderately high): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $100.10
  • Aetna — Commercial: $909
  • Aetna — Medicare: $114.98
  • AmeriHealth Caritas — Community HealthChoices (CHC): $56.38
  • AmeriHealth Caritas — Medicaid: $56.38
  • AmeriHealth Caritas — Medicare: $105.56
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $432.27
  • BCBS of Western NY — Commercial/Medicaid: $593.73
  • BCBS of Western NY — Medicare Advantage: $593.73
  • Cigna — Medicare: $110.84
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL V EMERGENCY ROOM VISIT $1,050 $630 $56.38 – $909
Emergency room visit (high): 10 of 35 insurance plan rates
  • Aetna — CHIP/Medicaid: $145.68
  • Aetna — Commercial: $909
  • Aetna — Medicare: $320.25
  • AmeriHealth Caritas — Community HealthChoices (CHC): $56.38
  • AmeriHealth Caritas — Medicaid: $56.38
  • AmeriHealth Caritas — Medicare: $294
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $553.93
  • BCBS of Western NY — Commercial/Medicaid: $760.81
  • BCBS of Western NY — Medicare Advantage: $760.81
  • Cigna — Medicare: $308.70
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED LEVEL V $552 $331.20 $56.38 – $909
Emergency room visit (high): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $145.68
  • Aetna — Commercial: $909
  • Aetna — Medicare: $168.36
  • AmeriHealth Caritas — Community HealthChoices (CHC): $56.38
  • AmeriHealth Caritas — Medicaid: $56.38
  • AmeriHealth Caritas — Medicare: $154.56
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $553.93
  • BCBS of Western NY — Commercial/Medicaid: $760.81
  • BCBS of Western NY — Medicare Advantage: $760.81
  • Cigna — Medicare: $162.29
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED;EXTENSIVE $552 $331.20 $56.38 – $909
Emergency room visit (high): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $145.68
  • Aetna — Commercial: $909
  • Aetna — Medicare: $168.36
  • AmeriHealth Caritas — Community HealthChoices (CHC): $56.38
  • AmeriHealth Caritas — Medicaid: $56.38
  • AmeriHealth Caritas — Medicare: $154.56
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $553.93
  • BCBS of Western NY — Commercial/Medicaid: $760.81
  • BCBS of Western NY — Medicare Advantage: $760.81
  • Cigna — Medicare: $162.29

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL-LC SCRN $136 $81.60 $5.50 – $108.80
Basic metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $9.83
  • Aetna — Commercial: $12.69
  • Aetna — Medicare: $41.48
  • AmeriHealth Caritas — Community HealthChoices (CHC): $39.03
  • AmeriHealth Caritas — Medicaid: $39.03
  • AmeriHealth Caritas — Medicare: $38.08
  • BCBS of Western NY — Medicare Advantage: $5.50
  • Cigna — Medicare: $39.98
  • Galaxy Health Plan — Commercial: $108.80
  • Geisinger — Commercial: $108.80
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL-LC SCRN $136 $81.60 $102 – $108.80
Basic metabolic panel (blood test): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $108.80
  • Geisinger — Commercial: $102
  • Humana — Commercial: $108.80
  • InterGroup — PPO: $108.80
  • Multiplan — PPO/Auto: $108.80
  • Multiplan — Worker's Compensation: $108.80
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREH METABOLIC PANEL-LC SCR $168 $100.80 $6.86 – $134.40
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $12.27
  • Aetna — Commercial: $15.84
  • Aetna — Medicare: $51.24
  • AmeriHealth Caritas — Community HealthChoices (CHC): $48.22
  • AmeriHealth Caritas — Medicaid: $48.22
  • AmeriHealth Caritas — Medicare: $47.04
  • BCBS of Western NY — Medicare Advantage: $6.86
  • Cigna — Medicare: $49.39
  • Galaxy Health Plan — Commercial: $134.40
  • Geisinger — Commercial: $134.40
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREH METABOLIC PANEL-LC SCR $168 $100.80 $126 – $134.40
Comprehensive metabolic panel (blood test): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $134.40
  • Geisinger — Commercial: $126
  • Humana — Commercial: $134.40
  • InterGroup — PPO: $134.40
  • Multiplan — PPO/Auto: $134.40
  • Multiplan — Worker's Compensation: $134.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL - LC SCREENING $163 $97.80 $8.70 – $130.40
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $14.70
  • Aetna — Commercial: $20.09
  • Aetna — Medicare: $49.72
  • AmeriHealth Caritas — Community HealthChoices (CHC): $46.78
  • AmeriHealth Caritas — Medicaid: $46.78
  • AmeriHealth Caritas — Medicare: $45.64
  • BCBS of Western NY — Medicare Advantage: $8.70
  • Cigna — Medicare: $47.92
  • Galaxy Health Plan — Commercial: $130.40
  • Geisinger — Commercial: $130.40
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL - LC SCREENING $163 $97.80 $122.25 – $130.40
Cholesterol panel (lipid panel): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $130.40
  • Geisinger — Commercial: $122.25
  • Humana — Commercial: $130.40
  • InterGroup — PPO: $130.40
  • Multiplan — PPO/Auto: $130.40
  • Multiplan — Worker's Compensation: $130.40
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $138 $82.80 $5.64 – $110.40
Kidney function panel: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $10.08
  • Aetna — Commercial: $13.02
  • Aetna — Medicare: $42.09
  • AmeriHealth Caritas — Community HealthChoices (CHC): $39.61
  • AmeriHealth Caritas — Medicaid: $39.61
  • AmeriHealth Caritas — Medicare: $38.64
  • BCBS of Western NY — Medicare Advantage: $5.64
  • Cigna — Medicare: $40.57
  • Galaxy Health Plan — Commercial: $110.40
  • Geisinger — Commercial: $110.40
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $138 $82.80 $103.50 – $110.40
Kidney function panel: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $110.40
  • Geisinger — Commercial: $103.50
  • Humana — Commercial: $110.40
  • InterGroup — PPO: $110.40
  • Multiplan — PPO/Auto: $110.40
  • Multiplan — Worker's Compensation: $110.40
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL-LC SCRN $132 $79.20 $5.31 – $105.60
Liver function panel: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $9.48
  • Aetna — Commercial: $12.26
  • Aetna — Medicare: $40.26
  • AmeriHealth Caritas — Community HealthChoices (CHC): $37.88
  • AmeriHealth Caritas — Medicaid: $37.88
  • AmeriHealth Caritas — Medicare: $36.96
  • BCBS of Western NY — Medicare Advantage: $5.31
  • Cigna — Medicare: $38.81
  • Galaxy Health Plan — Commercial: $105.60
  • Geisinger — Commercial: $105.60
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL-LC SCRN $132 $79.20 $99 – $105.60
Liver function panel: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $105.60
  • Geisinger — Commercial: $99
  • Humana — Commercial: $105.60
  • InterGroup — PPO: $105.60
  • Multiplan — PPO/Auto: $105.60
  • Multiplan — Worker's Compensation: $105.60
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE FOR KEOTONES $57 $34.20 $2.06 – $53
Urine test (automated, with microscope): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $3.15
  • Aetna — Commercial: $4.75
  • Aetna — Medicare: $17.39
  • AmeriHealth Caritas — Community HealthChoices (CHC): $16.36
  • AmeriHealth Caritas — Medicaid: $16.36
  • AmeriHealth Caritas — Medicare: $15.96
  • BCBS of Western NY — Medicare Advantage: $2.06
  • Cigna — Medicare: $16.76
  • Galaxy Health Plan — Commercial: $45.60
  • Geisinger — Commercial: $45.60
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINE FOR KEOTONES $57 $34.20 $42.75 – $45.60
Urine test (automated, with microscope): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $45.60
  • Geisinger — Commercial: $42.75
  • Humana — Commercial: $45.60
  • InterGroup — PPO: $45.60
  • Multiplan — PPO/Auto: $45.60
  • Multiplan — Worker's Compensation: $45.60
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OCC HEALTH URINE DIP $33 $19.80 $2.26 – $53
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $3.75
  • Aetna — Commercial: $5.22
  • Aetna — Medicare: $10.06
  • AmeriHealth Caritas — Community HealthChoices (CHC): $9.47
  • AmeriHealth Caritas — Medicaid: $9.47
  • AmeriHealth Caritas — Medicare: $9.24
  • BCBS of Western NY — Medicare Advantage: $2.26
  • Cigna — Medicare: $9.70
  • Galaxy Health Plan — Commercial: $26.40
  • Geisinger — Commercial: $26.40
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OCC HEALTH URINE DIP $33 $19.80 $24.75 – $26.40
Urine test (manual, without microscope): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $26.40
  • Geisinger — Commercial: $24.75
