Does UPMC Kane have an emergency room?

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

4372 Route 6, Kane, PA 16735, in McKean County, Pennsylvania.

What is the phone number of UPMC Kane?

(814) 837-8585, as listed by Medicare (CMS).

What is the Medicare star rating of UPMC Kane?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

UPMC Kane — Kane, PA | US Patient Guide

Quick answers

Does UPMC Kane have an emergency room?: Yes. Medicare (CMS) data lists emergency services at UPMC Kane. In a medical emergency, call 911.
Where is UPMC Kane?: 4372 Route 6, Kane, PA 16735, in McKean County, Pennsylvania.
What is the phone number of UPMC Kane?: (814) 837-8585, as listed by Medicare (CMS).
What is the Medicare star rating of UPMC Kane?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][7][8]

Gastroenterology
Heart and Vascular
Imaging
Occupational Health
Orthopaedics
Pain Management
Primary Care
Rehabilitation
Women's Health
Cardiopulmonary Services
Acute care
Emergency
Laboratory

Conditions treated^[5][9]

Heartburn/reflux (GERD)
Irritable bowel syndrome (IBS)
Abdominal pain, constipation, and diarrhea
Ulcerative colitis
Crohn's disease
Chronic and acute liver and pancreatic disorders
Gastric and duodenal ulcer disease
Anal and rectal disorders
Gastrointestinal cancers
Swallowing difficulties
Cognitive and memory deficits
Paralysis of the face
Head and/or neck trauma

Treatments^[5]

Physical therapy
Speech therapy
Swallow therapy
Electrical stimulation
Massage
Traction (cervical and lumbar)
Ultrasound therapy
Iontophoresis
Joint mobilization
Wound care
Ergonomic evaluation
Adaptive equipment

Procedures^[8][9][10]

Colonoscopy and flexible sigmoidoscopy screening
Ambulatory cardiac monitoring (telemetry)
EKG with interpretation
Spirometry/PFT
Chest x-ray
Drug screening collections
Physical exams
Vaccinations

Programs and centers^{[4][5][8][10]}

Cardiac Rehabilitation and Wellness
Interventional Pain Management Clinic
Home Health Care
Intensive care unit (ICU)
Occupational health services
Backpack program at school

Emergency care (hospital website)^[4]

Emergency room	Yes

Visiting and practical information

Parking	Free parking 24/7 in the main lot outside the main entrance and at outpatient locations; accessible spots near the ED entrance^[11]
Patient portal	MyUPMC

Doctors and clinicians (164)

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

Main specialties

And 140 more: the button below opens the full list.

Other emergency rooms nearby

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

Penn Highlands Elk18 mi · Saint Marys, PA · Critical Access Hospital
Warren General Hospital23 mi · Warren, PA · Acute Care Hospital
Penn Highlands Dubois36 mi · Dubois, PA · Acute Care Hospital
Penn Highlands Brookville36 mi · Brookville, PA · Critical Access Hospital
Olean General Hospital37 mi · Olean, NY · Acute Care Hospital

Other hospitals nearby

Warren State Hospital25 mi · North Warren, PA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

The Lutheran Home at Kane2.1 mi · Kane, PA · 4 of 5 stars
Elk Haven Nursing Home18 mi · Saint Marys, PA · 4 of 5 stars
Pinecrest Manor18 mi · St Marys, PA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Penn Highlands Community Nurses19 mi · Saint Marys, PA · 5 of 5 stars
VNA of Northwest PA, LLC20 mi · Bradford, PA
Hospice of Warren County23 mi · Warren, PA · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Penn Highlands Community Nurses19 mi · Saint Marys, PA · 3 of 5 stars
VNA of Northwest PA, LLC20 mi · Bradford, PA · 4 of 5 stars
Darling's Home Care23 mi · Warren, PA · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

USRC St. Marys19 mi · Saint Marys, PA · 3 of 5 stars
DaVita Bradford20 mi · Bradford, PA · 3 of 5 stars
DaVita Warren Dialysis23 mi · Warren, PA · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Community Surgery & Laser Center LLC23 mi · Warren, PA

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

Kane Dental and Primary Care Center2.3 mi · Kane, PA · Community health center
Ridgway Area Medical Center14 mi · Ridgway, PA · Community health center
Fox Township Dental Clinic22 mi · Kersey, PA · Community health center

Clinics and urgent care

Penn Highlands Elk9.8 mi · Johnsonburg, PA · Rural health clinic
UPMC Kane Primary & Specialty Care-Johnsonburg9.8 mi · Johnsonburg, PA · Rural health clinic
UPMC Kane Primary & Specialty Care - Sheffield14 mi · Sheffield, PA · Rural health clinic

Pharmacies

Medicine Shoppe0.0 mi · Kane, PA · Community/retail pharmacy
Penn Highlands Home Medical Equipment LLC0.0 mi · Kane, PA · Community/retail pharmacy

Assisted living nearby

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

Lutheran Home at Kane/Residential Care Center0.0 mi · Kane, PA
Ruth M Smith Center14 mi · Sheffield, PA
Ruth M Smith Center14 mi · Sheffield, PA
Ruth M Smith Center14 mi · Sheffield, PA

About the Medicare star rating

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

Medicare quality data

What UPMC Kane 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.

