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Acute Care Hospital

UPMC Jameson

New Castle, Pennsylvania · Lawrence County · Emergency services listed

UPMC Jameson is an acute care hospital at 1211 Wilmington Avenue, New Castle, PA 16105. Phone: (724) 656-4100. It has an emergency department. Medicare overall rating: 3 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 Jameson is an acute care hospital in New Castle, Pennsylvania. Medicare data lists emergency services. CMS overall star rating: 3 of 5 stars. Its official website lists 77 services, specialties and programs. Medicare lists 526 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(724) 656‑4100 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
3 of 5 stars3 of 5 stars · Medicare rating
526Doctors and clinicians
77Services listed

Quick answers

Does UPMC Jameson have an emergency room?
Yes. Medicare (CMS) data lists emergency services at UPMC Jameson. In a medical emergency, call 911.
Where is UPMC Jameson?
1211 Wilmington Avenue, New Castle, PA 16105, in Lawrence County, Pennsylvania.
What is the phone number of UPMC Jameson?
(724) 656-4100, as listed by Medicare (CMS).
What is the Medicare star rating of UPMC Jameson?
3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to UPMC Jameson for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to UPMC Jameson under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.6051; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][6][9]

Conditions treated[6][8][9][10]

Treatments[4][8][9][10]

Procedures[9]

  • Heart catheterization and angioplasty (pre- and post-op care)
  • Invasive medical imaging procedures (pre- and post-op care)

Programs and centers[4][6][8][9][10][11]

  • Stroke Care
  • Emergency department (24/7)
  • Safe Haven Program
  • Partial Hospitalization Program (outpatient behavioral health)
  • Same-day surgery unit
  • Inpatient rehabilitation
  • Pediatric rehabilitation therapies (UPMC Children's, at UPMC Jameson)

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

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingVisiting hours for patient support persons are 9 a.m.-9 p.m., seven days a week[5]
ParkingFree parking in the outpatient lot off Garfield Avenue; enter through the outpatient entrance[12]
Interpreters and languagesSign language interpreters and video remote interpreting available; financial forms offered in several languages[13][12]
Patient portalMyUPMC

Doctors and clinicians (526)

526 doctors and other clinicians list UPMC Jameson 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 (526)

And 502 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 New Castle

Hospitals in Lawrence 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 →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment2 of 5 stars
Care Coordination3 of 5 stars
Symptoms After Stay3 of 5 stars
Rated the hospital 9 or 10 out of 1065%National average: 72%
Would definitely recommend the hospital61%National average: 71%
Nurses “always” communicated well80%National average: 80%
Doctors “always” communicated well78%National average: 80%
“Always” got help as soon as they wanted58%National average: 64%
Staff “always” explained medicines before giving them59%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean68%National average: 73%
Completed surveys550Response rate: 27%

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.

Central line bloodstream infections (CLABSI)1.616No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.701No different from the national benchmark
Surgical site infections after colon surgery0No different from the national benchmark
MRSA bloodstream infections0No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.062No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

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 attack patients10.5%
Deaths within 30 days: heart failure patients13%
Deaths within 30 days: pneumonia patients19.7%
Deaths within 30 days: stroke patients11.1%
Serious complications (patient safety indicator PSI-90)1.15No different from the national rate
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG)
Too few cases to reportDeaths within 30 days: COPD patients; Complications after hip or knee replacement

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)16.9%
Readmitted within 30 days: heart attack14.7%
Readmitted within 30 days: heart failure20.9%
Readmitted within 30 days: pneumonia17.3%
Readmitted within 30 days: COPD19.8%
Readmitted within 30 days: hip or knee replacement5.6%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery

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)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)169 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)3%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)45%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 →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for UPMC Jameson, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score0.6051Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack0.9404Fewer readmissions than expected
Heart failure0.9341Fewer readmissions than expected
Pneumonia1.0625More readmissions than expected
COPD (chronic lung disease)1.0030More readmissions than expected
No result publishedHip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score18.33 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)26.67 out of 100
Person and community engagement (patient survey)25.00 out of 100
Safety (infections and sepsis care)11.67 out of 100
Efficiency and cost reduction (Medicare spending)10.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio1.03Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

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 62 common services exactly as UPMC Jameson 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 62 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: CLINIC VISIT NEW 99203 $564 $338.40 $25.29 – $496.32
New patient office visit (about 30–44 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $61.30
  • Aetna of PA — Medicare: $108.97
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $70.53
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $75.40
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $25.29
  • Highmark Wholecare (prev Gateway) — Medicare: $282
  • Humana — Commercial: $451.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $451.20
  • National Provider Network — PPO: $496.32
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99203 $564 $338.40 $423 – $496.32
New patient office visit (about 30–44 minutes): rates for 3 insurance plans
  • Humana — Commercial: $451.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $423
  • National Provider Network — PPO: $496.32
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99204 $723 $433.80 $27.66 – $636.24
New patient office visit (about 45–59 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $102.12
  • Aetna of PA — Medicare: $167.15
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $117.49
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $125.61
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $27.66
  • Highmark Wholecare (prev Gateway) — Medicare: $361.50
  • Humana — Commercial: $578.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $578.40
  • National Provider Network — PPO: $636.24
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99204 $723 $433.80 $542.25 – $636.24
New patient office visit (about 45–59 minutes): rates for 3 insurance plans
  • Humana — Commercial: $578.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $542.25
  • National Provider Network — PPO: $636.24
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: INITIAL VISIT-EXTENDED O/P $723 $433.80 $27.66 – $636.24
New patient office visit (about 45–59 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $102.12
  • Aetna of PA — Medicare: $125.36
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $117.49
  • Cigna — Commercial: $222.68
  • Geisinger — Medicaid/CHIP: $125.61
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $27.66
  • Highmark Wholecare (prev Gateway) — Medicare: $361.50
  • Humana — Commercial: $578.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $578.40
  • National Provider Network — PPO: $636.24
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99205 $877 $526.20 $29.68 – $771.76
New patient office visit (about 60–74 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $132.82
  • Aetna of PA — Medicare: $211.42
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $152.81
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $163.37
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $29.68
  • Highmark Wholecare (prev Gateway) — Medicare: $438.50
  • Humana — Commercial: $701.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $701.60
  • National Provider Network — PPO: $771.76
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99205 $877 $526.20 $657.75 – $771.76
New patient office visit (about 60–74 minutes): rates for 3 insurance plans
  • Humana — Commercial: $701.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $657.75
  • National Provider Network — PPO: $771.76
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: CLINIC VISIT NEW 99205 W/PROC $877 $526.20 $29.68 – $771.76
New patient office visit (about 60–74 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $132.82
  • Aetna of PA — Medicare: $158.56
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $152.81
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $163.37
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $29.68
  • Highmark Wholecare (prev Gateway) — Medicare: $438.50
  • Humana — Commercial: $701.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $701.60
  • National Provider Network — PPO: $771.76
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99213 $360 $216 $17.84 – $316.80
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $39.55
  • Aetna of PA — Medicare: $75.83
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $45.50
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $48.65
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $17.84
  • Highmark Wholecare (prev Gateway) — Medicare: $180
  • Humana — Commercial: $288
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $288
  • National Provider Network — PPO: $316.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99213 $360 $216 $270 – $316.80
Established patient office visit (about 20–29 minutes): rates for 3 insurance plans
  • Humana — Commercial: $288
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $270
  • National Provider Network — PPO: $316.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: CLINIC VISIT EST 99213 W/PROC $360 $216 $17.84 – $316.80
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $39.55
  • Aetna of PA — Medicare: $56.87
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $45.50
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $48.65
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $17.84
  • Highmark Wholecare (prev Gateway) — Medicare: $180
  • Humana — Commercial: $288
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $288
  • National Provider Network — PPO: $316.80
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99214 $418 $250.80 $23.27 – $367.84
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $61.49
  • Aetna of PA — Medicare: $110.19
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $70.75
  • Cigna — Commercial: $86.10
  • Geisinger — Medicaid/CHIP: $75.64
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $23.27
  • Highmark Wholecare (prev Gateway) — Medicare: $209
  • Humana — Commercial: $334.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $334.40
  • National Provider Network — PPO: $367.84
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99214 $418 $250.80 $313.50 – $367.84
Established patient office visit (about 30–39 minutes): rates for 3 insurance plans
  • Humana — Commercial: $334.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $313.50
  • National Provider Network — PPO: $367.84
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CRNP CLINIC VISIT EST 99214 $418 $250.80 $23.27 – $367.84
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates
  • Aetna — Medicaid: $61.49
  • Aetna of PA — Medicare: $82.64
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $70.75
  • Cigna — Commercial: $128.74
  • Geisinger — Medicaid/CHIP: $75.64
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $23.27
  • Highmark Wholecare (prev Gateway) — Medicare: $209
  • Humana — Commercial: $334.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $334.40
  • National Provider Network — PPO: $367.84
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACUITY LEVEL 3 $643 $385.80 $45.50 – $612
Emergency room visit (moderate): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $64.01
  • Aetna of PA — Medicare: $263.98
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $45.50
  • AmeriHealth Caritas — Medicare: $285.10
  • Cigna — Commercial: $198.04
  • Cigna — Medicare: $285.10
  • Geisinger — Medicaid/CHIP: $78.74
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $113.69
  • Highmark Wholecare (prev Gateway) — Medicare: $285.07
  • Humana — Commercial: $514.40
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ACUITY LEVEL 3 $643 $385.80 $482.25 – $565.84
Emergency room visit (moderate): rates for 3 insurance plans
  • Humana — Commercial: $514.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $482.25
  • National Provider Network — PPO: $565.84
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACUITY LEVEL 4 $1,009 $605.40 $65.01 – $1,733
Emergency room visit (moderately high): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $107.72
  • Aetna of PA — Medicare: $405.97
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $65.01
  • AmeriHealth Caritas — Medicare: $438.45
  • Cigna — Commercial: $310.77
  • Cigna — Medicare: $438.45
  • Geisinger — Medicaid/CHIP: $132.50
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $144.48
  • Highmark Wholecare (prev Gateway) — Medicare: $438.41
  • Humana — Commercial: $807.20
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ACUITY LEVEL 4 $1,009 $605.40 $756.75 – $887.92
Emergency room visit (moderately high): rates for 3 insurance plans
  • Humana — Commercial: $807.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $756.75
  • National Provider Network — PPO: $887.92
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACUITY LEVEL 5 $1,481 $888.60 $65.01 – $1,733
Emergency room visit (high): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $156.78
  • Aetna of PA — Medicare: $584.52
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $65.01
  • AmeriHealth Caritas — Medicare: $631.28
  • Cigna — Commercial: $456.15
  • Cigna — Medicare: $631.28
  • Geisinger — Medicaid/CHIP: $192.83
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $177.28
  • Highmark Wholecare (prev Gateway) — Medicare: $631.22
  • Humana — Commercial: $1,184.80
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ACUITY LEVEL 5 $1,481 $888.60 $1,110.75 – $1,303.28
Emergency room visit (high): rates for 3 insurance plans
  • Humana — Commercial: $1,184.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,110.75
  • National Provider Network — PPO: $1,303.28