  • Humana — Commercial: $26.40
  • InterGroup — PPO: $26.40
  • Multiplan — PPO/Auto: $26.40
  • Multiplan — Worker's Compensation: $26.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY FLUID $32 $19.20 $1.46 – $53
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $3.25
  • Aetna — Commercial: $3.38
  • Aetna — Medicare: $9.76
  • AmeriHealth Caritas — Community HealthChoices (CHC): $9.18
  • AmeriHealth Caritas — Medicaid: $9.18
  • AmeriHealth Caritas — Medicare: $8.96
  • BCBS of Western NY — Medicare Advantage: $1.46
  • Cigna — Medicare: $9.41
  • Galaxy Health Plan — Commercial: $25.60
  • Geisinger — Commercial: $25.60
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY FLUID $32 $19.20 $24 – $25.60
Urine test (automated, without microscope): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $25.60
  • Geisinger — Commercial: $24
  • Humana — Commercial: $25.60
  • InterGroup — PPO: $25.60
  • Multiplan — PPO/Auto: $25.60
  • Multiplan — Worker's Compensation: $25.60
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL $209 $125.40 $11.95 – $167.20
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $25.58
  • Aetna — Commercial: $27.59
  • Aetna — Medicare: $63.74
  • AmeriHealth Caritas — Community HealthChoices (CHC): $59.98
  • AmeriHealth Caritas — Medicaid: $59.98
  • AmeriHealth Caritas — Medicare: $58.52
  • BCBS of Western NY — Medicare Advantage: $11.95
  • Cigna — Medicare: $61.45
  • Galaxy Health Plan — Commercial: $167.20
  • Geisinger — Commercial: $167.20
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA TOTAL $209 $125.40 $156.75 – $167.20
PSA (prostate specific antigen) blood test: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $167.20
  • Geisinger — Commercial: $156.75
  • Humana — Commercial: $167.20
  • InterGroup — PPO: $167.20
  • Multiplan — PPO/Auto: $167.20
  • Multiplan — Worker's Compensation: $167.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH - LC SCREENING $131 $78.60 $10.92 – $104.80
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $24.37
  • Aetna — Commercial: $25.20
  • Aetna — Medicare: $39.95
  • AmeriHealth Caritas — Community HealthChoices (CHC): $37.60
  • AmeriHealth Caritas — Medicaid: $37.60
  • AmeriHealth Caritas — Medicare: $36.68
  • BCBS of Western NY — Medicare Advantage: $10.92
  • Cigna — Medicare: $38.51
  • Galaxy Health Plan — Commercial: $104.80
  • Geisinger — Commercial: $104.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TSH - LC SCREENING $131 $78.60 $98.25 – $104.80
Thyroid stimulating hormone (TSH) test: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $104.80
  • Geisinger — Commercial: $98.25
  • Humana — Commercial: $104.80
  • InterGroup — PPO: $104.80
  • Multiplan — PPO/Auto: $104.80
  • Multiplan — Worker's Compensation: $104.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC-LC SCREENING $71 $42.60 $5.05 – $56.80
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $6.30
  • Aetna — Commercial: $11.65
  • Aetna — Medicare: $21.66
  • AmeriHealth Caritas — Community HealthChoices (CHC): $20.38
  • AmeriHealth Caritas — Medicaid: $20.38
  • AmeriHealth Caritas — Medicare: $19.88
  • BCBS of Western NY — Medicare Advantage: $5.05
  • Cigna — Medicare: $20.87
  • Galaxy Health Plan — Commercial: $56.80
  • Geisinger — Commercial: $56.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC-LC SCREENING $71 $42.60 $53.25 – $56.80
Complete blood count (CBC) with differential: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $56.80
  • Geisinger — Commercial: $53.25
  • Humana — Commercial: $56.80
  • InterGroup — PPO: $56.80
  • Multiplan — PPO/Auto: $56.80
  • Multiplan — Worker's Compensation: $56.80
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC COMPLETE AUTO $78 $46.80 $4.21 – $62.40
Complete blood count (CBC), automated: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $7.90
  • Aetna — Commercial: $9.71
  • Aetna — Medicare: $23.79
  • AmeriHealth Caritas — Community HealthChoices (CHC): $22.39
  • AmeriHealth Caritas — Medicaid: $22.39
  • AmeriHealth Caritas — Medicare: $21.84
  • BCBS of Western NY — Medicare Advantage: $4.21
  • Cigna — Medicare: $22.93
  • Galaxy Health Plan — Commercial: $62.40
  • Geisinger — Commercial: $62.40
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC COMPLETE AUTO $78 $46.80 $58.50 – $62.40
Complete blood count (CBC), automated: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $62.40
  • Geisinger — Commercial: $58.50
  • Humana — Commercial: $62.40
  • InterGroup — PPO: $62.40
  • Multiplan — PPO/Auto: $62.40
  • Multiplan — Worker's Compensation: $62.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CIRCULATING ANTICOAGULANT $51 $30.60 $2.79 – $53
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $4.20
  • Aetna — Commercial: $6.43
  • Aetna — Medicare: $15.55
  • AmeriHealth Caritas — Community HealthChoices (CHC): $14.64
  • AmeriHealth Caritas — Medicaid: $14.64
  • AmeriHealth Caritas — Medicare: $14.28
  • BCBS of Western NY — Medicare Advantage: $2.79
  • Cigna — Medicare: $14.99
  • Galaxy Health Plan — Commercial: $40.80
  • Geisinger — Commercial: $40.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CIRCULATING ANTICOAGULANT $51 $30.60 $38.25 – $40.80
Blood clotting time test (prothrombin time, PT): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $40.80
  • Geisinger — Commercial: $38.25
  • Humana — Commercial: $40.80
  • InterGroup — PPO: $40.80
  • Multiplan — PPO/Auto: $40.80
  • Multiplan — Worker's Compensation: $40.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PARTIAL THROMBOPLASTIN TIME $74 $44.40 $3.91 – $59.20
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $7.88
  • Aetna — Commercial: $9.02
  • Aetna — Medicare: $22.57
  • AmeriHealth Caritas — Community HealthChoices (CHC): $21.24
  • AmeriHealth Caritas — Medicaid: $21.24
  • AmeriHealth Caritas — Medicare: $20.72
  • BCBS of Western NY — Medicare Advantage: $3.91
  • Cigna — Medicare: $21.76
  • Galaxy Health Plan — Commercial: $59.20
  • Geisinger — Commercial: $59.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PARTIAL THROMBOPLASTIN TIME $74 $44.40 $55.50 – $59.20
Blood clotting test (partial thromboplastin time, PTT): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $59.20
  • Geisinger — Commercial: $55.50
  • Humana — Commercial: $59.20
  • InterGroup — PPO: $59.20
  • Multiplan — PPO/Auto: $59.20
  • Multiplan — Worker's Compensation: $59.20

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD W/O CONTRAST VIZ.AI $1,255 $753 $115.89 – $1,279
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $122.59
  • Aetna — Commercial: $223.78
  • Aetna — Medicare: $382.77
  • AmeriHealth Caritas — Community HealthChoices (CHC): $360.19
  • AmeriHealth Caritas — Medicaid: $360.19
  • AmeriHealth Caritas — Medicare: $351.40
  • BCBS of Western NY — Medicare Advantage: $115.89
  • Cigna — Medicare: $368.97
  • Galaxy Health Plan — Commercial: $1,004
  • Geisinger — Commercial: $1,004
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD W/O CONTRAST-TECH $1,255 $753 $115.89 – $1,279
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $122.59
  • Aetna — Commercial: $223.78
  • Aetna — Medicare: $382.77
  • AmeriHealth Caritas — Community HealthChoices (CHC): $360.19
  • AmeriHealth Caritas — Medicaid: $360.19
  • AmeriHealth Caritas — Medicare: $351.40
  • BCBS of Western NY — Medicare Advantage: $115.89
  • Cigna — Medicare: $368.97
  • Galaxy Health Plan — Commercial: $1,004
  • Geisinger — Commercial: $1,004
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD W/O CONTRAST VIZ.AI $1,255 $753 $941.25 – $1,004
CT scan of the head or brain, without contrast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,004
  • Geisinger — Commercial: $941.25
  • Humana — Commercial: $1,004
  • InterGroup — PPO: $1,004
  • Multiplan — PPO/Auto: $1,004
  • Multiplan — Worker's Compensation: $1,004
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN W/WO CONTRAST $3,183 $1,909.80 $355.95 – $3,812.26
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $355.95
  • Aetna — Commercial: $667.24
  • Aetna — Medicare: $970.82
  • AmeriHealth Caritas — Community HealthChoices (CHC): $913.52
  • AmeriHealth Caritas — Medicaid: $913.52
  • AmeriHealth Caritas — Medicare: $891.24
  • BCBS of Western NY — Medicare Advantage: $376.47
  • Cigna — Medicare: $935.80
  • Galaxy Health Plan — Commercial: $2,546.40