Not reported to Medicare

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	Too few cases to report
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Too few cases to report

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Too few cases to report
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	Too few cases to report
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	102 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Too few cases to report

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 58 common services exactly as UPMC Kane 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 →

$ 9 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF OV NEW PATIENT DETAILED	$172	$103.20	$57.70 – $3,872.06
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $59.67 Aetna of PA — Medicare: $66.19 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.69 AmeriHealth Caritas — Medicare: $68.73 Cigna — Commercial: $63.91 Cigna — Medicare: $3,872.06 Focus Healthcare — Disability/PPO/Auto: $163.40 Focus Healthcare — Workers Compensation: $139.91 Geisinger — Medicaid/CHIP: $75.40 Health Coalition Partners — PPO: $137.60
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF NEW PAT LEVEL 3 INTERMED	$172	$103.20	$57.70 – $3,872.06
New patient office visit (about 30–44 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $59.67 Aetna of PA — Medicare: $66.19 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.69 AmeriHealth Caritas — Medicare: $68.73 Cigna — Commercial: $63.91 Cigna — Medicare: $3,872.06 Focus Healthcare — Disability/PPO/Auto: $163.40 Focus Healthcare — Workers Compensation: $139.91 Geisinger — Medicaid/CHIP: $75.40 Health Coalition Partners — PPO: $137.60
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TF OV NEW PATIENT DETAILED	$172	$103.20	$120.40 – $163.40
New patient office visit (about 30–44 minutes): rates for 5 insurance plans Cigna — Commercial: $120.40 Focus Healthcare — Disability/PPO/Auto: $163.40 Health Coalition Partners — PPO: $137.60 InterGroup — Commercial: $137.60 Multiplan — Auto/PPO/Worker's Compensation: $129
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF OV NEW PATIENT COMPREHENS	$217	$130.20	$63.10 – $4,885.10
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $99.41 Aetna of PA — Medicare: $83.50 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $141.08 AmeriHealth Caritas — Medicare: $86.71 Cigna — Commercial: $63.91 Cigna — Medicare: $4,885.10 Focus Healthcare — Disability/PPO/Auto: $206.15 Focus Healthcare — Workers Compensation: $214.03 Geisinger — Medicaid/CHIP: $125.61 Health Coalition Partners — PPO: $173.60
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF NEW PAT LEVEL 4 EXTENDED	$217	$130.20	$63.10 – $4,885.10
New patient office visit (about 45–59 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $99.41 Aetna of PA — Medicare: $83.50 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $141.08 AmeriHealth Caritas — Medicare: $86.71 Cigna — Commercial: $63.91 Cigna — Medicare: $4,885.10 Focus Healthcare — Disability/PPO/Auto: $206.15 Focus Healthcare — Workers Compensation: $214.03 Geisinger — Medicaid/CHIP: $125.61 Health Coalition Partners — PPO: $173.60
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TF OV NEW PATIENT COMPREHENS	$217	$130.20	$151.90 – $206.15
New patient office visit (about 45–59 minutes): rates for 5 insurance plans Cigna — Commercial: $151.90 Focus Healthcare — Disability/PPO/Auto: $206.15 Health Coalition Partners — PPO: $173.60 InterGroup — Commercial: $173.60 Multiplan — Auto/PPO/Worker's Compensation: $162.75
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF OV NEW PATIENT HIGH COMP	$318	$190.80	$63.91 – $7,158.82
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $129.29 Aetna of PA — Medicare: $122.37 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $183.49 AmeriHealth Caritas — Medicare: $127.07 Cigna — Commercial: $63.91 Cigna — Medicare: $7,158.82 Focus Healthcare — Disability/PPO/Auto: $302.10 Focus Healthcare — Workers Compensation: $260.74 Geisinger — Medicaid/CHIP: $163.37 Health Coalition Partners — PPO: $254.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF NEW PAT LEVEL 5 COMPREHEN	$317	$190.20	$63.91 – $7,136.30
New patient office visit (about 60–74 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $129.29 Aetna of PA — Medicare: $121.98 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $183.49 AmeriHealth Caritas — Medicare: $126.67 Cigna — Commercial: $63.91 Cigna — Medicare: $7,136.30 Focus Healthcare — Disability/PPO/Auto: $301.15 Focus Healthcare — Workers Compensation: $260.74 Geisinger — Medicaid/CHIP: $163.37 Health Coalition Partners — PPO: $253.60
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TF OV NEW PATIENT HIGH COMP	$318	$190.80	$222.60 – $302.10
New patient office visit (about 60–74 minutes): rates for 5 insurance plans Cigna — Commercial: $222.60 Focus Healthcare — Disability/PPO/Auto: $302.10 Health Coalition Partners — PPO: $254.40 InterGroup — Commercial: $254.40 Multiplan — Auto/PPO/Worker's Compensation: $238.50
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF OV EST PATIENT LOW COMPLE	$132	$79.20	$38.50 – $2,971.58
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $38.50 Aetna of PA — Medicare: $50.79 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64 AmeriHealth Caritas — Medicare: $52.75 Cigna — Commercial: $63.91 Cigna — Medicare: $2,971.58 Focus Healthcare — Disability/PPO/Auto: $125.40 Focus Healthcare — Workers Compensation: $90.64 Geisinger — Medicaid/CHIP: $48.65 Health Coalition Partners — PPO: $105.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF EST PAT LEVEL 3 INTERMED	$132	$79.20	$38.50 – $2,971.58