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 $134 $80.40 $8.36 – $117.92
Basic metabolic panel (blood test): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $10.58
  • Aetna of PA — Medicare: $8.46
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.58
  • AmeriHealth Caritas — Medicare: $9.14
  • Cigna — Commercial: $21.97
  • Cigna — Medicare: $9.14
  • Geisinger — Medicaid/CHIP: $13.01
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $22.87
  • Highmark Wholecare (prev Gateway) — Medicare: $9.14
  • Humana — Commercial: $107.20
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $134 $80.40 $100.50 – $117.92
Basic metabolic panel (blood test): rates for 3 insurance plans
  • Humana — Commercial: $107.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $100.50
  • National Provider Network — PPO: $117.92
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL $207 $124.20 $10.43 – $182.16
Comprehensive metabolic panel (blood test): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $13.21
  • Aetna of PA — Medicare: $10.56
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.21
  • AmeriHealth Caritas — Medicare: $11.40
  • Cigna — Commercial: $27.40
  • Cigna — Medicare: $11.40
  • Geisinger — Medicaid/CHIP: $16.25
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $28.56
  • Highmark Wholecare (prev Gateway) — Medicare: $11.40
  • Humana — Commercial: $165.60
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL $207 $124.20 $155.25 – $182.16
Comprehensive metabolic panel (blood test): rates for 3 insurance plans
  • Humana — Commercial: $165.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $155.25
  • National Provider Network — PPO: $182.16
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICS PANEL $991 $594.60 $13.20 – $872.08
Obstetric blood test panel: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $13.56
  • Aetna of PA — Medicare: $47.81
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.56
  • AmeriHealth Caritas — Medicare: $51.63
  • Cigna — Commercial: $124.17
  • Cigna — Medicare: $51.63
  • Geisinger — Medicaid/CHIP: $16.68
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $37.06
  • Highmark Wholecare (prev Gateway) — Medicare: $51.63
  • Humana — Commercial: $792.80
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OBSTETRICS PANEL $991 $594.60 $743.25 – $872.08
Obstetric blood test panel: rates for 3 insurance plans
  • Humana — Commercial: $792.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $743.25
  • National Provider Network — PPO: $872.08
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARD IQ LIPID PN W/REF DIR LDL $126 $75.60 $13.24 – $110.88
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $15.82
  • Aetna of PA — Medicare: $13.39
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $15.82
  • AmeriHealth Caritas — Medicare: $14.46
  • Cigna — Commercial: $34.76
  • Cigna — Medicare: $14.46
  • Geisinger — Medicaid/CHIP: $19.46
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $27.71
  • Highmark Wholecare (prev Gateway) — Medicare: $14.46
  • Humana — Commercial: $100.80
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARDIO IQ LIPID PANEL $126 $75.60 $13.24 – $110.88
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $15.82
  • Aetna of PA — Medicare: $13.39
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $15.82
  • AmeriHealth Caritas — Medicare: $14.46
  • Cigna — Commercial: $34.76
  • Cigna — Medicare: $14.46
  • Geisinger — Medicaid/CHIP: $19.46
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $27.71
  • Highmark Wholecare (prev Gateway) — Medicare: $14.46
  • Humana — Commercial: $100.80
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL P4483 $126 $75.60 $13.24 – $110.88
Cholesterol panel (lipid panel): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $15.82
  • Aetna of PA — Medicare: $13.39
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $15.82
  • AmeriHealth Caritas — Medicare: $14.46
  • Cigna — Commercial: $34.76
  • Cigna — Medicare: $14.46
  • Geisinger — Medicaid/CHIP: $19.46
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $27.71
  • Highmark Wholecare (prev Gateway) — Medicare: $14.46
  • Humana — Commercial: $100.80
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $172 $103.20 $8.58 – $151.36
Kidney function panel: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $10.85
  • Aetna of PA — Medicare: $8.68
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.85
  • AmeriHealth Caritas — Medicare: $9.37
  • Cigna — Commercial: $22.53
  • Cigna — Medicare: $9.37
  • Geisinger — Medicaid/CHIP: $13.34
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $23.46
  • Highmark Wholecare (prev Gateway) — Medicare: $9.37
  • Humana — Commercial: $137.60
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $172 $103.20 $129 – $151.36
Kidney function panel: rates for 3 insurance plans
  • Humana — Commercial: $137.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $129
  • National Provider Network — PPO: $151.36
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION - PANEL A $146 $87.60 $8.08 – $128.48
Liver function panel: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $10.20
  • Aetna of PA — Medicare: $8.17
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.21
  • AmeriHealth Caritas — Medicare: $8.82
  • Cigna — Commercial: $21.21
  • Cigna — Medicare: $8.82
  • Geisinger — Medicaid/CHIP: $12.55
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $22.07
  • Highmark Wholecare (prev Gateway) — Medicare: $8.82
  • Humana — Commercial: $116.80
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $146 $87.60 $8.08 – $128.48
Liver function panel: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $10.20
  • Aetna of PA — Medicare: $8.17
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.21
  • AmeriHealth Caritas — Medicare: $8.82
  • Cigna — Commercial: $21.21
  • Cigna — Medicare: $8.82
  • Geisinger — Medicaid/CHIP: $12.55
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $22.07
  • Highmark Wholecare (prev Gateway) — Medicare: $8.82
  • Humana — Commercial: $116.80
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION - PANEL A $146 $87.60 $109.50 – $128.48
Liver function panel: rates for 3 insurance plans
  • Humana — Commercial: $116.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $109.50
  • National Provider Network — PPO: $128.48
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UR COMPL W/REFLEX TO CULTURE $46 $27.60 $3.13 – $40.48
Urine test (automated, with microscope): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $3.39
  • Aetna of PA — Medicare: $3.17
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $3.39
  • AmeriHealth Caritas — Medicare: $3.42
  • Cigna — Commercial: $8.24
  • Cigna — Medicare: $3.42
  • Geisinger — Medicaid/CHIP: $4.17
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $8.55
  • Highmark Wholecare (prev Gateway) — Medicare: $3.42
  • Humana — Commercial: $36.80
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS R & M $46 $27.60 $3.13 – $40.48
Urine test (automated, with microscope): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $3.39
  • Aetna of PA — Medicare: $3.17
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $3.39
  • AmeriHealth Caritas — Medicare: $3.42
  • Cigna — Commercial: $8.24
  • Cigna — Medicare: $3.42
  • Geisinger — Medicaid/CHIP: $4.17
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $8.55
  • Highmark Wholecare (prev Gateway) — Medicare: $3.42
  • Humana — Commercial: $36.80
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UR COMPL W/REFLEX TO CULTURE $46 $27.60 $34.50 – $40.48
Urine test (automated, with microscope): rates for 3 insurance plans
  • Humana — Commercial: $36.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $34.50
  • National Provider Network — PPO: $40.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS DIPSTICK $45 $27 $3.44 – $39.60
Urine test (manual, without microscope): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $4.03
  • Aetna of PA — Medicare: $3.48
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.04
  • AmeriHealth Caritas — Medicare: $3.76
  • Cigna — Commercial: $9.03
  • Cigna — Medicare: $3.76
  • Geisinger — Medicaid/CHIP: $4.96
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $7.07
  • Highmark Wholecare (prev Gateway) — Medicare: $3.76
  • Humana — Commercial: $36
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS DIPSTICK $45 $27 $33.75 – $39.60
Urine test (manual, without microscope): rates for 3 insurance plans
  • Humana — Commercial: $36
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $33.75
  • National Provider Network — PPO: $39.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POC URINALYSIS/CLINITEK $41 $24.60 $2.22 – $36.08
Urine test (automated, without microscope): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $3.50
  • Aetna of PA — Medicare: $2.25
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $3.50
  • AmeriHealth Caritas — Medicare: $2.43
  • Cigna — Commercial: $5.84
  • Cigna — Medicare: $2.43
  • Geisinger — Medicaid/CHIP: $4.31
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $6.22
  • Highmark Wholecare (prev Gateway) — Medicare: $2.43
  • Humana — Commercial: $32.80
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTOMATED $41 $24.60 $2.22 – $36.08
Urine test (automated, without microscope): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $3.50
  • Aetna of PA — Medicare: $2.25
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $3.50
  • AmeriHealth Caritas — Medicare: $2.43
  • Cigna — Commercial: $5.84
  • Cigna — Medicare: $2.43
  • Geisinger — Medicaid/CHIP: $4.31
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $6.22