  • Geisinger — Commercial: $2,546.40
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN W/WO CONTRAST $3,183 $1,909.80 $2,387.25 – $2,546.40
MRI of the brain, before and after contrast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $2,546.40
  • Geisinger — Commercial: $2,387.25
  • Humana — Commercial: $2,546.40
  • InterGroup — PPO: $2,546.40
  • Multiplan — PPO/Auto: $2,546.40
  • Multiplan — Worker's Compensation: $2,546.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST W/INSTP & EXSP $251 $150.60 $24.82 – $200.80
Chest X-ray, 2 views: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $24.82
  • Aetna — Commercial: $69.30
  • Aetna — Medicare: $76.56
  • AmeriHealth Caritas — Community HealthChoices (CHC): $72.04
  • AmeriHealth Caritas — Medicaid: $72.04
  • AmeriHealth Caritas — Medicare: $70.28
  • BCBS of Western NY — Medicare Advantage: $31.35
  • Cigna — Medicare: $73.79
  • Galaxy Health Plan — Commercial: $200.80
  • Geisinger — Commercial: $200.80
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHEST W/INSTP & EXSP $251 $150.60 $188.25 – $200.80
Chest X-ray, 2 views: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $200.80
  • Geisinger — Commercial: $188.25
  • Humana — Commercial: $200.80
  • InterGroup — PPO: $200.80
  • Multiplan — PPO/Auto: $200.80
  • Multiplan — Worker's Compensation: $200.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUMBO/SACRAL SPINE $488 $292.80 $38.45 – $390.40
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $38.45
  • Aetna — Commercial: $106.63
  • Aetna — Medicare: $148.84
  • AmeriHealth Caritas — Community HealthChoices (CHC): $140.06
  • AmeriHealth Caritas — Medicaid: $140.06
  • AmeriHealth Caritas — Medicare: $136.64
  • BCBS of Western NY — Medicare Advantage: $47.02
  • Cigna — Medicare: $143.47
  • Galaxy Health Plan — Commercial: $390.40
  • Geisinger — Commercial: $390.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LUMBO/SACRAL SPINE $488 $292.80 $366 – $390.40
X-ray of the lower spine, at least 4 views: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $390.40
  • Geisinger — Commercial: $366
  • Humana — Commercial: $390.40
  • InterGroup — PPO: $390.40
  • Multiplan — PPO/Auto: $390.40
  • Multiplan — Worker's Compensation: $390.40
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 CONTRAST $1,720 $1,032 $223.32 – $1,977
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $268.96
  • Aetna — Commercial: $400.50
  • Aetna — Medicare: $524.60
  • AmeriHealth Caritas — Community HealthChoices (CHC): $493.64
  • AmeriHealth Caritas — Medicaid: $493.64
  • AmeriHealth Caritas — Medicare: $481.60
  • BCBS of Western NY — Medicare Advantage: $223.32
  • Cigna — Medicare: $505.68
  • Galaxy Health Plan — Commercial: $1,376
  • Geisinger — Commercial: $1,376
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O CONTRAST $1,720 $1,032 $1,290 – $1,376
MRI of the lower back (lumbar spine), without contrast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,376
  • Geisinger — Commercial: $1,290
  • Humana — Commercial: $1,376
  • InterGroup — PPO: $1,376
  • Multiplan — PPO/Auto: $1,376
  • Multiplan — Worker's Compensation: $1,376
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTR & VENOGRAM $1,133 $679.80 $147.09 – $1,279
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $147.09
  • Aetna — Commercial: $471.67
  • Aetna — Medicare: $345.56
  • AmeriHealth Caritas — Community HealthChoices (CHC): $325.17
  • AmeriHealth Caritas — Medicaid: $325.17
  • AmeriHealth Caritas — Medicare: $317.24
  • BCBS of Western NY — Medicare Advantage: $228.53
  • Cigna — Medicare: $333.10
  • Galaxy Health Plan — Commercial: $906.40
  • Geisinger — Commercial: $906.40
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTR & VENOGRAM $1,133 $679.80 $849.75 – $906.40
CT scan of the pelvis, with contrast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $906.40
  • Geisinger — Commercial: $849.75
  • Humana — Commercial: $906.40
  • InterGroup — PPO: $906.40
  • Multiplan — PPO/Auto: $906.40
  • Multiplan — Worker's Compensation: $906.40
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOWER EXT JOINT W/O CONT $1,611 $966.60 $236.03 – $1,977
MRI of a leg joint (such as the knee), without contrast: 10 of 31 insurance plan rates
  • Aetna — Commercial: $424.78
  • Aetna — Medicare: $491.36
  • AmeriHealth Caritas — Community HealthChoices (CHC): $462.36
  • AmeriHealth Caritas — Medicaid: $462.36
  • AmeriHealth Caritas — Medicare: $451.08
  • BCBS of Western NY — Medicare Advantage: $236.03
  • Cigna — Medicare: $473.63
  • Galaxy Health Plan — Commercial: $1,288.80
  • Geisinger — Commercial: $1,288.80
  • Geisinger — Medicaid: $886.05
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LOWER EXT JOINT W/O CONT $1,611 $966.60 $1,208.25 – $1,288.80
MRI of a leg joint (such as the knee), without contrast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,288.80
  • Geisinger — Commercial: $1,208.25
  • Humana — Commercial: $1,288.80
  • InterGroup — PPO: $1,288.80
  • Multiplan — PPO/Auto: $1,288.80
  • Multiplan — Worker's Compensation: $1,288.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W/CONTRAST $2,385 $1,431 $276.32 – $3,952.42
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $276.32
  • Aetna — Commercial: $629.66
  • Aetna — Medicare: $727.42
  • AmeriHealth Caritas — Community HealthChoices (CHC): $684.50
  • AmeriHealth Caritas — Medicaid: $684.50
  • AmeriHealth Caritas — Medicare: $667.80
  • BCBS of Western NY — Medicare Advantage: $329.36
  • Cigna — Medicare: $701.19
  • Galaxy Health Plan — Commercial: $1,908
  • Geisinger — Commercial: $1,908
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W/CONTRAST $2,385 $1,431 $1,788.75 – $1,908
CT scan of the abdomen and pelvis, with contrast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,908
  • Geisinger — Commercial: $1,788.75
  • Humana — Commercial: $1,908
  • InterGroup — PPO: $1,908
  • Multiplan — PPO/Auto: $1,908
  • Multiplan — Worker's Compensation: $1,908
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHCUS ABDOMEN $732 $439.20 $100.03 – $585.60
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $100.03
  • Aetna — Commercial: $237.74
  • Aetna — Medicare: $223.26
  • AmeriHealth Caritas — Community HealthChoices (CHC): $210.08
  • AmeriHealth Caritas — Medicaid: $210.08
  • AmeriHealth Caritas — Medicare: $204.96
  • BCBS of Western NY — Medicare Advantage: $120.81
  • Cigna — Medicare: $215.21
  • Galaxy Health Plan — Commercial: $585.60
  • Geisinger — Commercial: $585.60
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PHCUS ABDOMEN $732 $439.20 $549 – $585.60
Ultrasound of the abdomen, complete: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $585.60
  • Geisinger — Commercial: $549
  • Humana — Commercial: $585.60
  • InterGroup — PPO: $585.60
  • Multiplan — PPO/Auto: $585.60
  • Multiplan — Worker's Compensation: $585.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHCUS PREG FETAL 20 WEEKS $1,054 $632.40 $81.38 – $843.20
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $81.38
  • Aetna — Commercial: $276.46
  • Aetna — Medicare: $321.47
  • AmeriHealth Caritas — Community HealthChoices (CHC): $302.50
  • AmeriHealth Caritas — Medicaid: $302.50
  • AmeriHealth Caritas — Medicare: $295.12
  • BCBS of Western NY — Medicare Advantage: $139.23
  • Cigna — Medicare: $309.88
  • Galaxy Health Plan — Commercial: $843.20
  • Geisinger — Commercial: $843.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PHCUS PREG FETAL 20 WEEKS $1,054 $632.40 $790.50 – $843.20
Pregnancy ultrasound (after the first trimester): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $843.20
  • Geisinger — Commercial: $790.50
  • Humana — Commercial: $843.20
  • InterGroup — PPO: $843.20
  • Multiplan — PPO/Auto: $843.20
  • Multiplan — Worker's Compensation: $843.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PHCUS TRANSVAG GYN $562 $337.20 $80.33 – $572.83
Transvaginal ultrasound: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $80.33
  • Aetna — Commercial: $241.81
  • Aetna — Medicare: $171.41
  • AmeriHealth Caritas — Community HealthChoices (CHC): $161.29
  • AmeriHealth Caritas — Medicaid: $161.29
  • AmeriHealth Caritas — Medicare: $157.36
  • BCBS of Western NY — Medicare Advantage: $117.97
  • Cigna — Medicare: $165.23
  • Galaxy Health Plan — Commercial: $449.60