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $38.50 Aetna of PA — Medicare: $50.79 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64 AmeriHealth Caritas — Medicare: $52.75 Cigna — Commercial: $63.91 Cigna — Medicare: $2,971.58 Focus Healthcare — Disability/PPO/Auto: $125.40 Focus Healthcare — Workers Compensation: $90.64 Geisinger — Medicaid/CHIP: $48.65 Health Coalition Partners — PPO: $105.60
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KOM FU SIMPLE 15 MIN	$75	$45	$26.25 – $1,688.40
Established patient office visit (about 20–29 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $38.50 Aetna of PA — Medicare: $28.86 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64 AmeriHealth Caritas — Medicare: $29.97 Cigna — Commercial: $52.50 Cigna — Medicare: $1,688.40 Focus Healthcare — Disability/PPO/Auto: $71.25 Focus Healthcare — Workers Compensation: $90.64 Geisinger — Medicaid/CHIP: $48.65 Health Coalition Partners — PPO: $60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OT FIT FOR DUTY PHYSICAL EVAL	$224	$134.40	$53.09 – $5,042.69
Established patient office visit (about 30–39 minutes): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $59.86 Aetna of PA — Medicare: $86.20 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96 AmeriHealth Caritas — Medicare: $89.51 Cigna — Commercial: $156.80 Cigna — Medicare: $5,042.69 Focus Healthcare — Disability/PPO/Auto: $212.80 Focus Healthcare — Workers Compensation: $135.06 Geisinger — Medicaid/CHIP: $75.64 Health Coalition Partners — PPO: $179.20
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF OV EST PATIENT MODERATE	$172	$103.20	$53.09 – $3,872.06
Established patient office visit (about 30–39 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $59.86 Aetna of PA — Medicare: $66.19 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96 AmeriHealth Caritas — Medicare: $68.73 Cigna — Commercial: $63.91 Cigna — Medicare: $3,872.06 Focus Healthcare — Disability/PPO/Auto: $163.40 Focus Healthcare — Workers Compensation: $135.06 Geisinger — Medicaid/CHIP: $75.64 Health Coalition Partners — PPO: $137.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF EST PAT LEVEL 4 EXTENDED	$172	$103.20	$53.09 – $3,872.06
Established patient office visit (about 30–39 minutes): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $59.86 Aetna of PA — Medicare: $66.19 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96 AmeriHealth Caritas — Medicare: $68.73 Cigna — Commercial: $63.91 Cigna — Medicare: $3,872.06 Focus Healthcare — Disability/PPO/Auto: $163.40 Focus Healthcare — Workers Compensation: $135.06 Geisinger — Medicaid/CHIP: $75.64 Health Coalition Partners — PPO: $137.60
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM LEVEL 3	$342	$205.20	$62.31 – $7,699.10
Emergency room visit (moderate): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $62.31 Aetna of PA — Medicare: $131.60 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $88.44 AmeriHealth Caritas — Medicare: $136.66 Cigna — Commercial: $239.40 Cigna — Medicare: $7,699.10 Focus Healthcare — Disability/PPO/Auto: $324.90 Focus Healthcare — Workers Compensation: $126.32 Geisinger — Medicaid/CHIP: $78.74 Health Coalition Partners — PPO: $273.60
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRO FEE LEVEL 3	$307	$184.20	$62.31 – $6,911.18
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $62.31 Aetna of PA — Medicare: $118.13 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $88.44 AmeriHealth Caritas — Medicare: $122.68 Cigna — Commercial: $214.90 Cigna — Medicare: $6,911.18 Focus Healthcare — Disability/PPO/Auto: $291.65 Focus Healthcare — Workers Compensation: $126.32 Geisinger — Medicaid/CHIP: $78.74 Health Coalition Partners — PPO: $245.60
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PRO FEE LEVEL 3	$307	$184.20	$214.90 – $291.65
Emergency room visit (moderate): rates for 5 insurance plans Cigna — Commercial: $214.90 Focus Healthcare — Disability/PPO/Auto: $291.65 Health Coalition Partners — PPO: $245.60 InterGroup — Commercial: $245.60 Multiplan — Auto/PPO/Worker's Compensation: $230.25
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM LEVEL 4	$521	$312.60	$104.86 – $11,728.75
Emergency room visit (moderately high): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $104.86 Aetna of PA — Medicare: $200.48 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.82 AmeriHealth Caritas — Medicare: $208.19 Cigna — Commercial: $364.70 Cigna — Medicare: $11,728.75 Focus Healthcare — Disability/PPO/Auto: $494.95 Focus Healthcare — Workers Compensation: $185.58 Geisinger — Medicaid/CHIP: $132.50 Health Coalition Partners — PPO: $416.80
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY ROOM LEVEL 4	$521	$312.60	$364.70 – $494.95
Emergency room visit (moderately high): rates for 5 insurance plans Cigna — Commercial: $364.70 Focus Healthcare — Disability/PPO/Auto: $494.95 Health Coalition Partners — PPO: $416.80 InterGroup — Commercial: $416.80 Multiplan — Auto/PPO/Worker's Compensation: $390.75
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY ROOM LEVEL 5	$835	$501	$152.61 – $18,797.52
Emergency room visit (high): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $152.61 Aetna of PA — Medicare: $321.31 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $216.59 AmeriHealth Caritas — Medicare: $333.67 Cigna — Commercial: $584.50 Cigna — Medicare: $18,797.52 Focus Healthcare — Disability/PPO/Auto: $793.25 Focus Healthcare — Workers Compensation: $285.20 Geisinger — Medicaid/CHIP: $192.83 Health Coalition Partners — PPO: $668
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EMERGENCY ROOM LEVEL 5	$835	$501	$584.50 – $793.25
Emergency room visit (high): rates for 5 insurance plans Cigna — Commercial: $584.50 Focus Healthcare — Disability/PPO/Auto: $793.25 Health Coalition Partners — PPO: $668 InterGroup — Commercial: $668 Multiplan — Auto/PPO/Worker's Compensation: $626.25