  • Highmark Wholecare (prev Gateway) — Medicare: $2.43
  • Humana — Commercial: $32.80
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE MACRO $17 $10.20 $2.22 – $24.08
Urine test (automated, without microscope): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $3.50
  • Aetna of PA — Medicare: $2.25
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $3.50
  • AmeriHealth Caritas — Medicare: $2.43
  • Cigna — Commercial: $5.84
  • Cigna — Medicare: $2.43
  • Geisinger — Medicaid/CHIP: $4.31
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $6.22
  • Highmark Wholecare (prev Gateway) — Medicare: $2.43
  • Humana — Commercial: $13.60
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC PSA $195 $117 $18.17 – $171.60
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $27.53
  • Aetna of PA — Medicare: $18.39
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $27.53
  • AmeriHealth Caritas — Medicare: $19.86
  • Cigna — Commercial: $47.75
  • Cigna — Medicare: $19.86
  • Geisinger — Medicaid/CHIP: $33.86
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $36.19
  • Highmark Wholecare (prev Gateway) — Medicare: $19.86
  • Humana — Commercial: $156
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC $195 $117 $18.17 – $171.60
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $27.53
  • Aetna of PA — Medicare: $18.39
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $27.53
  • AmeriHealth Caritas — Medicare: $19.86
  • Cigna — Commercial: $47.75
  • Cigna — Medicare: $19.86
  • Geisinger — Medicaid/CHIP: $33.86
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $36.19
  • Highmark Wholecare (prev Gateway) — Medicare: $19.86
  • Humana — Commercial: $156
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL REFLEX TO FREE PSA $195 $117 $18.17 – $171.60
PSA (prostate specific antigen) blood test: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $27.53
  • Aetna of PA — Medicare: $18.39
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $27.53
  • AmeriHealth Caritas — Medicare: $19.86
  • Cigna — Commercial: $47.75
  • Cigna — Medicare: $19.86
  • Geisinger — Medicaid/CHIP: $33.86
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $36.19
  • Highmark Wholecare (prev Gateway) — Medicare: $19.86
  • Humana — Commercial: $156
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID FUNCTION CASCADE SERUM $100 $60 $16.60 – $101.30
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $26.23
  • Aetna of PA — Medicare: $16.80
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $26.23
  • AmeriHealth Caritas — Medicare: $18.14
  • Cigna — Commercial: $43.63
  • Cigna — Medicare: $18.14
  • Geisinger — Medicaid/CHIP: $32.26
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $33.05
  • Highmark Wholecare (prev Gateway) — Medicare: $18.14
  • Humana — Commercial: $80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE $100 $60 $16.60 – $101.30
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $26.23
  • Aetna of PA — Medicare: $16.80
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $26.23
  • AmeriHealth Caritas — Medicare: $18.14
  • Cigna — Commercial: $43.63
  • Cigna — Medicare: $18.14
  • Geisinger — Medicaid/CHIP: $32.26
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $33.05
  • Highmark Wholecare (prev Gateway) — Medicare: $18.14
  • Humana — Commercial: $80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH THIRD GENERATION $100 $60 $16.60 – $101.30
Thyroid stimulating hormone (TSH) test: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $26.23
  • Aetna of PA — Medicare: $16.80
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $26.23
  • AmeriHealth Caritas — Medicare: $18.14
  • Cigna — Commercial: $43.63
  • Cigna — Medicare: $18.14
  • Geisinger — Medicaid/CHIP: $32.26
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $33.05
  • Highmark Wholecare (prev Gateway) — Medicare: $18.14
  • Humana — Commercial: $80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC & PLT & AUTO COMP DIFF $53 $31.80 $6.60 – $49.45
Complete blood count (CBC) with differential: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $6.78
  • Aetna of PA — Medicare: $7.77
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.78
  • AmeriHealth Caritas — Medicare: $8.39
  • Cigna — Commercial: $20.17
  • Cigna — Medicare: $8.39
  • Geisinger — Medicaid/CHIP: $8.34
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $15.28
  • Highmark Wholecare (prev Gateway) — Medicare: $8.39
  • Humana — Commercial: $42.40
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/DIFF & PLATELETS $53 $31.80 $6.60 – $49.45
Complete blood count (CBC) with differential: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $6.78
  • Aetna of PA — Medicare: $7.77
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.78
  • AmeriHealth Caritas — Medicare: $8.39
  • Cigna — Commercial: $20.17
  • Cigna — Medicare: $8.39
  • Geisinger — Medicaid/CHIP: $8.34
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $15.28
  • Highmark Wholecare (prev Gateway) — Medicare: $8.39
  • Humana — Commercial: $42.40
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OXLDL $53 $31.80 $6.60 – $49.45
Complete blood count (CBC) with differential: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $6.78
  • Aetna of PA — Medicare: $7.77
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.78
  • AmeriHealth Caritas — Medicare: $8.39
  • Cigna — Commercial: $20.17
  • Cigna — Medicare: $8.39
  • Geisinger — Medicaid/CHIP: $8.34
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $15.28
  • Highmark Wholecare (prev Gateway) — Medicare: $8.39
  • Humana — Commercial: $42.40
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC & PLT ONLY $47 $28.20 $6.39 – $41.36
Complete blood count (CBC), automated: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $8.50
  • Aetna of PA — Medicare: $6.47
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $8.50
  • AmeriHealth Caritas — Medicare: $6.99
  • Cigna — Commercial: $16.81
  • Cigna — Medicare: $6.99
  • Geisinger — Medicaid/CHIP: $10.45
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $12.73
  • Highmark Wholecare (prev Gateway) — Medicare: $6.99
  • Humana — Commercial: $37.60
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC & PLT ONLY $47 $28.20 $35.25 – $41.36
Complete blood count (CBC), automated: rates for 3 insurance plans
  • Humana — Commercial: $37.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $35.25
  • National Provider Network — PPO: $41.36
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME P P7021 $26 $15.60 $4.24 – $22.88
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $4.52
  • Aetna of PA — Medicare: $4.29
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.52
  • AmeriHealth Caritas — Medicare: $4.63
  • Cigna — Commercial: $11.15
  • Cigna — Medicare: $4.63
  • Geisinger — Medicaid/CHIP: $5.56
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $7.76
  • Highmark Wholecare (prev Gateway) — Medicare: $4.63
  • Humana — Commercial: $20.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME P0070 $26 $15.60 $4.24 – $22.88
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $4.52
  • Aetna of PA — Medicare: $4.29
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.52
  • AmeriHealth Caritas — Medicare: $4.63
  • Cigna — Commercial: $11.15
  • Cigna — Medicare: $4.63
  • Geisinger — Medicaid/CHIP: $5.56
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $7.76
  • Highmark Wholecare (prev Gateway) — Medicare: $4.63
  • Humana — Commercial: $20.80
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME P4160 $26 $15.60 $4.24 – $22.88
Blood clotting time test (prothrombin time, PT): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $4.52
  • Aetna of PA — Medicare: $4.29
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.52
  • AmeriHealth Caritas — Medicare: $4.63
  • Cigna — Commercial: $11.15
  • Cigna — Medicare: $4.63
  • Geisinger — Medicaid/CHIP: $5.56
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $7.76
  • Highmark Wholecare (prev Gateway) — Medicare: $4.63
  • Humana — Commercial: $20.80
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACT PART THROMBOP TIME P P7021 $43 $25.80 $5.94 – $37.84
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $8.47
  • Aetna of PA — Medicare: $6.01
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $8.48
  • AmeriHealth Caritas — Medicare: $6.49
  • Cigna — Commercial: $15.63
  • Cigna — Medicare: $6.49
  • Geisinger — Medicaid/CHIP: $10.42
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $11.80
  • Highmark Wholecare (prev Gateway) — Medicare: $6.49
  • Humana — Commercial: $34.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACTIVATED PTT $43 $25.80 $5.94 – $37.84
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $8.47
  • Aetna of PA — Medicare: $6.01
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $8.48
  • AmeriHealth Caritas — Medicare: $6.49
  • Cigna — Commercial: $15.63
  • Cigna — Medicare: $6.49
  • Geisinger — Medicaid/CHIP: $10.42
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $11.80
  • Highmark Wholecare (prev Gateway) — Medicare: $6.49
  • Humana — Commercial: $34.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APTT (BASELINE) PNL 5464 $43 $25.80 $5.94 – $37.84
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $8.47
  • Aetna of PA — Medicare: $6.01
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $8.48
  • AmeriHealth Caritas — Medicare: $6.49
  • Cigna — Commercial: $15.63
  • Cigna — Medicare: $6.49
  • Geisinger — Medicaid/CHIP: $10.42
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $11.80
  • Highmark Wholecare (prev Gateway) — Medicare: $6.49
  • Humana — Commercial: $34.40