  • Geisinger — Commercial: $449.60
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PHCUS TRANSVAG GYN $562 $337.20 $421.50 – $449.60
Transvaginal ultrasound: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $449.60
  • Geisinger — Commercial: $421.50
  • Humana — Commercial: $449.60
  • InterGroup — PPO: $449.60
  • Multiplan — PPO/Auto: $449.60
  • Multiplan — Worker's Compensation: $449.60
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO-UNILATERAL $600 $360 $107.53 – $572.83
Diagnostic mammogram, one breast: 10 of 32 insurance plan rates
  • Aetna — CHIP/Medicaid: $107.53
  • Aetna — Commercial: $258.64
  • Aetna — Medicare: $183
  • AmeriHealth Caritas — Community HealthChoices (CHC): $172.20
  • AmeriHealth Caritas — Medicaid: $172.20
  • AmeriHealth Caritas — Medicare: $168
  • BCBS of Western NY — Medicare Advantage: $130.01
  • Cigna — Medicare: $176.40
  • Galaxy Health Plan — Commercial: $480
  • Geisinger — Commercial: $480
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO-UNILATERAL $600 $360 $450 – $480
Diagnostic mammogram, one breast: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $480
  • Geisinger — Commercial: $450
  • Humana — Commercial: $480
  • InterGroup — PPO: $480
  • Multiplan — PPO/Auto: $480
  • Multiplan — Worker's Compensation: $480
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO-DIAG BILAT W/WO CAD $764 $458.40 $136.34 – $730.23
Diagnostic mammogram, both breasts: 10 of 32 insurance plan rates
  • Aetna — CHIP/Medicaid: $136.34
  • Aetna — Commercial: $325.78
  • Aetna — Medicare: $233.02
  • AmeriHealth Caritas — Community HealthChoices (CHC): $219.27
  • AmeriHealth Caritas — Medicaid: $219.27
  • AmeriHealth Caritas — Medicare: $213.92
  • BCBS of Western NY — Medicare Advantage: $164.56
  • Cigna — Medicare: $224.62
  • Galaxy Health Plan — Commercial: $611.20
  • Geisinger — Commercial: $611.20
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO-DIAG BILAT W/WO CAD $764 $458.40 $573 – $611.20
Diagnostic mammogram, both breasts: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $611.20
  • Geisinger — Commercial: $573
  • Humana — Commercial: $611.20
  • InterGroup — PPO: $611.20
  • Multiplan — PPO/Auto: $611.20
  • Multiplan — Worker's Compensation: $611.20
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO-SCREENING W/WO CAD $635 $381 $109.94 – $605.61
Screening mammogram, both breasts: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $109.94
  • Aetna — Commercial: $263.77
  • Aetna — Medicare: $193.68
  • AmeriHealth Caritas — Community HealthChoices (CHC): $182.25
  • AmeriHealth Caritas — Medicaid: $182.25
  • AmeriHealth Caritas — Medicare: $177.80
  • BCBS of Western NY — Medicare Advantage: $133.01
  • Cigna — Medicare: $186.69
  • Galaxy Health Plan — Commercial: $508
  • Geisinger — Commercial: $508
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO-SCREENING W/WO CAD $635 $381 $476.25 – $508
Screening mammogram, both breasts: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $508
  • Geisinger — Commercial: $476.25
  • Humana — Commercial: $508
  • InterGroup — PPO: $508
  • Multiplan — PPO/Auto: $508
  • Multiplan — Worker's Compensation: $508

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ONC ECG INTP/REP W/AT LEAST 1 $257 $154.20 $16.94 – $210.74
Electrocardiogram (ECG/EKG) with reading: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $20.18
  • Aetna — Commercial: $210.74
  • Aetna — Medicare: $78.39
  • AmeriHealth Caritas — Community HealthChoices (CHC): $73.76
  • AmeriHealth Caritas — Medicaid: $73.76
  • AmeriHealth Caritas — Medicare: $71.96
  • BCBS of Western NY — Medicare Advantage: $16.94
  • Cigna — Medicare: $75.56
  • Galaxy Health Plan — Commercial: $205.60
  • Geisinger — Commercial: $205.60
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ED PEDIATRIC EKG UPMC $87 $52.20 $16.94 – $74.89
Electrocardiogram (ECG/EKG) with reading: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $20.18
  • Aetna — Commercial: $71.34
  • Aetna — Medicare: $26.54
  • AmeriHealth Caritas — Community HealthChoices (CHC): $24.97
  • AmeriHealth Caritas — Medicaid: $24.97
  • AmeriHealth Caritas — Medicare: $24.36
  • BCBS of Western NY — Medicare Advantage: $16.94
  • Cigna — Medicare: $25.58
  • Galaxy Health Plan — Commercial: $69.60
  • Geisinger — Commercial: $69.60
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ONC ECG INTP/REP W/AT LEAST 1 $257 $154.20 $192.75 – $205.60
Electrocardiogram (ECG/EKG) with reading: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $205.60
  • Geisinger — Commercial: $192.75
  • Humana — Commercial: $205.60
  • InterGroup — PPO: $205.60
  • Multiplan — PPO/Auto: $205.60
  • Multiplan — Worker's Compensation: $205.60

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SME PT THER ES,ROM,END,FLX 15' $128 $76.80 $8.80 – $211
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $8.80
  • Aetna — Commercial: $30.64
  • Aetna — Medicare: $39.04
  • AmeriHealth Caritas — Community HealthChoices (CHC): $36.74
  • AmeriHealth Caritas — Medicaid: $36.74
  • AmeriHealth Caritas — Medicare: $35.84
  • BCBS of Western NY — Medicare Advantage: $45
  • Cigna — Medicare: $37.63
  • Galaxy Health Plan — Commercial: $102.40
  • Geisinger — Commercial: $102.40
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OT THER ES,ROM,END,FLX 15' $128 $76.80 $8.80 – $152
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $8.80
  • Aetna — Commercial: $30.64
  • Aetna — Medicare: $39.04
  • AmeriHealth Caritas — Community HealthChoices (CHC): $36.74
  • AmeriHealth Caritas — Medicaid: $36.74
  • AmeriHealth Caritas — Medicare: $35.84
  • BCBS of Western NY — Medicare Advantage: $45
  • Cigna — Medicare: $37.63
  • Galaxy Health Plan — Commercial: $102.40
  • Geisinger — Commercial: $102.40
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SME PT THER ES,ROM,END,FLX 15' $128 $76.80 $96 – $102.40
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $102.40
  • Geisinger — Commercial: $96
  • Humana — Commercial: $102.40
  • InterGroup — PPO: $102.40
  • Multiplan — PPO/Auto: $102.40
  • Multiplan — Worker's Compensation: $102.40
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SME PT EVAL LOW COMPLEXITY $469 $281.40 $84.11 – $386.38
Physical therapy evaluation (low complexity): 10 of 31 insurance plan rates
  • Aetna — Commercial: $104.28
  • Aetna — Medicare: $143.04
  • AmeriHealth Caritas — Community HealthChoices (CHC): $134.60
  • AmeriHealth Caritas — Medicaid: $134.60
  • AmeriHealth Caritas — Medicare: $131.32
  • BCBS of Western NY — Medicare Advantage: $84.11
  • Cigna — Medicare: $137.89
  • Galaxy Health Plan — Commercial: $375.20
  • Geisinger — Commercial: $375.20
  • Geisinger — Medicaid: $257.95
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SME PT EVAL LOW COMPLEXITY $469 $281.40 $351.75 – $375.20
Physical therapy evaluation (low complexity): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $375.20
  • Geisinger — Commercial: $351.75
  • Humana — Commercial: $375.20
  • InterGroup — PPO: $375.20
  • Multiplan — PPO/Auto: $375.20
  • Multiplan — Worker's Compensation: $375.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SME PT EVAL MOD COMPLEXITY $469 $281.40 $84.11 – $386.38
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates
  • Aetna — Commercial: $104.28
  • Aetna — Medicare: $143.04
  • AmeriHealth Caritas — Community HealthChoices (CHC): $134.60
  • AmeriHealth Caritas — Medicaid: $134.60
  • AmeriHealth Caritas — Medicare: $131.32
  • BCBS of Western NY — Medicare Advantage: $84.11
  • Cigna — Medicare: $137.89
  • Galaxy Health Plan — Commercial: $375.20
  • Geisinger — Commercial: $375.20
  • Geisinger — Medicaid: $257.95
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SME PT EVAL MOD COMPLEXITY $469 $281.40 $351.75 – $375.20
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $375.20
  • Geisinger — Commercial: $351.75
  • Humana — Commercial: $375.20
  • InterGroup — PPO: $375.20
  • Multiplan — PPO/Auto: $375.20
  • Multiplan — Worker's Compensation: $375.20
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SME PT EVAL HIGH COMPLEXITY $469 $281.40 $84.11 – $386.38
Physical therapy evaluation (high complexity): 10 of 31 insurance plan rates
  • Aetna — Commercial: $104.28
  • Aetna — Medicare: $143.04
  • AmeriHealth Caritas — Community HealthChoices (CHC): $134.60
  • AmeriHealth Caritas — Medicaid: $134.60