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ISTAT CHEM 8 WITH HGB AND HCT	$220	$132	$8.36 – $4,952.64
Basic metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $10.30 Aetna of PA — Medicare: $84.66 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.61 AmeriHealth Caritas — Medicare: $87.91 Cigna — Commercial: $154 Cigna — Medicare: $4,952.64 Focus Healthcare — Disability/PPO/Auto: $209 Focus Healthcare — Workers Compensation: $9.23 Geisinger — Medicaid/CHIP: $13.01 Health Coalition Partners — PPO: $176
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL FREQ	$220	$132	$8.36 – $4,952.64
Basic metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $10.30 Aetna of PA — Medicare: $84.66 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.61 AmeriHealth Caritas — Medicare: $87.91 Cigna — Commercial: $154 Cigna — Medicare: $4,952.64 Focus Healthcare — Disability/PPO/Auto: $209 Focus Healthcare — Workers Compensation: $9.23 Geisinger — Medicaid/CHIP: $13.01 Health Coalition Partners — PPO: $176
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$220	$132	$8.36 – $4,952.64
Basic metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $10.30 Aetna of PA — Medicare: $84.66 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.61 AmeriHealth Caritas — Medicare: $87.91 Cigna — Commercial: $154 Cigna — Medicare: $4,952.64 Focus Healthcare — Disability/PPO/Auto: $209 Focus Healthcare — Workers Compensation: $9.23 Geisinger — Medicaid/CHIP: $13.01 Health Coalition Partners — PPO: $176
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL FREQ	$283	$169.80	$10.43 – $6,370.90
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $12.86 Aetna of PA — Medicare: $108.90 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.25 AmeriHealth Caritas — Medicare: $113.09 Cigna — Commercial: $198.10 Cigna — Medicare: $6,370.90 Focus Healthcare — Disability/PPO/Auto: $268.85 Focus Healthcare — Workers Compensation: $11.52 Geisinger — Medicaid/CHIP: $16.25 Health Coalition Partners — PPO: $226.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL	$283	$169.80	$10.43 – $6,370.90
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $12.86 Aetna of PA — Medicare: $108.90 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.25 AmeriHealth Caritas — Medicare: $113.09 Cigna — Commercial: $198.10 Cigna — Medicare: $6,370.90 Focus Healthcare — Disability/PPO/Auto: $268.85 Focus Healthcare — Workers Compensation: $11.52 Geisinger — Medicaid/CHIP: $16.25 Health Coalition Partners — PPO: $226.40
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL FREQ	$283	$169.80	$198.10 – $268.85
Comprehensive metabolic panel (blood test): rates for 5 insurance plans Cigna — Commercial: $198.10 Focus Healthcare — Disability/PPO/Auto: $268.85 Health Coalition Partners — PPO: $226.40 InterGroup — Commercial: $226.40 Multiplan — Auto/PPO/Worker's Compensation: $212.25
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$611	$366.60	$13.20 – $13,754.83
Obstetric blood test panel: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $13.20 Aetna of PA — Medicare: $235.11 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.73 AmeriHealth Caritas — Medicare: $244.16 Cigna — Commercial: $427.70 Cigna — Medicare: $13,754.83 Focus Healthcare — Disability/PPO/Auto: $580.45 Focus Healthcare — Workers Compensation: $52.20 Geisinger — Medicaid/CHIP: $16.68 Health Coalition Partners — PPO: $488.80
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$611	$366.60	$427.70 – $580.45
Obstetric blood test panel: rates for 5 insurance plans Cigna — Commercial: $427.70 Focus Healthcare — Disability/PPO/Auto: $580.45 Health Coalition Partners — PPO: $488.80 InterGroup — Commercial: $488.80 Multiplan — Auto/PPO/Worker's Compensation: $458.25
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRIGLYCERIDES SEND OUT	$158	$94.80	$13.24 – $3,556.90
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $15.40 Aetna of PA — Medicare: $60.80 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86 AmeriHealth Caritas — Medicare: $63.14 Cigna — Commercial: $110.60 Cigna — Medicare: $3,556.90 Focus Healthcare — Disability/PPO/Auto: $150.10 Focus Healthcare — Workers Compensation: $14.62 Geisinger — Medicaid/CHIP: $19.46 Health Coalition Partners — PPO: $126.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$158	$94.80	$13.24 – $3,556.90
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $15.40 Aetna of PA — Medicare: $60.80 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86 AmeriHealth Caritas — Medicare: $63.14 Cigna — Commercial: $110.60 Cigna — Medicare: $3,556.90 Focus Healthcare — Disability/PPO/Auto: $150.10 Focus Healthcare — Workers Compensation: $14.62 Geisinger — Medicaid/CHIP: $19.46 Health Coalition Partners — PPO: $126.40
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TRIGLYCERIDES SEND OUT	$158	$94.80	$110.60 – $150.10
Cholesterol panel (lipid panel): rates for 5 insurance plans Cigna — Commercial: $110.60 Focus Healthcare — Disability/PPO/Auto: $150.10 Health Coalition Partners — PPO: $126.40 InterGroup — Commercial: $126.40 Multiplan — Auto/PPO/Worker's Compensation: $118.50
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL PROFILE	$371	$222.60	$8.58 – $8,351.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Kidney function panel: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $10.56 Aetna of PA — Medicare: $142.76 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.99 AmeriHealth Caritas — Medicare: $148.25 Cigna — Commercial: $259.70 Cigna — Medicare: $8,351.95 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Focus Healthcare — Disability/PPO/Auto: $352.45 Focus Healthcare — Workers Compensation: $9.48 Geisinger — Medicaid/CHIP: $13.34 Health Coalition Partners — PPO: $296.80
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL PROFILE	$371	$222.60	$259.70 – $352.45
Kidney function panel: rates for 5 insurance plans Cigna — Commercial: $259.70 Focus Healthcare — Disability/PPO/Auto: $352.45 Health Coalition Partners — PPO: $296.80 InterGroup — Commercial: $296.80 Multiplan — Auto/PPO/Worker's Compensation: $278.25