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 WO CONTRAST $1,054 $632.40 $89.12 – $927.52
CT scan of the head or brain, without contrast: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $131.93
  • Aetna of PA — Medicare: $101.38
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $151.79
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $670.35
  • Cigna — Medicare: $109.49
  • Geisinger — Medicaid/CHIP: $162.27
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $262.04
  • Highmark Wholecare (prev Gateway) — Medicare: $109.48
  • Humana — Commercial: $843.20
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD WO CONTRAST $1,054 $632.40 $790.50 – $927.52
CT scan of the head or brain, without contrast: rates for 3 insurance plans
  • Humana — Commercial: $843.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $790.50
  • National Provider Network — PPO: $927.52
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CT HEAD WO CONTRAST $1,054 $632.40 $89.12 – $927.52
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $131.93
  • Aetna of PA — Medicare: $102.57
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $151.79
  • Cigna — Commercial: $670.35
  • Geisinger — Medicaid/CHIP: $162.27
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $262.04
  • Highmark Wholecare (prev Gateway) — Medicare: $527
  • Humana — Commercial: $843.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $843.20
  • National Provider Network — PPO: $927.52
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR BRAIN W WO CON $4,307 $2,584.20 $309.35 – $3,812.26
MRI of the brain, before and after contrast: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $383.07
  • Aetna of PA — Medicare: $340.48
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $440.73
  • AmeriHealth Caritas — Medicare: $367.72
  • Cigna — Commercial: $1,122.38
  • Cigna — Medicare: $367.72
  • Geisinger — Medicaid/CHIP: $471.18
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,223.87
  • Highmark Wholecare (prev Gateway) — Medicare: $367.68
  • Humana — Commercial: $3,445.60
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR BRAIN W WO CON $4,307 $2,584.20 $3,230.25 – $3,790.16
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • Humana — Commercial: $3,445.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,230.25
  • National Provider Network — PPO: $3,790.16
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MR BRAIN W WO CON $4,307 $2,584.20 $309.35 – $3,812.26
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $383.07
  • Aetna of PA — Medicare: $329.85
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $440.73
  • Cigna — Commercial: $1,122.38
  • Geisinger — Medicaid/CHIP: $471.18
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,223.87
  • Highmark Wholecare (prev Gateway) — Medicare: $2,153.50
  • Humana — Commercial: $3,445.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,445.60
  • National Provider Network — PPO: $3,790.16
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST 2 VIEWS $359 $215.40 $11.99 – $315.92
Chest X-ray, 2 views: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $26.71
  • Aetna of PA — Medicare: $83.95
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $30.73
  • AmeriHealth Caritas — Medicare: $90.67
  • Cigna — Commercial: $208.21
  • Cigna — Medicare: $90.67
  • Geisinger — Medicaid/CHIP: $32.86
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $11.99
  • Highmark Wholecare (prev Gateway) — Medicare: $90.66
  • Humana — Commercial: $287.20
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHEST 2 VIEWS $359 $215.40 $269.25 – $315.92
Chest X-ray, 2 views: rates for 3 insurance plans
  • Humana — Commercial: $287.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $269.25
  • National Provider Network — PPO: $315.92
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: CHEST 2 VIEWS $359 $215.40 $11.99 – $315.92
Chest X-ray, 2 views: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $26.71
  • Aetna of PA — Medicare: $29.30
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $30.73
  • Cigna — Commercial: $208.21
  • Geisinger — Medicaid/CHIP: $32.86
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $11.99
  • Highmark Wholecare (prev Gateway) — Medicare: $179.50
  • Humana — Commercial: $287.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $287.20
  • National Provider Network — PPO: $315.92
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE LUMBOSAC MIN 4 VWS $475 $285 $25.88 – $418
X-ray of the lower spine, at least 4 views: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $41.38
  • Aetna of PA — Medicare: $101.38
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $47.61
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $251.90
  • Cigna — Medicare: $109.49
  • Geisinger — Medicaid/CHIP: $50.90
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $59.43
  • Highmark Wholecare (prev Gateway) — Medicare: $109.48
  • Humana — Commercial: $380
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINE LUMBOSAC MIN 4 VWS $475 $285 $356.25 – $418
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • Humana — Commercial: $380
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $356.25
  • National Provider Network — PPO: $418
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: SPINE LUMBOSAC MIN 4 VWS $475 $285 $25.88 – $418
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $41.38
  • Aetna of PA — Medicare: $44.71
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $47.61
  • Cigna — Commercial: $251.90
  • Geisinger — Medicaid/CHIP: $50.90
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $59.43
  • Highmark Wholecare (prev Gateway) — Medicare: $237.50
  • Humana — Commercial: $380
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $380
  • National Provider Network — PPO: $418
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR SP CANAL LUMBAR WO $2,533 $1,519.80 $215.28 – $2,229.04
MRI of the lower back (lumbar spine), without contrast: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $289.45
  • Aetna of PA — Medicare: $230.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $333.02
  • AmeriHealth Caritas — Medicare: $248.89
  • Cigna — Commercial: $1,122.38
  • Cigna — Medicare: $248.89
  • Geisinger — Medicaid/CHIP: $356.02
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $630.41
  • Highmark Wholecare (prev Gateway) — Medicare: $248.86
  • Humana — Commercial: $2,026.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR SP CANAL LUMBAR WO $2,533 $1,519.80 $1,899.75 – $2,229.04
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans
  • Humana — Commercial: $2,026.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,899.75
  • National Provider Network — PPO: $2,229.04
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MR SP CANAL LUMBAR WO $2,533 $1,519.80 $197.92 – $2,229.04
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $289.45
  • Aetna of PA — Medicare: $197.92
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $333.02
  • Cigna — Commercial: $1,122.38
  • Geisinger — Medicaid/CHIP: $356.02
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $630.41
  • Highmark Wholecare (prev Gateway) — Medicare: $1,266.50
  • Humana — Commercial: $2,026.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $2,026.40
  • National Provider Network — PPO: $2,229.04
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W CON $1,981 $1,188.60 $99.47 – $1,743.28
CT scan of the pelvis, with contrast: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $158.30
  • Aetna of PA — Medicare: $169.72
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.13
  • AmeriHealth Caritas — Medicare: $183.30
  • Cigna — Commercial: $670.35
  • Cigna — Medicare: $183.30
  • Geisinger — Medicaid/CHIP: $194.71
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $368.62
  • Highmark Wholecare (prev Gateway) — Medicare: $183.28
  • Humana — Commercial: $1,584.80
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W CON $1,981 $1,188.60 $1,485.75 – $1,743.28
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • Humana — Commercial: $1,584.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,485.75
  • National Provider Network — PPO: $1,743.28
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CT PELVIS W CON $1,981 $1,188.60 $99.47 – $1,743.28
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $158.30
  • Aetna of PA — Medicare: $215.23
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.13
  • Cigna — Commercial: $670.35
  • Geisinger — Medicaid/CHIP: $194.71
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $368.62
  • Highmark Wholecare (prev Gateway) — Medicare: $990.50
  • Humana — Commercial: $1,584.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,584.80
  • National Provider Network — PPO: $1,743.28
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LOW EXTREM ANY JNT WO $4,660 $2,796 $230.45 – $4,100.80
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates
  • Aetna of PA — Medicare: $230.45
  • AmeriHealth Caritas — Medicare: $248.89
  • Cigna — Commercial: $1,122.38
  • Cigna — Medicare: $248.89
  • Geisinger — Medicaid/CHIP: $2,563
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $543.49
  • Highmark Wholecare (prev Gateway) — Medicare: $248.86
  • Humana — Commercial: $3,728
  • Humana — Medicare: $230.45
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,728
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR LOW EXTREM ANY JNT WO $4,660 $2,796 $3,495 – $4,100.80
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • Humana — Commercial: $3,728
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,495
  • National Provider Network — PPO: $4,100.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MR LOW EXTREM ANY JNT WO $4,660 $2,796 $208.37 – $4,100.80