  • AmeriHealth Caritas — Medicare: $131.32
  • BCBS of Western NY — Medicare Advantage: $84.11
  • Cigna — Medicare: $137.89
  • Galaxy Health Plan — Commercial: $375.20
  • Geisinger — Commercial: $375.20
  • Geisinger — Medicaid: $257.95
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SME PT EVAL HIGH COMPLEXITY $469 $281.40 $351.75 – $375.20
Physical therapy evaluation (high complexity): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $375.20
  • Geisinger — Commercial: $351.75
  • Humana — Commercial: $375.20
  • InterGroup — PPO: $375.20
  • Multiplan — PPO/Auto: $375.20
  • Multiplan — Worker's Compensation: $375.20

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXCISION OF CYST $1,034 $620.40 $181.65 – $2,795.54
Removal of breast growth (open surgery): 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $181.65
  • Aetna — Commercial: $847.88
  • Aetna — Medicare: $315.37
  • AmeriHealth Caritas — Community HealthChoices (CHC): $296.76
  • AmeriHealth Caritas — Medicaid: $296.76
  • AmeriHealth Caritas — Medicare: $289.52
  • BCBS of Western NY — Medicare Advantage: $1,192.92
  • Cigna — Medicare: $304
  • Galaxy Health Plan — Commercial: $827.20
  • Geisinger — Commercial: $827.20
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EXCISION OF CYST $1,034 $620.40 $775.50 – $827.20
Removal of breast growth (open surgery): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $827.20
  • Geisinger — Commercial: $775.50
  • Humana — Commercial: $827.20
  • InterGroup — PPO: $827.20
  • Multiplan — PPO/Auto: $827.20
  • Multiplan — Worker's Compensation: $827.20
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LESION, NIPPLE OR AREOLAR LESION (EXCEPT 19 Not listed in the file Not listed in the file $181.65 – $2,795.54
Removal of breast growth (open surgery): 10 of 13 insurance plan rates
  • Aetna — CHIP/Medicaid: $181.65
  • BCBS of Western NY — Medicare Advantage: $1,192.92
  • Geisinger — Medicaid: $240.45
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $260.88
  • Highmark BCBS of PA — Commercial - Indemnity: $2,795.54
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $2,295.70
  • Highmark BCBS of PA — Managed Care: $2,795.54
  • Highmark BCBS of PA — Managed Care - Social Mission: $2,295.70
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $294.83
  • UPMC Health Plan — CHIP: $2,654.85
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROPLASTY TOTAL HIP REPLACE $5,795 $3,477 $1,606.37 – $6,936.39
Total hip replacement: 10 of 28 insurance plan rates
  • Aetna — Commercial: $4,751.90
  • Aetna — Medicare: $1,767.47
  • AmeriHealth Caritas — Community HealthChoices (CHC): $1,663.16
  • AmeriHealth Caritas — Medicaid: $1,663.16
  • AmeriHealth Caritas — Medicare: $1,622.60
  • BCBS of Western NY — Medicare Advantage: $2,325.85
  • Cigna — Medicare: $1,703.73
  • Galaxy Health Plan — Commercial: $4,636
  • Geisinger — Commercial: $4,636
  • Geisinger — Medicaid: $3,187.25
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSIST ARTHRP TOTAL HIP REPLCE $1,938 $1,162.80 $537.21 – $1,589.16
Total hip replacement: 10 of 26 insurance plan rates
  • Aetna — Commercial: $1,589.16
  • Aetna — Medicare: $591.09
  • AmeriHealth Caritas — Community HealthChoices (CHC): $556.21
  • AmeriHealth Caritas — Medicaid: $556.21
  • AmeriHealth Caritas — Medicare: $542.64
  • Cigna — Medicare: $569.77
  • Galaxy Health Plan — Commercial: $1,550.40
  • Geisinger — Commercial: $1,550.40
  • Geisinger — Medicaid: $1,065.90
  • Highmark BCBS of PA — Commercial - Indemnity: $1,472.88
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHROPLASTY TOTAL HIP REPLACE $5,795 $3,477 $4,346.25 – $4,636
Total hip replacement: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $4,636
  • Geisinger — Commercial: $4,346.25
  • Humana — Commercial: $4,636
  • InterGroup — PPO: $4,636
  • Multiplan — PPO/Auto: $4,636
  • Multiplan — Worker's Compensation: $4,636
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: T.K.R. $5,453 $3,271.80 $1,511.57 – $14,888.05
Total knee replacement: 10 of 29 insurance plan rates
  • Aetna — Commercial: $4,471.46
  • Aetna — Medicare: $1,663.16
  • AmeriHealth Caritas — Community HealthChoices (CHC): $1,565.01
  • AmeriHealth Caritas — Medicaid: $1,565.01
  • AmeriHealth Caritas — Medicare: $1,526.84
  • BCBS of Western NY — Medicare Advantage: $1,677.17
  • Cigna — Medicare: $1,603.18
  • Galaxy Health Plan — Commercial: $4,362.40
  • Geisinger — Commercial: $4,362.40
  • Geisinger — Medicaid: $2,999.15
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSIST T.K.R. $1,824 $1,094.40 $505.61 – $1,495.68
Total knee replacement: 10 of 26 insurance plan rates
  • Aetna — Commercial: $1,495.68
  • Aetna — Medicare: $556.32
  • AmeriHealth Caritas — Community HealthChoices (CHC): $523.49
  • AmeriHealth Caritas — Medicaid: $523.49
  • AmeriHealth Caritas — Medicare: $510.72
  • Cigna — Medicare: $536.26
  • Galaxy Health Plan — Commercial: $1,459.20
  • Geisinger — Commercial: $1,459.20
  • Geisinger — Medicaid: $1,003.20
  • Highmark BCBS of PA — Commercial - Indemnity: $1,386.24
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Hospital (facility) fee In the file: T.K.R. $5,453 $3,271.80 $4,089.75 – $4,362.40
Total knee replacement: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $4,362.40
  • Geisinger — Commercial: $4,089.75
  • Humana — Commercial: $4,362.40
  • InterGroup — PPO: $4,362.40
  • Multiplan — PPO/Auto: $4,362.40
  • Multiplan — Worker's Compensation: $4,362.40
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRO;SHOULDER-SAD $2,904 $1,742.40 $761.99 – $2,655.58
Shoulder arthroscopy: shaving of shoulder bone: 10 of 29 insurance plan rates
  • Aetna — Commercial: $2,381.28
  • Aetna — Medicare: $885.72
  • AmeriHealth Caritas — Community HealthChoices (CHC): $833.45
  • AmeriHealth Caritas — Medicaid: $833.45
  • AmeriHealth Caritas — Medicare: $813.12
  • BCBS of Western NY — Medicare Advantage: $1,192.92
  • Cigna — Medicare: $853.78
  • Galaxy Health Plan — Commercial: $2,323.20
  • Geisinger — Commercial: $2,323.20
  • Geisinger — Medicaid: $1,597.20
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSIST ARTHRO SHOULDER $973 $583.80 $269.72 – $797.86
Shoulder arthroscopy: shaving of shoulder bone: 10 of 26 insurance plan rates
  • Aetna — Commercial: $797.86
  • Aetna — Medicare: $296.76
  • AmeriHealth Caritas — Community HealthChoices (CHC): $279.25
  • AmeriHealth Caritas — Medicaid: $279.25
  • AmeriHealth Caritas — Medicare: $272.44
  • Cigna — Medicare: $286.06
  • Galaxy Health Plan — Commercial: $778.40
  • Geisinger — Commercial: $778.40
  • Geisinger — Medicaid: $535.15
  • Highmark BCBS of PA — Commercial - Indemnity: $739.48
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHRO;SHOULDER-SAD $2,904 $1,742.40 $2,178 – $2,323.20
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $2,323.20
  • Geisinger — Commercial: $2,178
  • Humana — Commercial: $2,323.20
  • InterGroup — PPO: $2,323.20
  • Multiplan — PPO/Auto: $2,323.20
  • Multiplan — Worker's Compensation: $2,323.20
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRO;KNEE-MED/LAT MENISCE $2,732 $1,639.20 $570.67 – $3,250.30
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $570.67
  • Aetna — Commercial: $2,240.24
  • Aetna — Medicare: $833.26
  • AmeriHealth Caritas — Community HealthChoices (CHC): $784.08
  • AmeriHealth Caritas — Medicaid: $784.08
  • AmeriHealth Caritas — Medicare: $764.96
  • BCBS of Western NY — Medicare Advantage: $1,470.59
  • Cigna — Medicare: $803.21
  • Galaxy Health Plan — Commercial: $2,185.60
  • Geisinger — Commercial: $2,185.60
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ARTHRO;KNEE-MED/LAT MENISCE $2,732 $1,639.20 $2,049 – $2,185.60
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $2,185.60
  • Geisinger — Commercial: $2,049
  • Humana — Commercial: $2,185.60
  • InterGroup — PPO: $2,185.60
  • Multiplan — PPO/Auto: $2,185.60
  • Multiplan — Worker's Compensation: $2,185.60
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULA Not listed in the file Not listed in the file $570.67 – $3,250.30
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 13 insurance plan rates
  • Aetna — CHIP/Medicaid: $570.67
  • BCBS of Western NY — Medicare Advantage: $1,470.59
  • Geisinger — Medicaid: $755.41
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $819.60