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER PROFILE FREQ	$202	$121.20	$8.08 – $4,547.42
Liver function panel: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $9.93 Aetna of PA — Medicare: $77.73 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.10 AmeriHealth Caritas — Medicare: $80.72 Cigna — Commercial: $141.40 Cigna — Medicare: $4,547.42 Focus Healthcare — Disability/PPO/Auto: $191.90 Focus Healthcare — Workers Compensation: $8.92 Geisinger — Medicaid/CHIP: $12.55 Health Coalition Partners — PPO: $161.60
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER PROFILE	$202	$121.20	$8.08 – $4,547.42
Liver function panel: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $9.93 Aetna of PA — Medicare: $77.73 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.10 AmeriHealth Caritas — Medicare: $80.72 Cigna — Commercial: $141.40 Cigna — Medicare: $4,547.42 Focus Healthcare — Disability/PPO/Auto: $191.90 Focus Healthcare — Workers Compensation: $8.92 Geisinger — Medicaid/CHIP: $12.55 Health Coalition Partners — PPO: $161.60
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIVER PROFILE FREQ	$202	$121.20	$141.40 – $191.90
Liver function panel: rates for 5 insurance plans Cigna — Commercial: $141.40 Focus Healthcare — Disability/PPO/Auto: $191.90 Health Coalition Partners — PPO: $161.60 InterGroup — Commercial: $161.60 Multiplan — Auto/PPO/Worker's Compensation: $151.50
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE WITH MICROSCOPIC	$86	$51.60	$3.13 – $1,936.03
Urine test (automated, with microscope): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $3.30 Aetna of PA — Medicare: $33.09 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.68 AmeriHealth Caritas — Medicare: $34.37 Cigna — Commercial: $60.20 Cigna — Medicare: $1,936.03 Focus Healthcare — Disability/PPO/Auto: $81.70 Focus Healthcare — Workers Compensation: $3.46 Geisinger — Medicaid/CHIP: $4.17 Health Coalition Partners — PPO: $68.80
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA W/MICRO CHARGE ONLY	$168	$100.80	$3.13 – $3,782.02 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, with microscope): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $3.30 Aetna of PA — Medicare: $64.65 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.68 AmeriHealth Caritas — Medicare: $67.13 Cigna — Commercial: $117.60 Cigna — Medicare: $3,782.02 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Focus Healthcare — Disability/PPO/Auto: $159.60 Focus Healthcare — Workers Compensation: $3.46 Geisinger — Medicaid/CHIP: $4.17 Health Coalition Partners — PPO: $134.40
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINE WITH MICROSCOPIC	$86	$51.60	$60.20 – $81.70
Urine test (automated, with microscope): rates for 5 insurance plans Cigna — Commercial: $60.20 Focus Healthcare — Disability/PPO/Auto: $81.70 Health Coalition Partners — PPO: $68.80 InterGroup — Commercial: $68.80 Multiplan — Auto/PPO/Worker's Compensation: $64.50
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS DIPSTICK CHARGE ONLY	$73	$43.80	$2.22 – $1,643.38
Urine test (automated, without microscope): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $3.41 Aetna of PA — Medicare: $28.09 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84 AmeriHealth Caritas — Medicare: $29.17 Cigna — Commercial: $51.10 Cigna — Medicare: $1,643.38 Focus Healthcare — Disability/PPO/Auto: $69.35 Focus Healthcare — Workers Compensation: $2.45 Geisinger — Medicaid/CHIP: $4.31 Health Coalition Partners — PPO: $58.40
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL PROTEIN SERUM	$134	$80.40	$2.22 – $3,016.61 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, without microscope): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $3.41 Aetna of PA — Medicare: $51.56 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84 AmeriHealth Caritas — Medicare: $53.55 Cigna — Commercial: $93.80 Cigna — Medicare: $3,016.61 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Focus Healthcare — Disability/PPO/Auto: $127.30 Focus Healthcare — Workers Compensation: $2.45 Geisinger — Medicaid/CHIP: $4.31 Health Coalition Partners — PPO: $107.20
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY URINE	$134	$80.40	$2.22 – $3,016.61 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, without microscope): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $3.41 Aetna of PA — Medicare: $51.56 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84 AmeriHealth Caritas — Medicare: $53.55 Cigna — Commercial: $93.80 Cigna — Medicare: $3,016.61 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Focus Healthcare — Disability/PPO/Auto: $127.30 Focus Healthcare — Workers Compensation: $2.45 Geisinger — Medicaid/CHIP: $4.31 Health Coalition Partners — PPO: $107.20
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL	$117	$70.20	$18.17 – $2,633.90
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $26.80 Aetna of PA — Medicare: $45.02 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03 AmeriHealth Caritas — Medicare: $46.75 Cigna — Commercial: $81.90 Cigna — Medicare: $2,633.90 Focus Healthcare — Disability/PPO/Auto: $111.15 Focus Healthcare — Workers Compensation: $20.07 Geisinger — Medicaid/CHIP: $33.86 Health Coalition Partners — PPO: $93.60
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA TOTAL	$117	$70.20	$81.90 – $111.15
PSA (prostate specific antigen) blood test: rates for 5 insurance plans Cigna — Commercial: $81.90 Focus Healthcare — Disability/PPO/Auto: $111.15 Health Coalition Partners — PPO: $93.60 InterGroup — Commercial: $93.60 Multiplan — Auto/PPO/Worker's Compensation: $87.75
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE SERUM FREQ	$166	$99.60	$16.60 – $3,736.99
Thyroid stimulating hormone (TSH) test: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $25.53 Aetna of PA — Medicare: $63.88 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23 AmeriHealth Caritas — Medicare: $66.33 Cigna — Commercial: $116.20 Cigna — Medicare: $3,736.99 Focus Healthcare — Disability/PPO/Auto: $157.70 Focus Healthcare — Workers Compensation: $18.34 Geisinger — Medicaid/CHIP: $32.26 Health Coalition Partners — PPO: $132.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE SERUM	$180	$108	$16.60 – $4,052.16