MRI of a leg joint (such as the knee), without contrast: 10 of 14 insurance plan rates
  • Aetna of PA — Medicare: $208.37
  • Cigna — Commercial: $1,122.38
  • Geisinger — Medicaid/CHIP: $2,563
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $543.49
  • Highmark Wholecare (prev Gateway) — Medicare: $2,330
  • Humana — Commercial: $3,728
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,728
  • National Provider Network — PPO: $4,100.80
  • PA Health & Wellness — PA Medicaid HMO: $2,563
  • United Healthcare — Commercial: $1,614
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PLVS W CONTRAST $4,591 $2,754.60 $221.64 – $4,040.08
CT scan of the abdomen and pelvis, with contrast: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $297.37
  • Aetna of PA — Medicare: $340.48
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $342.13
  • AmeriHealth Caritas — Medicare: $367.72
  • Cigna — Commercial: $670.35
  • Cigna — Medicare: $367.72
  • Geisinger — Medicaid/CHIP: $365.77
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $558.32
  • Highmark Wholecare (prev Gateway) — Medicare: $367.68
  • Humana — Commercial: $3,672.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABD & PLVS W CONTRAST $4,591 $2,754.60 $3,443.25 – $4,040.08
CT scan of the abdomen and pelvis, with contrast: rates for 3 insurance plans
  • Humana — Commercial: $3,672.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,443.25
  • National Provider Network — PPO: $4,040.08
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CT ABD & PLVS W CONTRAST $4,591 $2,754.60 $221.64 – $4,040.08
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $297.37
  • Aetna of PA — Medicare: $300.75
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $342.13
  • Cigna — Commercial: $670.35
  • Geisinger — Medicaid/CHIP: $365.77
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $558.32
  • Highmark Wholecare (prev Gateway) — Medicare: $2,295.50
  • Humana — Commercial: $3,672.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,672.80
  • National Provider Network — PPO: $4,040.08
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMINAL COMPLETE $1,520 $912 $66.12 – $1,337.60
Ultrasound of the abdomen, complete: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $107.66
  • Aetna of PA — Medicare: $101.38
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $123.86
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $251.90
  • Cigna — Medicare: $109.49
  • Geisinger — Medicaid/CHIP: $132.42
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $136.88
  • Highmark Wholecare (prev Gateway) — Medicare: $109.48
  • Humana — Commercial: $1,216
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMINAL COMPLETE $1,520 $912 $1,140 – $1,337.60
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • Humana — Commercial: $1,216
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,140
  • National Provider Network — PPO: $1,337.60
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: US ABDOMINAL COMPLETE $1,520 $912 $66.12 – $1,337.60
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $107.66
  • Aetna of PA — Medicare: $103.53
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $123.86
  • Cigna — Commercial: $251.90
  • Geisinger — Medicaid/CHIP: $132.42
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $136.88
  • Highmark Wholecare (prev Gateway) — Medicare: $760
  • Humana — Commercial: $1,216
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,216
  • National Provider Network — PPO: $1,337.60
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREGNANT UTERUS>14WKS $404 $242.40 $53.48 – $486.98
Pregnancy ultrasound (after the first trimester): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $87.58
  • Aetna of PA — Medicare: $101.38
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $100.76
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $251.90
  • Cigna — Medicare: $109.49
  • Geisinger — Medicaid/CHIP: $107.72
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $154.35
  • Highmark Wholecare (prev Gateway) — Medicare: $109.48
  • Humana — Commercial: $323.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PREGNANT UTERUS>14WKS $404 $242.40 $303 – $355.52
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • Humana — Commercial: $323.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $303
  • National Provider Network — PPO: $355.52
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: US PREGNANT UTERUS>14WKS $404 $242.40 $53.48 – $486.98
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates
  • Aetna — Medicaid: $87.58
  • Aetna of PA — Medicare: $118.91
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $100.76
  • Cigna — Commercial: $251.90
  • Geisinger — Medicaid/CHIP: $107.72
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $154.35
  • Highmark Wholecare (prev Gateway) — Medicare: $202
  • Humana — Commercial: $323.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $323.20
  • National Provider Network — PPO: $355.52
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $658 $394.80 $53.48 – $579.04
Transvaginal ultrasound: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $86.44
  • Aetna of PA — Medicare: $101.38
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $99.46
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $251.90
  • Cigna — Medicare: $109.49
  • Geisinger — Medicaid/CHIP: $106.33
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $110.77
  • Highmark Wholecare (prev Gateway) — Medicare: $109.48
  • Humana — Commercial: $526.40
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $658 $394.80 $493.50 – $579.04
Transvaginal ultrasound: rates for 3 insurance plans
  • Humana — Commercial: $526.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $493.50
  • National Provider Network — PPO: $579.04
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: US TRANSVAGINAL $658 $394.80 $53.48 – $579.04
Transvaginal ultrasound: 10 of 17 insurance plan rates
  • Aetna — Medicaid: $86.44
  • Aetna of PA — Medicare: $105.62
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $99.46
  • Cigna — Commercial: $251.90
  • Geisinger — Medicaid/CHIP: $106.33
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $110.77
  • Highmark Wholecare (prev Gateway) — Medicare: $329
  • Humana — Commercial: $526.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $526.40
  • National Provider Network — PPO: $579.04
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DX UNI WWO CAD $293 $175.80 $58.73 – $364.39
Diagnostic mammogram, one breast: 10 of 16 insurance plan rates
  • Aetna — Medicaid: $115.72
  • Aetna of PA — Medicare: $110.19
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $133.14
  • Cigna — Commercial: $204.08
  • Geisinger — Medicaid/CHIP: $142.34
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $58.73
  • Highmark Wholecare (prev Gateway) — Medicare: $146.50
  • Humana — Commercial: $234.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $234.40
  • National Provider Network — PPO: $257.84
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DX UNI WWO CAD $293 $175.80 $219.75 – $257.84
Diagnostic mammogram, one breast: rates for 3 insurance plans
  • Humana — Commercial: $234.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $219.75
  • National Provider Network — PPO: $257.84
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: MAMMO DIGITAL DX UNI WWO CAD $293 $175.80 $58.73 – $364.39
Diagnostic mammogram, one breast: 10 of 16 insurance plan rates
  • Aetna — Medicaid: $115.72
  • Aetna of PA — Medicare: $110.19
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $133.14
  • Cigna — Commercial: $204.08
  • Geisinger — Medicaid/CHIP: $142.34
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $58.73
  • Highmark Wholecare (prev Gateway) — Medicare: $146.50
  • Humana — Commercial: $234.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $234.40
  • National Provider Network — PPO: $257.84
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: MAMMO DIGITAL DX BILAT WWO CAD $510 $306 $74.91 – $675.02
Diagnostic mammogram, both breasts: 10 of 16 insurance plan rates
  • Aetna — Medicaid: $146.73
  • Aetna of PA — Medicare: $139.16
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $168.82
  • Cigna — Commercial: $261.72
  • Geisinger — Medicaid/CHIP: $180.48
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $74.91
  • Highmark Wholecare (prev Gateway) — Medicare: $255
  • Humana — Commercial: $408
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $408
  • National Provider Network — PPO: $448.80
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee · modifier PN In the file: MAMMO DIGITAL DX BILAT WWO CAD $510 $306 $382.50 – $448.80
Diagnostic mammogram, both breasts: rates for 3 insurance plans
  • Humana — Commercial: $408
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $382.50
  • National Provider Network — PPO: $448.80
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: MAMMO DIGI SCR BILAT WWO CAD $342 $205.20 $62.03 – $551.43
Screening mammogram, both breasts: 10 of 16 insurance plan rates
  • Aetna — Medicaid: $118.31
  • Aetna of PA — Medicare: $112.12
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $136.12
  • Cigna — Commercial: $215.76
  • Geisinger — Medicaid/CHIP: $145.52
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $62.03
  • Highmark Wholecare (prev Gateway) — Medicare: $171
  • Humana — Commercial: $273.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $273.60
  • National Provider Network — PPO: $300.96
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee · modifier PN In the file: MAMMO DIGI SCR BILAT WWO CAD $342 $205.20 $256.50 – $300.96
Screening mammogram, both breasts: rates for 3 insurance plans
  • Humana — Commercial: $273.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $256.50
  • National Provider Network — PPO: $300.96