  • Highmark BCBS of PA — Commercial - Indemnity: $2,935.74
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $2,410.83
  • Highmark BCBS of PA — Managed Care: $2,935.74
  • Highmark BCBS of PA — Managed Care - Social Mission: $2,410.83
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $926.23
  • UPMC Health Plan — CHIP: $3,250.30
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12 Not listed in the file Not listed in the file $635.33 – $5,149.42
Removal of tonsils and adenoids (under age 12): rates for 9 insurance plans
  • BCBS of Western NY — Medicare Advantage: $1,192.92
  • Highmark BCBS of PA — Commercial - Indemnity: $1,581.15
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,298.44
  • Highmark BCBS of PA — Managed Care: $1,581.15
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,298.44
  • UPMC Health Plan — CHIP: $5,149.42
  • UPMC Work Partners — Workers Comp: $635.33
  • Aetna — Commercial: 82% (a percentage in the contract, not a dollar amount)
  • United Healthcare — Commercial: 65% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ENDOSCOPY UPPER GI COMPLEX DI $1,464 $878.40 $131.48 – $1,713.43
Upper GI endoscopy (diagnostic): 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $131.48
  • Aetna — Commercial: $1,200.48
  • Aetna — Medicare: $446.52
  • AmeriHealth Caritas — Community HealthChoices (CHC): $420.17
  • AmeriHealth Caritas — Medicaid: $420.17
  • AmeriHealth Caritas — Medicare: $409.92
  • BCBS of Western NY — Medicare Advantage: $771.51
  • Cigna — Medicare: $430.42
  • Galaxy Health Plan — Commercial: $1,171.20
  • Geisinger — Commercial: $1,171.20
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ENDOSCOPY UPPER GI COMPLEX DI $1,464 $878.40 $1,098 – $1,171.20
Upper GI endoscopy (diagnostic): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,171.20
  • Geisinger — Commercial: $1,098
  • Humana — Commercial: $1,171.20
  • InterGroup — PPO: $1,171.20
  • Multiplan — PPO/Auto: $1,171.20
  • Multiplan — Worker's Compensation: $1,171.20
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEP Not listed in the file Not listed in the file $131.48 – $1,713.43
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates
  • Aetna — CHIP/Medicaid: $131.48
  • BCBS of Western NY — Medicare Advantage: $771.51
  • Geisinger — Medicaid: $174.04
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $188.83
  • Highmark BCBS of PA — Commercial - Indemnity: $1,538.64
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,263.53
  • Highmark BCBS of PA — Managed Care: $1,538.64
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,263.53
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $213.40
  • UPMC Health Plan — CHIP: $1,713.43
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UPPER GI ENDO W/BIOPSY $1,062 $637.20 $156.01 – $2,316.50
Upper GI endoscopy with biopsy: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $156.01
  • Aetna — Commercial: $870.84
  • Aetna — Medicare: $323.91
  • AmeriHealth Caritas — Community HealthChoices (CHC): $304.79
  • AmeriHealth Caritas — Medicaid: $304.79
  • AmeriHealth Caritas — Medicare: $297.36
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $312.23
  • Galaxy Health Plan — Commercial: $849.60
  • Geisinger — Commercial: $849.60
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UPPER GI ENDO W/BIOPSY $1,062 $637.20 $796.50 – $849.60
Upper GI endoscopy with biopsy: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $849.60
  • Geisinger — Commercial: $796.50
  • Humana — Commercial: $849.60
  • InterGroup — PPO: $849.60
  • Multiplan — PPO/Auto: $849.60
  • Multiplan — Worker's Compensation: $849.60
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE Not listed in the file Not listed in the file $156.01 – $2,316.50
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates
  • Aetna — CHIP/Medicaid: $156.01
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Geisinger — Medicaid: $206.51
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $224.06
  • Highmark BCBS of PA — Commercial - Indemnity: $2,010.72
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,651.20
  • Highmark BCBS of PA — Managed Care: $2,010.72
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,651.20
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $253.21
  • UPMC Health Plan — CHIP: $2,316.50
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY $1,015 $609 $189.53 – $2,315.60
Colonoscopy (diagnostic): 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $189.53
  • Aetna — Commercial: $832.30
  • Aetna — Medicare: $309.57
  • AmeriHealth Caritas — Community HealthChoices (CHC): $291.31
  • AmeriHealth Caritas — Medicaid: $291.31
  • AmeriHealth Caritas — Medicare: $284.20
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $298.41
  • Galaxy Health Plan — Commercial: $812
  • Geisinger — Commercial: $812
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY $1,015 $609 $761.25 – $812
Colonoscopy (diagnostic): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $812
  • Geisinger — Commercial: $761.25
  • Humana — Commercial: $812
  • InterGroup — PPO: $812
  • Multiplan — PPO/Auto: $812
  • Multiplan — Worker's Compensation: $812
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE) Not listed in the file Not listed in the file $189.53 – $2,315.60
Colonoscopy (diagnostic): 10 of 12 insurance plan rates
  • Aetna — CHIP/Medicaid: $189.53
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Geisinger — Medicaid: $250.88
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $272.19
  • Highmark BCBS of PA — Commercial - Indemnity: $1,819.93
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,494.52
  • Highmark BCBS of PA — Managed Care: $1,819.93
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,494.52
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $307.61
  • UPMC Health Plan — CHIP: $2,315.60
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY SGL/MULTI $1,212 $727.20 $236.69 – $2,321.75
Colonoscopy with biopsy: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $236.69
  • Aetna — Commercial: $993.84
  • Aetna — Medicare: $369.66
  • AmeriHealth Caritas — Community HealthChoices (CHC): $347.84
  • AmeriHealth Caritas — Medicaid: $347.84
  • AmeriHealth Caritas — Medicare: $339.36
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $356.33
  • Galaxy Health Plan — Commercial: $969.60
  • Geisinger — Commercial: $969.60
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BIOPSY SGL/MULTI $1,212 $727.20 $909 – $969.60
Colonoscopy with biopsy: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $969.60
  • Geisinger — Commercial: $909
  • Humana — Commercial: $969.60
  • InterGroup — PPO: $969.60
  • Multiplan — PPO/Auto: $969.60
  • Multiplan — Worker's Compensation: $969.60
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE Not listed in the file Not listed in the file $236.69 – $2,321.75
Colonoscopy with biopsy: 10 of 12 insurance plan rates
  • Aetna — CHIP/Medicaid: $236.69
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Geisinger — Medicaid: $313.31
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $339.93
  • Highmark BCBS of PA — Commercial - Indemnity: $2,321.75
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,906.62
  • Highmark BCBS of PA — Managed Care: $2,321.75
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,906.62
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $384.16
  • UPMC Health Plan — CHIP: $2,298.97
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/REMOVAL BY SNARE $1,438 $862.80 $281.48 – $2,433.54
Colonoscopy with removal of polyps (snare): 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $281.48
  • Aetna — Commercial: $1,179.16
  • Aetna — Medicare: $438.59
  • AmeriHealth Caritas — Community HealthChoices (CHC): $412.71
  • AmeriHealth Caritas — Medicaid: $412.71
  • AmeriHealth Caritas — Medicare: $402.64
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $422.77
  • Galaxy Health Plan — Commercial: $1,150.40
  • Geisinger — Commercial: $1,150.40
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/REMOVAL BY SNARE $1,438 $862.80 $1,078.50 – $1,150.40
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,150.40
  • Geisinger — Commercial: $1,078.50
  • Humana — Commercial: $1,150.40
  • InterGroup — PPO: $1,150.40
  • Multiplan — PPO/Auto: $1,150.40
  • Multiplan — Worker's Compensation: $1,150.40