Thyroid stimulating hormone (TSH) test: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $25.53 Aetna of PA — Medicare: $69.26 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23 AmeriHealth Caritas — Medicare: $71.93 Cigna — Commercial: $126 Cigna — Medicare: $4,052.16 Focus Healthcare — Disability/PPO/Auto: $171 Focus Healthcare — Workers Compensation: $18.34 Geisinger — Medicaid/CHIP: $32.26 Health Coalition Partners — PPO: $144
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE SERUM FREQ	$166	$99.60	$116.20 – $157.70
Thyroid stimulating hormone (TSH) test: rates for 5 insurance plans Cigna — Commercial: $116.20 Focus Healthcare — Disability/PPO/Auto: $157.70 Health Coalition Partners — PPO: $132.80 InterGroup — Commercial: $132.80 Multiplan — Auto/PPO/Worker's Compensation: $124.50
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC AUTO DIFFERENTIAL CHARGE ONLY	$132	$79.20	$6.60 – $2,971.58
Complete blood count (CBC) with differential: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $6.60 Aetna of PA — Medicare: $50.79 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $9.37 AmeriHealth Caritas — Medicare: $52.75 Cigna — Commercial: $92.40 Cigna — Medicare: $2,971.58 Focus Healthcare — Disability/PPO/Auto: $125.40 Focus Healthcare — Workers Compensation: $8.48 Geisinger — Medicaid/CHIP: $8.34 Health Coalition Partners — PPO: $105.60
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC AUTO DIFFERENTIAL CHARGE ONLY	$132	$79.20	$92.40 – $125.40
Complete blood count (CBC) with differential: rates for 5 insurance plans Cigna — Commercial: $92.40 Focus Healthcare — Disability/PPO/Auto: $125.40 Health Coalition Partners — PPO: $105.60 InterGroup — Commercial: $105.60 Multiplan — Auto/PPO/Worker's Compensation: $99
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KOM CBC	$26	$15.60	$6.39 – $585.31
Complete blood count (CBC), automated: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $8.27 Aetna of PA — Medicare: $10 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.74 AmeriHealth Caritas — Medicare: $10.39 Cigna — Commercial: $18.20 Cigna — Medicare: $585.31 Focus Healthcare — Disability/PPO/Auto: $24.70 Focus Healthcare — Workers Compensation: $7.06 Geisinger — Medicaid/CHIP: $10.45 Health Coalition Partners — PPO: $20.80
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC HEMOGRAM CHARGE ONLY	$67	$40.20	$6.39 – $1,508.30
Complete blood count (CBC), automated: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $8.27 Aetna of PA — Medicare: $25.78 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.74 AmeriHealth Caritas — Medicare: $26.77 Cigna — Commercial: $46.90 Cigna — Medicare: $1,508.30 Focus Healthcare — Disability/PPO/Auto: $63.65 Focus Healthcare — Workers Compensation: $7.06 Geisinger — Medicaid/CHIP: $10.45 Health Coalition Partners — PPO: $53.60
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: KOM CBC	$26	$15.60	$18.20 – $24.70
Complete blood count (CBC), automated: rates for 5 insurance plans Cigna — Commercial: $18.20 Focus Healthcare — Disability/PPO/Auto: $24.70 Health Coalition Partners — PPO: $20.80 InterGroup — Commercial: $20.80 Multiplan — Auto/PPO/Worker's Compensation: $19.50
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT/INR PLASMA FREQ	$68	$40.80	$4.24 – $1,530.82
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $4.40 Aetna of PA — Medicare: $26.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24 AmeriHealth Caritas — Medicare: $27.17 Cigna — Commercial: $47.60 Cigna — Medicare: $1,530.82 Focus Healthcare — Disability/PPO/Auto: $64.60 Focus Healthcare — Workers Compensation: $4.68 Geisinger — Medicaid/CHIP: $5.56 Health Coalition Partners — PPO: $54.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT/INR PLASMA	$68	$40.80	$4.24 – $1,530.82
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $4.40 Aetna of PA — Medicare: $26.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24 AmeriHealth Caritas — Medicare: $27.17 Cigna — Commercial: $47.60 Cigna — Medicare: $1,530.82 Focus Healthcare — Disability/PPO/Auto: $64.60 Focus Healthcare — Workers Compensation: $4.68 Geisinger — Medicaid/CHIP: $5.56 Health Coalition Partners — PPO: $54.40
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT/INR PLASMA FREQ	$68	$40.80	$47.60 – $64.60
Blood clotting time test (prothrombin time, PT): rates for 5 insurance plans Cigna — Commercial: $47.60 Focus Healthcare — Disability/PPO/Auto: $64.60 Health Coalition Partners — PPO: $54.40 InterGroup — Commercial: $54.40 Multiplan — Auto/PPO/Worker's Compensation: $51
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT PARTIAL THOMBOPLASTI	$68	$40.80	$5.94 – $1,530.82
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $8.25 Aetna of PA — Medicare: $26.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71 AmeriHealth Caritas — Medicare: $27.17 Cigna — Commercial: $47.60 Cigna — Medicare: $1,530.82 Focus Healthcare — Disability/PPO/Auto: $64.60 Focus Healthcare — Workers Compensation: $6.56 Geisinger — Medicaid/CHIP: $10.42 Health Coalition Partners — PPO: $54.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT	$68	$40.80	$5.94 – $1,530.82
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $8.25 Aetna of PA — Medicare: $26.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71 AmeriHealth Caritas — Medicare: $27.17 Cigna — Commercial: $47.60 Cigna — Medicare: $1,530.82 Focus Healthcare — Disability/PPO/Auto: $64.60 Focus Healthcare — Workers Compensation: $6.56 Geisinger — Medicaid/CHIP: $10.42 Health Coalition Partners — PPO: $54.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: APTT/PTT FREQ	$68	$40.80	$5.94 – $1,530.82
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $8.25 Aetna of PA — Medicare: $26.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71 AmeriHealth Caritas — Medicare: $27.17 Cigna — Commercial: $47.60 Cigna — Medicare: $1,530.82 Focus Healthcare — Disability/PPO/Auto: $64.60 Focus Healthcare — Workers Compensation: $6.56 Geisinger — Medicaid/CHIP: $10.42 Health Coalition Partners — PPO: $54.40