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W VENTRCLGRPHY $9,455 $5,673 $892.40 – $8,320.40
Left heart catheterization (diagnostic): 10 of 22 insurance plan rates
  • Aetna of PA — Medicare: $3,066.46
  • AmeriHealth Caritas — Medicare: $3,311.78
  • Cigna — Commercial: $4,232.23
  • Cigna — Medicare: $3,311.78
  • Geisinger — Medicaid/CHIP: $5,200.25
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,064.82
  • Highmark Wholecare (prev Gateway) — Medicare: $3,311.47
  • Humana — Commercial: $7,564
  • Humana — Medicare: $3,066.46
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $7,564
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEFT HRT CATH W VENTRCLGRPHY $9,455 $5,673 $7,091.25 – $8,320.40
Left heart catheterization (diagnostic): rates for 3 insurance plans
  • Humana — Commercial: $7,564
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $7,091.25
  • National Provider Network — PPO: $8,320.40

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 · modifier GO,CO In the file: CO THERAPEUTIC EXERCISE P/15M $153 $91.80 $9.22 – $172
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates
  • Aetna — Medicaid: $9.47
  • Aetna of PA — Medicare: $20.43
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.89
  • Cigna — Commercial: $145.55
  • Geisinger — Medicaid/CHIP: $11.65
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $25.93
  • Highmark Wholecare (prev Gateway) — Medicare: $76.50
  • Humana — Commercial: $122.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $122.40
  • National Provider Network — PPO: $134.64
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP,CQ In the file: CQ THERAPEUTIC EXERCISE P/15M $153 $91.80 $9.22 – $172
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates
  • Aetna — Medicaid: $9.47
  • Aetna of PA — Medicare: $20.43
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.89
  • Cigna — Commercial: $145.55
  • Geisinger — Medicaid/CHIP: $11.65
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $25.93
  • Highmark Wholecare (prev Gateway) — Medicare: $76.50
  • Humana — Commercial: $122.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $122.40
  • National Provider Network — PPO: $134.64
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: OT THERAPEUTIC EXERCISE P/15M $153 $91.80 $9.22 – $172
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 18 insurance plan rates
  • Aetna — Medicaid: $9.47
  • Aetna of PA — Medicare: $20.43
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $10.89
  • Cigna — Commercial: $145.55
  • Geisinger — Medicaid/CHIP: $11.65
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $25.93
  • Highmark Wholecare (prev Gateway) — Medicare: $76.50
  • Humana — Commercial: $122.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $122.40
  • National Provider Network — PPO: $134.64
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX $281 $168.60 $52.47 – $247.28
Physical therapy evaluation (low complexity): 10 of 15 insurance plan rates
  • Aetna of PA — Medicare: $69.52
  • Cigna — Commercial: $145.55
  • Geisinger — Medicaid/CHIP: $154.55
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $52.47
  • Highmark Wholecare (prev Gateway) — Medicare: $140.50
  • Humana — Commercial: $224.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $224.80
  • National Provider Network — PPO: $247.28
  • Occunet — Commercial: $85
  • PA Health & Wellness — PA Medicaid HMO: $154.55
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX $281 $168.60 $210.75 – $247.28
Physical therapy evaluation (low complexity): rates for 3 insurance plans
  • Humana — Commercial: $224.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $210.75
  • National Provider Network — PPO: $247.28
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX $281 $168.60 $29.13 – $247.28
Physical therapy evaluation (moderate complexity): 10 of 15 insurance plan rates
  • Aetna of PA — Medicare: $69.52
  • Cigna — Commercial: $145.55
  • Geisinger — Medicaid/CHIP: $154.55
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $52.47
  • Highmark Wholecare (prev Gateway) — Medicare: $140.50
  • Humana — Commercial: $224.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $224.80
  • National Provider Network — PPO: $247.28
  • Occunet — Commercial: $85
  • PA Health & Wellness — PA Medicaid HMO: $154.55
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX $281 $168.60 $210.75 – $247.28
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans
  • Humana — Commercial: $224.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $210.75
  • National Provider Network — PPO: $247.28
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX $281 $168.60 $52.47 – $247.28
Physical therapy evaluation (high complexity): 10 of 15 insurance plan rates
  • Aetna of PA — Medicare: $69.52
  • Cigna — Commercial: $145.55
  • Geisinger — Medicaid/CHIP: $154.55
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $52.47
  • Highmark Wholecare (prev Gateway) — Medicare: $140.50
  • Humana — Commercial: $224.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $224.80
  • National Provider Network — PPO: $247.28
  • Occunet — Commercial: $85
  • PA Health & Wellness — PA Medicaid HMO: $154.55
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX $281 $168.60 $210.75 – $247.28
Physical therapy evaluation (high complexity): rates for 3 insurance plans
  • Humana — Commercial: $224.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $210.75
  • National Provider Network — PPO: $247.28
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: IOP PSYCHOTHERAPY 30 MIN $204 $122.40 $28.60 – $179.52
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $29.38
  • Aetna of PA — Medicare: $56.44
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $33.80
  • Cigna — Commercial: $62.83
  • Geisinger — Medicaid/CHIP: $36.14
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $121.06
  • Highmark Wholecare (prev Gateway) — Medicare: $102
  • Humana — Commercial: $163.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $163.20
  • National Provider Network — PPO: $179.52
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: PSYCHOTHERAPY 30 MINUTES $204 $122.40 $28.60 – $179.52
Psychotherapy, 30 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $29.38
  • Aetna of PA — Medicare: $56.44
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $33.80
  • Cigna — Commercial: $62.83
  • Geisinger — Medicaid/CHIP: $36.14
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $121.06
  • Highmark Wholecare (prev Gateway) — Medicare: $102
  • Humana — Commercial: $163.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $163.20
  • National Provider Network — PPO: $179.52
Psychotherapy, 30 minutes CPT 90832 · Inpatient (hospital stay) · Hospital (facility) fee · modifier PO In the file: IOP PSYCHOTHERAPY 30 MIN $204 $122.40 $153 – $179.52
Psychotherapy, 30 minutes: rates for 3 insurance plans
  • Humana — Commercial: $163.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $153
  • National Provider Network — PPO: $179.52
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: IOP PSYCHOTHERAPY 45 MIN $303 $181.80 $42.90 – $266.64
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $44.07
  • Aetna of PA — Medicare: $75.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $50.70
  • Cigna — Commercial: $93.32
  • Geisinger — Medicaid/CHIP: $54.21
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $178.76
  • Highmark Wholecare (prev Gateway) — Medicare: $151.50
  • Humana — Commercial: $242.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $242.40
  • National Provider Network — PPO: $266.64
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: PSYCHOTHERAPY 45 MINUTES $303 $181.80 $42.90 – $266.64
Psychotherapy, 45 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $44.07
  • Aetna of PA — Medicare: $75.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $50.70
  • Cigna — Commercial: $93.32
  • Geisinger — Medicaid/CHIP: $54.21
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $178.76
  • Highmark Wholecare (prev Gateway) — Medicare: $151.50
  • Humana — Commercial: $242.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $242.40
  • National Provider Network — PPO: $266.64
Psychotherapy, 45 minutes CPT 90834 · Inpatient (hospital stay) · Hospital (facility) fee · modifier PO In the file: IOP PSYCHOTHERAPY 45 MIN $303 $181.80 $227.25 – $266.64
Psychotherapy, 45 minutes: rates for 3 insurance plans
  • Humana — Commercial: $242.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $227.25
  • National Provider Network — PPO: $266.64
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: IND THERAPY 75 MINUTES $396 $237.60 $57.20 – $348.48
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $58.76
  • Aetna of PA — Medicare: $112.35
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $67.61
  • Cigna — Commercial: $121.97
  • Geisinger — Medicaid/CHIP: $72.27
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $261.04
  • Highmark Wholecare (prev Gateway) — Medicare: $198
  • Humana — Commercial: $316.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $316.80
  • National Provider Network — PPO: $348.48
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: IOP PSYCHOTHERAPY 60 MIN $396 $237.60 $57.20 – $348.48
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $58.76
  • Aetna of PA — Medicare: $112.35
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $67.61
  • Cigna — Commercial: $121.97
  • Geisinger — Medicaid/CHIP: $72.27
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $261.04
  • Highmark Wholecare (prev Gateway) — Medicare: $198
  • Humana — Commercial: $316.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $316.80
  • National Provider Network — PPO: $348.48
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: PSYCHOTHERAPY 60 MINUTES $396 $237.60 $57.20 – $348.48
Psychotherapy, 60 minutes: 10 of 15 insurance plan rates
  • Aetna — Medicaid: $58.76
  • Aetna of PA — Medicare: $112.35
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $67.61
  • Cigna — Commercial: $121.97
  • Geisinger — Medicaid/CHIP: $72.27
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $261.04
  • Highmark Wholecare (prev Gateway) — Medicare: $198
  • Humana — Commercial: $316.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $316.80
  • National Provider Network — PPO: $348.48
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: IOP FAMILY W/O PT $112 $67.20 $34.50 – $215.10
Family psychotherapy, without the patient: 10 of 12 insurance plan rates
  • Aetna of PA — Medicare: $79.24
  • Cigna — Commercial: $34.50
  • Geisinger — Medicaid/CHIP: $61.60
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $74.21
  • Highmark Wholecare (prev Gateway) — Medicare: $56
  • Humana — Commercial: $89.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $89.60
  • National Provider Network — PPO: $98.56
  • PA Health & Wellness — PA Medicaid HMO: $61.60
  • UPMC Health Plan — CHIP: $215.10
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: PRTL ACUTE FAMILY W/O PT $112 $67.20 $34.50 – $215.10
Family psychotherapy, without the patient: 10 of 12 insurance plan rates
  • Aetna of PA — Medicare: $79.24
  • Cigna — Commercial: $34.50
  • Geisinger — Medicaid/CHIP: $61.60
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $74.21
  • Highmark Wholecare (prev Gateway) — Medicare: $56
  • Humana — Commercial: $89.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $89.60
  • National Provider Network — PPO: $98.56
  • PA Health & Wellness — PA Medicaid HMO: $61.60
  • UPMC Health Plan — CHIP: $215.10
Family psychotherapy, without the patient CPT 90846 · Inpatient (hospital stay) · Hospital (facility) fee · modifier PO In the file: IOP FAMILY W/O PT $112 $67.20 $84 – $98.56
Family psychotherapy, without the patient: rates for 3 insurance plans
  • Humana — Commercial: $89.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $84
  • National Provider Network — PPO: $98.56
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: IOP FAMILY W/PT $112 $67.20 $34.50 – $253.51
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna of PA — Medicare: $82.03
  • Cigna — Commercial: $34.50
  • Geisinger — Medicaid/CHIP: $61.60
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $86.33
  • Highmark Wholecare (prev Gateway) — Medicare: $56
  • Humana — Commercial: $89.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $89.60
  • National Provider Network — PPO: $98.56
  • PA Health & Wellness — PA Medicaid HMO: $61.60
  • UPMC Health Plan — CHIP: $253.51
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: PRTL ACUTE FAMILY W PT $112 $67.20 $34.50 – $253.51
Family psychotherapy, with the patient: 10 of 12 insurance plan rates
  • Aetna of PA — Medicare: $82.03
  • Cigna — Commercial: $34.50
  • Geisinger — Medicaid/CHIP: $61.60
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $86.33
  • Highmark Wholecare (prev Gateway) — Medicare: $56
  • Humana — Commercial: $89.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $89.60
  • National Provider Network — PPO: $98.56
  • PA Health & Wellness — PA Medicaid HMO: $61.60
  • UPMC Health Plan — CHIP: $253.51
Family psychotherapy, with the patient CPT 90847 · Inpatient (hospital stay) · Hospital (facility) fee · modifier PO In the file: IOP FAMILY W/PT $112 $67.20 $84 – $98.56
Family psychotherapy, with the patient: rates for 3 insurance plans
  • Humana — Commercial: $89.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $84
  • National Provider Network — PPO: $98.56
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IP GROUP THERAPY $74 $44.40 $22.79 – $323.57
Group psychotherapy: 10 of 20 insurance plan rates
  • Aetna of PA — Medicare: $88.19
  • AmeriHealth Caritas — Medicare: $95.25
  • Cigna — Commercial: $22.79
  • Cigna — Medicare: $95.25
  • Geisinger — Medicaid/CHIP: $40.70
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $109.50
  • Highmark Wholecare (prev Gateway) — Medicare: $95.24
  • Humana — Commercial: $59.20
  • Humana — Medicare: $88.19
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $59.20
Group psychotherapy CPT 90853 · Inpatient (hospital stay) · Hospital (facility) fee In the file: IP GROUP THERAPY $74 $44.40 $55.50 – $65.12
Group psychotherapy: rates for 3 insurance plans
  • Humana — Commercial: $59.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $55.50
  • National Provider Network — PPO: $65.12