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE Not listed in the file Not listed in the file $281.48 – $2,433.54
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates
  • Aetna — CHIP/Medicaid: $281.48
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Geisinger — Medicaid: $372.60
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $404.26
  • Highmark BCBS of PA — Commercial - Indemnity: $2,433.54
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,998.42
  • Highmark BCBS of PA — Managed Care: $2,433.54
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,998.42
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $456.86
  • UPMC Health Plan — CHIP: $2,297.51
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREEN/COLON;LOW RISK $1,055 $633 $292.45 – $2,182.77
Screening colonoscopy (not high risk): 10 of 28 insurance plan rates
  • Aetna — Commercial: $865.10
  • Aetna — Medicare: $321.77
  • AmeriHealth Caritas — Community HealthChoices (CHC): $302.79
  • AmeriHealth Caritas — Medicaid: $302.79
  • AmeriHealth Caritas — Medicare: $295.40
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $310.17
  • Galaxy Health Plan — Commercial: $844
  • Geisinger — Commercial: $844
  • Geisinger — Medicaid: $580.25
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SCREEN/COLON;LOW RISK $1,055 $633 $791.25 – $844
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $844
  • Geisinger — Commercial: $791.25
  • Humana — Commercial: $844
  • InterGroup — PPO: $844
  • Multiplan — PPO/Auto: $844
  • Multiplan — Worker's Compensation: $844
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 Not listed in the file Not listed in the file $1,041.88 – $2,182.77
Screening colonoscopy (not high risk): rates for 7 insurance plans
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Highmark BCBS of PA — Commercial - Indemnity: $1,821.64
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,495.93
  • Highmark BCBS of PA — Managed Care: $1,821.64
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,495.93
  • UPMC Health Plan — CHIP: $2,182.77
  • United Healthcare — Commercial: 65% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROS SURG;CHOLECYSTECTOMY $1,683 $1,009.80 $466.53 – $5,150.38
Gallbladder removal by laparoscope: 10 of 29 insurance plan rates
  • Aetna — Commercial: $1,380.06
  • Aetna — Medicare: $513.32
  • AmeriHealth Caritas — Community HealthChoices (CHC): $483.02
  • AmeriHealth Caritas — Medicaid: $483.02
  • AmeriHealth Caritas — Medicare: $471.24
  • BCBS of Western NY — Medicare Advantage: $1,677.17
  • Cigna — Medicare: $494.80
  • Galaxy Health Plan — Commercial: $1,346.40
  • Geisinger — Commercial: $1,346.40
  • Geisinger — Medicaid: $925.65
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSIST LAP/CHOLECYSTECTOMY $566 $339.60 $156.90 – $464.12
Gallbladder removal by laparoscope: 10 of 26 insurance plan rates
  • Aetna — Commercial: $464.12
  • Aetna — Medicare: $172.63
  • AmeriHealth Caritas — Community HealthChoices (CHC): $162.44
  • AmeriHealth Caritas — Medicaid: $162.44
  • AmeriHealth Caritas — Medicare: $158.48
  • Cigna — Medicare: $166.40
  • Galaxy Health Plan — Commercial: $452.80
  • Geisinger — Commercial: $452.80
  • Geisinger — Medicaid: $311.30
  • Highmark BCBS of PA — Commercial - Indemnity: $430.16
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LAPAROS SURG;CHOLECYSTECTOMY $1,683 $1,009.80 $1,262.25 – $1,346.40
Gallbladder removal by laparoscope: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,346.40
  • Geisinger — Commercial: $1,262.25
  • Humana — Commercial: $1,346.40
  • InterGroup — PPO: $1,346.40
  • Multiplan — PPO/Auto: $1,346.40
  • Multiplan — Worker's Compensation: $1,346.40
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR INGUINAL HERIA > 5Y $1,530 $918 $333.38 – $3,250.58
Groin (inguinal) hernia repair, age 5 or older: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $333.38
  • Aetna — Commercial: $1,254.60
  • Aetna — Medicare: $466.65
  • AmeriHealth Caritas — Community HealthChoices (CHC): $439.11
  • AmeriHealth Caritas — Medicaid: $439.11
  • AmeriHealth Caritas — Medicare: $428.40
  • BCBS of Western NY — Medicare Advantage: $1,470.59
  • Cigna — Medicare: $449.82
  • Galaxy Health Plan — Commercial: $1,224
  • Geisinger — Commercial: $1,224
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSIST REP INITAL ING HERNIA>5 $516 $309.60 $143.04 – $423.12
Groin (inguinal) hernia repair, age 5 or older: 10 of 26 insurance plan rates
  • Aetna — Commercial: $423.12
  • Aetna — Medicare: $157.38
  • AmeriHealth Caritas — Community HealthChoices (CHC): $148.09
  • AmeriHealth Caritas — Medicaid: $148.09
  • AmeriHealth Caritas — Medicare: $144.48
  • Cigna — Medicare: $151.70
  • Galaxy Health Plan — Commercial: $412.80
  • Geisinger — Commercial: $412.80
  • Geisinger — Medicaid: $283.80
  • Highmark BCBS of PA — Commercial - Indemnity: $392.16
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: REPAIR INGUINAL HERIA > 5Y $1,530 $918 $1,147.50 – $1,224
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,224
  • Geisinger — Commercial: $1,147.50
  • Humana — Commercial: $1,224
  • InterGroup — PPO: $1,224
  • Multiplan — PPO/Auto: $1,224
  • Multiplan — Worker's Compensation: $1,224
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY,PROSTATE;NEEDLE/PUNCH $713 $427.80 $93.97 – $2,316.78
Prostate biopsy: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $93.97
  • Aetna — Commercial: $584.66
  • Aetna — Medicare: $217.47
  • AmeriHealth Caritas — Community HealthChoices (CHC): $204.63
  • AmeriHealth Caritas — Medicaid: $204.63
  • AmeriHealth Caritas — Medicare: $199.64
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $209.62
  • Galaxy Health Plan — Commercial: $570.40
  • Geisinger — Commercial: $570.40
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BIOPSY,PROSTATE;NEEDLE/PUNCH $713 $427.80 $534.75 – $570.40
Prostate biopsy: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $570.40
  • Geisinger — Commercial: $534.75
  • Humana — Commercial: $570.40
  • InterGroup — PPO: $570.40
  • Multiplan — PPO/Auto: $570.40
  • Multiplan — Worker's Compensation: $570.40
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH Not listed in the file Not listed in the file $93.97 – $2,316.78
Prostate biopsy: 10 of 13 insurance plan rates
  • Aetna — CHIP/Medicaid: $93.97
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Geisinger — Medicaid: $124.40
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $134.97
  • Highmark BCBS of PA — Commercial - Indemnity: $1,290.13
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,059.45
  • Highmark BCBS of PA — Managed Care: $1,290.13
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,059.45
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $152.53
  • UPMC Health Plan — CHIP: $2,316.78
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY SURGICAL $859 $515.40 $238.11 – $7,128.01
Hysteroscopy with biopsy of the uterus lining: 10 of 29 insurance plan rates
  • Aetna — Commercial: $704.38
  • Aetna — Medicare: $262
  • AmeriHealth Caritas — Community HealthChoices (CHC): $246.53
  • AmeriHealth Caritas — Medicaid: $246.53
  • AmeriHealth Caritas — Medicare: $240.52
  • BCBS of Western NY — Medicare Advantage: $1,192.92
  • Cigna — Medicare: $252.55
  • Galaxy Health Plan — Commercial: $687.20
  • Geisinger — Commercial: $687.20
  • Geisinger — Medicaid: $472.45
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HYSTEROSCOPY SURGICAL $859 $515.40 $644.25 – $687.20
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $687.20
  • Geisinger — Commercial: $644.25
  • Humana — Commercial: $687.20
  • InterGroup — PPO: $687.20
  • Multiplan — PPO/Auto: $687.20
  • Multiplan — Worker's Compensation: $687.20
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D & C Not listed in the file Not listed in the file $577.87 – $7,128.01
Hysteroscopy with biopsy of the uterus lining: rates for 9 insurance plans
  • BCBS of Western NY — Medicare Advantage: $1,192.92
  • Highmark BCBS of PA — Commercial - Indemnity: $7,128.01
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $5,853.51
  • Highmark BCBS of PA — Managed Care: $7,128.01
  • Highmark BCBS of PA — Managed Care - Social Mission: $5,853.51
  • UPMC Health Plan — CHIP: $1,336.10
  • UPMC Work Partners — Workers Comp: $577.87
  • Aetna — Commercial: 82% (a percentage in the contract, not a dollar amount)