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD WO ACUTE STROKE VIZ AI	$31	$18.60	$10.85 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $701
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $128.43 Aetna of PA — Medicare: $11.93 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.26 AmeriHealth Caritas — Medicare: $12.39 Cigna — Commercial: $21.70 Cigna — Medicare: $697.87 Focus Healthcare — Disability/PPO/Auto: $29.45 Focus Healthcare — Workers Compensation: $579.07 Geisinger — Medicaid/CHIP: $162.27 Health Coalition Partners — PPO: $24.80
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD WO	$1,656	$993.60	$128.43 – $37,279.87
CT scan of the head or brain, without contrast: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $128.43 Aetna of PA — Medicare: $637.23 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.26 AmeriHealth Caritas — Medicare: $661.74 Cigna — Commercial: $1,159.20 Cigna — Medicare: $37,279.87 Focus Healthcare — Disability/PPO/Auto: $1,573.20 Focus Healthcare — Workers Compensation: $579.07 Geisinger — Medicaid/CHIP: $162.27 Health Coalition Partners — PPO: $1,324.80
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF HEAD W/O	$433	$259.80	$128.43 – $9,747.70
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $128.43 Aetna of PA — Medicare: $166.62 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.26 AmeriHealth Caritas — Medicare: $173.03 Cigna — Commercial: $303.10 Cigna — Medicare: $9,747.70 Focus Healthcare — Disability/PPO/Auto: $411.35 Focus Healthcare — Workers Compensation: $579.07 Geisinger — Medicaid/CHIP: $162.27 Health Coalition Partners — PPO: $346.40
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR BRAIN W/WO	$4,924	$2,954.40	$372.90 – $110,849.09
MRI of the brain, before and after contrast: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $372.90 Aetna of PA — Medicare: $1,894.76 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $529.21 AmeriHealth Caritas — Medicare: $1,967.63 Cigna — Commercial: $3,446.80 Cigna — Medicare: $110,849.09 Focus Healthcare — Disability/PPO/Auto: $4,677.80 Focus Healthcare — Workers Compensation: $2,629.27 Geisinger — Medicaid/CHIP: $471.18 Health Coalition Partners — PPO: $3,939.20
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF MR BRAIN/STEM WO/W	$425	$255	$148.75 – $9,567.60
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $372.90 Aetna of PA — Medicare: $163.54 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $529.21 AmeriHealth Caritas — Medicare: $169.83 Cigna — Commercial: $297.50 Cigna — Medicare: $9,567.60 Focus Healthcare — Disability/PPO/Auto: $403.75 Focus Healthcare — Workers Compensation: $2,629.27 Geisinger — Medicaid/CHIP: $471.18 Health Coalition Partners — PPO: $340
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PF MR BRAIN/STEM WO/W	$425	$255	$297.50 – $403.75
MRI of the brain, before and after contrast: rates for 5 insurance plans Cigna — Commercial: $297.50 Focus Healthcare — Disability/PPO/Auto: $403.75 Health Coalition Partners — PPO: $340 InterGroup — Commercial: $340 Multiplan — Auto/PPO/Worker's Compensation: $318.75
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR CHEST 2V	$298	$178.80	$26 – $6,708.58
Chest X-ray, 2 views: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $26 Aetna of PA — Medicare: $114.67 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.90 AmeriHealth Caritas — Medicare: $119.08 Cigna — Commercial: $208.60 Cigna — Medicare: $6,708.58 Focus Healthcare — Disability/PPO/Auto: $283.10 Focus Healthcare — Workers Compensation: $41.70 Geisinger — Medicaid/CHIP: $32.86 Health Coalition Partners — PPO: $238.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FL FLUORO CHEST	$412	$247.20	$26 – $9,274.94
Chest X-ray, 2 views: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $26 Aetna of PA — Medicare: $158.54 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.90 AmeriHealth Caritas — Medicare: $164.64 Cigna — Commercial: $288.40 Cigna — Medicare: $9,274.94 Focus Healthcare — Disability/PPO/Auto: $391.40 Focus Healthcare — Workers Compensation: $41.70 Geisinger — Medicaid/CHIP: $32.86 Health Coalition Partners — PPO: $329.60
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: XR CHEST 2V	$298	$178.80	$208.60 – $283.10
Chest X-ray, 2 views: rates for 5 insurance plans Cigna — Commercial: $208.60 Focus Healthcare — Disability/PPO/Auto: $283.10 Health Coalition Partners — PPO: $238.40 InterGroup — Commercial: $238.40 Multiplan — Auto/PPO/Worker's Compensation: $223.50
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR LUMBAR COMPLETE	$489	$293.40	$40.28 – $11,008.37
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $40.28 Aetna of PA — Medicare: $188.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $57.17 AmeriHealth Caritas — Medicare: $195.40 Cigna — Commercial: $342.30 Cigna — Medicare: $11,008.37 Focus Healthcare — Disability/PPO/Auto: $464.55 Focus Healthcare — Workers Compensation: $129.55 Geisinger — Medicaid/CHIP: $50.90 Health Coalition Partners — PPO: $391.20
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF LUMBAR COMPLETE	$87	$52.20	$30.45 – $1,958.54
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $40.28 Aetna of PA — Medicare: $33.48 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $57.17 AmeriHealth Caritas — Medicare: $34.77 Cigna — Commercial: $60.90 Cigna — Medicare: $1,958.54 Focus Healthcare — Disability/PPO/Auto: $82.65 Focus Healthcare — Workers Compensation: $129.55 Geisinger — Medicaid/CHIP: $50.90 Health Coalition Partners — PPO: $69.60
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: XR LUMBAR COMPLETE	$489	$293.40	$342.30 – $464.55
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans Cigna — Commercial: $342.30 Focus Healthcare — Disability/PPO/Auto: $464.55 Health Coalition Partners — PPO: $391.20 InterGroup — Commercial: $391.20 Multiplan — Auto/PPO/Worker's Compensation: $366.75
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LUMBAR WO	$3,898	$2,338.80	$281.76 – $87,751.78
MRI of the lower back (lumbar spine), without contrast: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $281.76 Aetna of PA — Medicare: $1,499.95 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $399.88 AmeriHealth Caritas — Medicare: $1,557.64 Cigna — Commercial: $2,728.60 Cigna — Medicare: $87,751.78 Focus Healthcare — Disability/PPO/Auto: $3,703.10 Focus Healthcare — Workers Compensation: $1,356.41 Geisinger — Medicaid/CHIP: $356.02 Health Coalition Partners — PPO: $3,118.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF MR LUMBAR WO	$268	$160.80	$93.80 – $6,033.22
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $281.76 Aetna of PA — Medicare: $103.13 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $399.88 AmeriHealth Caritas — Medicare: $107.09 Cigna — Commercial: $187.60 Cigna — Medicare: $6,033.22 Focus Healthcare — Disability/PPO/Auto: $254.60 Focus Healthcare — Workers Compensation: $1,356.41 Geisinger — Medicaid/CHIP: $356.02 Health Coalition Partners — PPO: $214.40