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD W/WO BRUSHINGS $3,121 $1,872.60 $137.74 – $2,746.48
Upper GI endoscopy (diagnostic): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $141.50
  • Aetna of PA — Medicare: $893.85
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $162.80
  • AmeriHealth Caritas — Medicare: $965.36
  • Cigna — Commercial: $704.18
  • Cigna — Medicare: $965.36
  • Geisinger — Medicaid/CHIP: $174.04
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $554.65
  • Highmark Wholecare (prev Gateway) — Medicare: $965.27
  • Humana — Commercial: $2,496.80
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD W/WO BRUSHINGS $3,121 $1,872.60 $2,340.75 – $2,746.48
Upper GI endoscopy (diagnostic): rates for 3 insurance plans
  • Humana — Commercial: $2,496.80
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $2,340.75
  • National Provider Network — PPO: $2,746.48
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD W/BIOPSY SINGLE/MULT $2,197 $1,318.20 $163.44 – $2,316.50
Upper GI endoscopy with biopsy: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $167.90
  • Aetna of PA — Medicare: $893.85
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $193.17
  • AmeriHealth Caritas — Medicare: $965.36
  • Cigna — Commercial: $953.25
  • Cigna — Medicare: $965.36
  • Geisinger — Medicaid/CHIP: $206.51
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $742.68
  • Highmark Wholecare (prev Gateway) — Medicare: $965.27
  • Humana — Commercial: $1,757.60
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD W/BIOPSY SINGLE/MULT $2,197 $1,318.20 $1,647.75 – $1,933.36
Upper GI endoscopy with biopsy: rates for 3 insurance plans
  • Humana — Commercial: $1,757.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,647.75
  • National Provider Network — PPO: $1,933.36
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAG W/WO BRUSHING $2,500 $1,500 $198.55 – $2,315.60
Colonoscopy (diagnostic): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $203.97
  • Aetna of PA — Medicare: $869.21
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $234.67
  • AmeriHealth Caritas — Medicare: $938.75
  • Cigna — Commercial: $953.25
  • Cigna — Medicare: $938.75
  • Geisinger — Medicaid/CHIP: $250.88
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $742.68
  • Highmark Wholecare (prev Gateway) — Medicare: $938.66
  • Humana — Commercial: $2,000
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAG W/WO BRUSHING $2,500 $1,500 $1,875 – $2,200
Colonoscopy (diagnostic): rates for 3 insurance plans
  • Humana — Commercial: $2,000
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,875
  • National Provider Network — PPO: $2,200
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BX SINGLE/MULT $4,127 $2,476.20 $247.96 – $3,631.76
Colonoscopy with biopsy: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $254.72
  • Aetna of PA — Medicare: $1,124.11
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $293.07
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Cigna — Commercial: $953.25
  • Cigna — Medicare: $1,214.04
  • Geisinger — Medicaid/CHIP: $313.31
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $742.68
  • Highmark Wholecare (prev Gateway) — Medicare: $1,213.93
  • Humana — Commercial: $3,301.60
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BX SINGLE/MULT $4,127 $2,476.20 $3,095.25 – $3,631.76
Colonoscopy with biopsy: rates for 3 insurance plans
  • Humana — Commercial: $3,301.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,095.25
  • National Provider Network — PPO: $3,631.76
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/SNARE TECHNIQUE $4,127 $2,476.20 $294.89 – $3,631.76
Colonoscopy with removal of polyps (snare): 10 of 25 insurance plan rates
  • Aetna — Medicaid: $302.93
  • Aetna of PA — Medicare: $1,124.11
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $348.53
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Cigna — Commercial: $953.25
  • Cigna — Medicare: $1,214.04
  • Geisinger — Medicaid/CHIP: $372.60
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $742.68
  • Highmark Wholecare (prev Gateway) — Medicare: $1,213.93
  • Humana — Commercial: $3,301.60
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/SNARE TECHNIQUE $4,127 $2,476.20 $3,095.25 – $3,631.76
Colonoscopy with removal of polyps (snare): rates for 3 insurance plans
  • Humana — Commercial: $3,301.60
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,095.25
  • National Provider Network — PPO: $3,631.76
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY Not listed in the file Not listed in the file $892.40 – $7,509.19
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates
  • Aetna of PA — Medicare: $5,562.36
  • AmeriHealth Caritas — Medicare: $6,007.35
  • Cigna — Commercial: $4,444.40
  • Cigna — Medicare: $6,007.35
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,660.22
  • Highmark Wholecare (prev Gateway) — Medicare: $6,006.79
  • Humana — Medicare: $5,562.36
  • Occunet — Commercial: $7,509.19
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $6,007.35
  • United Healthcare — Commercial: $6,270
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BX PROSTATE NDL/PNCH SGL/MULT $4,393 $2,635.80 $98.45 – $3,865.84
Prostate biopsy: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $101.14
  • Aetna of PA — Medicare: $1,953.01
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $116.36
  • AmeriHealth Caritas — Medicare: $2,109.25
  • Cigna — Commercial: $953.25
  • Cigna — Medicare: $2,109.25
  • Geisinger — Medicaid/CHIP: $124.40
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $742.68
  • Highmark Wholecare (prev Gateway) — Medicare: $2,109.06
  • Humana — Commercial: $3,514.40
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BX PROSTATE NDL/PNCH SGL/MULT $4,393 $2,635.80 $3,294.75 – $3,865.84
Prostate biopsy: rates for 3 insurance plans
  • Humana — Commercial: $3,514.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,294.75
  • National Provider Network — PPO: $3,865.84
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTRLMNR LUM/SAC W/IMG GDE $2,489 $1,493.40 $89.45 – $2,190.32
Spinal injection, lower back (epidural), with imaging guidance: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $91.89
  • Aetna of PA — Medicare: $660.23
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $105.72
  • AmeriHealth Caritas — Medicare: $713.05
  • Cigna — Commercial: $704.18
  • Cigna — Medicare: $713.05
  • Geisinger — Medicaid/CHIP: $113.03
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $156.36
  • Highmark Wholecare (prev Gateway) — Medicare: $712.98
  • Humana — Commercial: $1,991.20
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX INTRLMNR LUM/SAC W/IMG GDE $2,489 $1,493.40 $1,866.75 – $2,190.32
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans
  • Humana — Commercial: $1,991.20
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $1,866.75
  • National Provider Network — PPO: $2,190.32
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSFORAM EPID LUMB/SAC SNGL $4,458 $2,674.80 $104.54 – $3,923.04
Nerve root injection, lower back, with imaging guidance: 10 of 25 insurance plan rates
  • Aetna — Medicaid: $107.40
  • Aetna of PA — Medicare: $848.78
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $123.56
  • AmeriHealth Caritas — Medicare: $916.68
  • Cigna — Commercial: $704.18
  • Cigna — Medicare: $916.68
  • Geisinger — Medicaid/CHIP: $132.10
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $596.53
  • Highmark Wholecare (prev Gateway) — Medicare: $916.60
  • Humana — Commercial: $3,566.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TRANSFORAM EPID LUMB/SAC SNGL $4,458 $2,674.80 $3,343.50 – $3,923.04
Nerve root injection, lower back, with imaging guidance: rates for 3 insurance plans
  • Humana — Commercial: $3,566.40
  • Multiplan — PPO (inc. Auto and Worker's Compensation): $3,343.50
  • National Provider Network — PPO: $3,923.04