  • United Healthcare — Commercial: 65% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EPIDURAL INJ LUMBAR OR SACRAL $276 $165.60 $76.51 – $1,834.56
Spinal injection, lower back (epidural), with imaging guidance: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $85.39
  • Aetna — Commercial: $226.32
  • Aetna — Medicare: $84.18
  • AmeriHealth Caritas — Community HealthChoices (CHC): $79.21
  • AmeriHealth Caritas — Medicaid: $79.21
  • AmeriHealth Caritas — Medicare: $77.28
  • BCBS of Western NY — Medicare Advantage: $771.51
  • Cigna — Medicare: $81.14
  • Galaxy Health Plan — Commercial: $220.80
  • Geisinger — Commercial: $220.80
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EPIDURAL INJ LUMBAR OR SACRAL $276 $165.60 $207 – $220.80
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $220.80
  • Geisinger — Commercial: $207
  • Humana — Commercial: $220.80
  • InterGroup — PPO: $220.80
  • Multiplan — PPO/Auto: $220.80
  • Multiplan — Worker's Compensation: $220.80
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION(S), OF DIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) (EG, ANESTHETIC, ANTISPASMODIC, OPIOID, STEROID, OTHER SOLUTION), NOT INCLUDING NEUR Not listed in the file Not listed in the file $85.39 – $1,834.56
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates
  • Aetna — CHIP/Medicaid: $85.39
  • BCBS of Western NY — Medicare Advantage: $771.51
  • Geisinger — Medicaid: $113.03
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $122.63
  • Highmark BCBS of PA — Commercial - Indemnity: $1,374.61
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,128.83
  • Highmark BCBS of PA — Managed Care: $1,374.61
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,128.83
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $138.59
  • UPMC Health Plan — CHIP: $1,834.56
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ ANES AGENT/STEROID SGL LEV $205 $123 $56.83 – $1,309.43
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates
  • Aetna — CHIP/Medicaid: $99.79
  • Aetna — Commercial: $168.10
  • Aetna — Medicare: $62.52
  • AmeriHealth Caritas — Community HealthChoices (CHC): $58.84
  • AmeriHealth Caritas — Medicaid: $58.84
  • AmeriHealth Caritas — Medicare: $57.40
  • BCBS of Western NY — Medicare Advantage: $771.51
  • Cigna — Medicare: $60.27
  • Galaxy Health Plan — Commercial: $164
  • Geisinger — Commercial: $164
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJ ANES AGENT/STEROID SGL LEV $205 $123 $153.75 – $164
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $164
  • Geisinger — Commercial: $153.75
  • Humana — Commercial: $164
  • InterGroup — PPO: $164
  • Multiplan — PPO/Auto: $164
  • Multiplan — Worker's Compensation: $164
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL, SING Not listed in the file Not listed in the file $99.79 – $1,309.43
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates
  • Aetna — CHIP/Medicaid: $99.79
  • BCBS of Western NY — Medicare Advantage: $771.51
  • Geisinger — Medicaid: $132.10
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $143.32
  • Highmark BCBS of PA — Commercial - Indemnity: $1,309.43
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,075.30
  • Highmark BCBS of PA — Managed Care: $1,309.43
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,075.30
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $161.97
  • UPMC Health Plan — CHIP: $636.50
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CAR TUNNEL REL-NEUROPLSTY MEDI $1,273 $763.80 $315 – $2,406.72
Carpal tunnel release: 10 of 31 insurance plan rates
  • Aetna — CHIP/Medicaid: $315
  • Aetna — Commercial: $1,043.86
  • Aetna — Medicare: $388.26
  • AmeriHealth Caritas — Community HealthChoices (CHC): $365.35
  • AmeriHealth Caritas — Medicaid: $365.35
  • AmeriHealth Caritas — Medicare: $356.44
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Cigna — Medicare: $374.26
  • Galaxy Health Plan — Commercial: $1,018.40
  • Geisinger — Commercial: $1,018.40
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CAR TUNNEL REL-NEUROPLSTY MEDI $1,273 $763.80 $954.75 – $1,018.40
Carpal tunnel release: rates for 6 insurance plans
  • Galaxy Health Plan — Commercial: $1,018.40
  • Geisinger — Commercial: $954.75
  • Humana — Commercial: $1,018.40
  • InterGroup — PPO: $1,018.40
  • Multiplan — PPO/Auto: $1,018.40
  • Multiplan — Worker's Compensation: $1,018.40
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL Not listed in the file Not listed in the file $315 – $2,406.72
Carpal tunnel release: 10 of 13 insurance plan rates
  • Aetna — CHIP/Medicaid: $315
  • BCBS of Western NY — Medicare Advantage: $1,041.88
  • Geisinger — Medicaid: $416.97
  • Health Partners Plans (Jefferson Health Plan) — Medicaid/CHIP: $452.40
  • Highmark BCBS of PA — Commercial - Indemnity: $2,406.72
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,976.40
  • Highmark BCBS of PA — Managed Care: $2,406.72
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,976.40
  • PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $511.26
  • UPMC Health Plan — CHIP: $2,299.19

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $59,798.05 – $97,692.55
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 8 insurance plans
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $59,798.05
  • BCBS of Western NY — Commercial/Medicaid: $59,798.05
  • Highmark BCBS of PA — Commercial - Indemnity: $97,692.55
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $80,227.56
  • Highmark BCBS of PA — Managed Care: $97,692.55
  • Highmark BCBS of PA — Managed Care - Social Mission: $80,227.56
  • United Healthcare — Commercial: $95,000.77
  • UPMC Health Plan — Commercial: $70,166.74
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $13,290.66 – $18,731.55
Hip or knee replacement (major joint of the leg), without major complications: rates for 9 insurance plans
  • Aetna — Commercial: $14,825
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $13,290.66
  • BCBS of Western NY — Commercial/Medicaid: $13,290.66
  • Highmark BCBS of PA — Commercial - Indemnity: $17,179.53
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $14,108.26
  • Highmark BCBS of PA — Managed Care: $17,179.53
  • Highmark BCBS of PA — Managed Care - Social Mission: $14,108.26
  • United Healthcare — Commercial: $18,731.55
  • UPMC Health Plan — Commercial: $13,834.96
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $14,922.62 – $23,707.46
Neck (cervical) spinal fusion, without complications: rates for 8 insurance plans
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $14,922.62
  • BCBS of Western NY — Commercial/Medicaid: $14,922.62
  • Highmark BCBS of PA — Commercial - Indemnity: $22,108.32
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $18,155.90
  • Highmark BCBS of PA — Managed Care: $22,108.32
  • Highmark BCBS of PA — Managed Care - Social Mission: $18,155.90
  • United Healthcare — Commercial: $23,707.46
  • UPMC Health Plan — Commercial: $17,510.13
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 $7,583.87 – $12,435.93
Uterus and ovary surgery (not for cancer), without complications: rates for 8 insurance plans
  • BCBS of Western NY — CC/CHP/FHP/CHIP: $7,583.87
  • BCBS of Western NY — Commercial/Medicaid: $7,583.87
  • Highmark BCBS of PA — Commercial - Indemnity: $12,435.93
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $10,212.69
  • Highmark BCBS of PA — Managed Care: $12,435.93
  • Highmark BCBS of PA — Managed Care - Social Mission: $10,212.69
  • United Healthcare — Commercial: $12,048.44
  • UPMC Health Plan — Commercial: $8,898.87

Source: UPMC Cole’s standard charges file (dam.upmc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 6, 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 typeCritical Access Hospital
Address1001 East Second Street, Coudersport, PA 16915
CountyPotter County
StatePennsylvania
Phone(814) 274‑9301
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating4 of 5 stars
CMS Certification Number391313
Name in Medicare recordsUPMC COLE
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(814) 274‑9300[4]
Official websiteupmc.com
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

  1. UPMC Cole — upmc.com
  2. Our Emergency Department Locations | UPMC | North Central Pa — upmc.com
  3. Clinical Services | UPMC Cole — upmc.com
  4. Wound Care Center | UPMC Cole | Coudersport, Pa — upmc.com