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 $69,904.03 – $99,608.47
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 14 insurance plan rates
  • Aetna of PA — Medicare: $69,904.03
  • AmeriHealth Caritas — Medicare: $75,496.35
  • Cigna — Commercial: $77,762.30
  • Cigna — Medicare: $75,496.35
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $86,051.86
  • Highmark Wholecare (prev Gateway) — Medicare: $75,489.36
  • Humana — Medicare: $69,904.03
  • Occunet — Commercial: $97,865.64
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $75,496.35
  • United Healthcare — Commercial: $99,608.47
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: DRG Grouper 12 (10/1/1994): DRG 216: BIOPSIES OF MUSCULOSKELETAL SYSTEM Not listed in the file Not listed in the file $18,211.80 – $21,661.70
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $18,211.80
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DRG Grouper 12 (10/1/1994): DRG 460: NON-EXTENSIVE BURNS W/O O.R. Not listed in the file Not listed in the file $8,673.23 – $10,316.22
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $8,673.23
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 $14,203.26 – $19,884.56
Hip or knee replacement (major joint of the leg), without major complications: 10 of 14 insurance plan rates
  • Aetna of PA — Medicare: $14,203.26
  • AmeriHealth Caritas — Medicare: $15,339.52
  • Cigna — Commercial: $15,332.59
  • Cigna — Medicare: $15,339.52
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $17,484.21
  • Highmark Wholecare (prev Gateway) — Medicare: $15,338.10
  • Humana — Medicare: $14,203.26
  • Occunet — Commercial: $19,884.56
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $15,339.52
  • United Healthcare — Commercial: $19,640.06
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 $17,837.26 – $24,972.16
Neck (cervical) spinal fusion, without complications: 10 of 14 insurance plan rates
  • Aetna of PA — Medicare: $17,837.26
  • AmeriHealth Caritas — Medicare: $19,264.24
  • Cigna — Commercial: $19,405.60
  • Cigna — Medicare: $19,264.24
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $21,957.67
  • Highmark Wholecare (prev Gateway) — Medicare: $19,262.46
  • Humana — Medicare: $17,837.26
  • Occunet — Commercial: $24,972.16
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $19,264.24
  • United Healthcare — Commercial: $24,857.32
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DRG Grouper 12 (10/1/1994): DRG 473: ACUTE LEUKEMIA W/O MAJOR O.R. Not listed in the file Not listed in the file $31,255.83 – $37,176.69
Neck (cervical) spinal fusion, without complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $31,255.83
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 $9,322.44 – $13,051.42
Uterus and ovary surgery (not for cancer), without complications: 10 of 14 insurance plan rates
  • Aetna of PA — Medicare: $9,322.44
  • AmeriHealth Caritas — Medicare: $10,068.24
  • Cigna — Commercial: $9,862.18
  • Cigna — Medicare: $10,068.24
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $11,475.92
  • Highmark Wholecare (prev Gateway) — Medicare: $10,067.30
  • Humana — Medicare: $9,322.44
  • Occunet — Commercial: $13,051.42
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $10,068.24
  • United Healthcare — Commercial: $12,632.81

Source: UPMC Jameson’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 typeAcute Care Hospital
Address1211 Wilmington Avenue, New Castle, PA 16105
CountyLawrence County
StatePennsylvania
Phone(724) 656‑4100
Emergency servicesYes
OwnershipVoluntary non-profit - Other
Medicare overall rating3 of 5 stars
CMS Certification Number390016
Name in Medicare recordsUPMC JAMESON
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(724) 658‑9001[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 Jameson — upmc.com
  2. UPMC Jameson visitor information — upmc.com
  3. Emergency Department | UPMC Jameson — upmc.com
  4. Pediatric Rehab Clinic | UPMC Jameson — upmc.com
  5. General Surgery | UPMC Jameson — upmc.com
  6. Behavioral Health | UPMC Jameson — upmc.com
  7. Rehabilitation Services | UPMC Jameson — upmc.com
  8. Before Your Stay | UPMC Jameson — upmc.com
  9. During Your Stay | UPMC Jameson — upmc.com