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PF MR LUMBAR WO	$268	$160.80	$187.60 – $254.60
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans Cigna — Commercial: $187.60 Focus Healthcare — Disability/PPO/Auto: $254.60 Health Coalition Partners — PPO: $214.40 InterGroup — Commercial: $214.40 Multiplan — Auto/PPO/Worker's Compensation: $201
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W	$1,984	$1,190.40	$154.10 – $44,663.81
CT scan of the pelvis, with contrast: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $154.10 Aetna of PA — Medicare: $763.44 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $218.69 AmeriHealth Caritas — Medicare: $792.81 Cigna — Commercial: $1,388.80 Cigna — Medicare: $44,663.81 Focus Healthcare — Disability/PPO/Auto: $1,884.80 Focus Healthcare — Workers Compensation: $793.76 Geisinger — Medicaid/CHIP: $194.71 Health Coalition Partners — PPO: $1,587.20
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF PELVIS W	$391	$234.60	$136.85 – $8,802.19
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $154.10 Aetna of PA — Medicare: $150.46 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $218.69 AmeriHealth Caritas — Medicare: $156.24 Cigna — Commercial: $273.70 Cigna — Medicare: $8,802.19 Focus Healthcare — Disability/PPO/Auto: $371.45 Focus Healthcare — Workers Compensation: $793.76 Geisinger — Medicaid/CHIP: $194.71 Health Coalition Partners — PPO: $312.80
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PF PELVIS W	$391	$234.60	$273.70 – $371.45
CT scan of the pelvis, with contrast: rates for 5 insurance plans Cigna — Commercial: $273.70 Focus Healthcare — Disability/PPO/Auto: $371.45 Health Coalition Partners — PPO: $312.80 InterGroup — Commercial: $312.80 Multiplan — Auto/PPO/Worker's Compensation: $293.25
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LOWER EXTREMITY JOINT WO RIGHT	$3,636	$2,181.60	$598.97 – $81,853.63
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna of PA — Medicare: $1,399.13 AmeriHealth Caritas — Medicare: $1,452.95 Cigna — Commercial: $2,545.20 Cigna — Medicare: $81,853.63 Focus Healthcare — Disability/PPO/Auto: $3,454.20 Focus Healthcare — Workers Compensation: $1,196.53 Geisinger — Medicaid/CHIP: $1,999.80 Health Coalition Partners — PPO: $2,908.80 Highmark BCBS of PA — Commercial - Indemnity: $733.67 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $598.97
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LOWER EXTREMITY JOINT WO LEFT	$3,636	$2,181.60	$598.97 – $81,853.63
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna of PA — Medicare: $1,399.13 AmeriHealth Caritas — Medicare: $1,452.95 Cigna — Commercial: $2,545.20 Cigna — Medicare: $81,853.63 Focus Healthcare — Disability/PPO/Auto: $3,454.20 Focus Healthcare — Workers Compensation: $1,196.53 Geisinger — Medicaid/CHIP: $1,999.80 Health Coalition Partners — PPO: $2,908.80 Highmark BCBS of PA — Commercial - Indemnity: $733.67 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $598.97
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LOWER EXTREMITY JOINT WO BILATERAL	$7,272	$4,363.20	$598.97 – $163,707.26
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates Aetna of PA — Medicare: $2,798.27 AmeriHealth Caritas — Medicare: $2,905.89 Cigna — Commercial: $5,090.40 Cigna — Medicare: $163,707.26 Focus Healthcare — Disability/PPO/Auto: $6,908.40 Focus Healthcare — Workers Compensation: $1,196.53 Geisinger — Medicaid/CHIP: $3,999.60 Health Coalition Partners — PPO: $5,817.60 Highmark BCBS of PA — Commercial - Indemnity: $733.67 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $598.97
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABDOMEN PELVIS W	$1,231	$738.60	$289.48 – $27,712.27
CT scan of the abdomen and pelvis, with contrast: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $289.48 Aetna of PA — Medicare: $473.69 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $410.82 AmeriHealth Caritas — Medicare: $491.91 Cigna — Commercial: $861.70 Cigna — Medicare: $27,712.27 Focus Healthcare — Disability/PPO/Auto: $1,169.45 Focus Healthcare — Workers Compensation: $554.49 Geisinger — Medicaid/CHIP: $365.77 Health Coalition Partners — PPO: $984.80
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABDOMEN PELVIS W	$1,231	$738.60	$861.70 – $1,169.45
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans Cigna — Commercial: $861.70 Focus Healthcare — Disability/PPO/Auto: $1,169.45 Health Coalition Partners — PPO: $984.80 InterGroup — Commercial: $984.80 Multiplan — Auto/PPO/Worker's Compensation: $923.25
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN	$880	$528	$104.80 – $19,810.56
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $104.80 Aetna of PA — Medicare: $338.62 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.73 AmeriHealth Caritas — Medicare: $351.65 Cigna — Commercial: $616 Cigna — Medicare: $19,810.56 Focus Healthcare — Disability/PPO/Auto: $836 Focus Healthcare — Workers Compensation: $301.60 Geisinger — Medicaid/CHIP: $132.42 Health Coalition Partners — PPO: $704
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF US COMPLETE	$797	$478.20	$104.80 – $17,942.06
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $104.80 Aetna of PA — Medicare: $306.69 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.73 AmeriHealth Caritas — Medicare: $318.48 Cigna — Commercial: $557.90 Cigna — Medicare: $17,942.06 Focus Healthcare — Disability/PPO/Auto: $757.15 Focus Healthcare — Workers Compensation: $301.60 Geisinger — Medicaid/CHIP: $132.42 Health Coalition Partners — PPO: $637.60
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF ABDOMEN	$233	$139.80	$81.55 – $5,245.30
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $104.80 Aetna of PA — Medicare: $89.66 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.73 AmeriHealth Caritas — Medicare: $93.11 Cigna — Commercial: $163.10 Cigna — Medicare: $5,245.30 Focus Healthcare — Disability/PPO/Auto: $221.35 Focus Healthcare — Workers Compensation: $301.60 Geisinger — Medicaid/CHIP: $132.42 Health Coalition Partners — PPO: $186.40
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US OB >14WEEKS SINGLE FETUS	$819	$491.40	$85.25 – $18,437.33
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $85.25 Aetna of PA — Medicare: $315.15 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $120.99 AmeriHealth Caritas — Medicare: $327.27 Cigna — Commercial: $573.30 Cigna — Medicare: $18,437.33 Focus Healthcare — Disability/PPO/Auto: $778.05 Focus Healthcare — Workers Compensation: $341.66 Geisinger — Medicaid/CHIP: $107.72 Health Coalition Partners — PPO: $655.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF FETAL OB COMPLETE	$168	$100.80	$58.80 – $3,782.02
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $85.25 Aetna of PA — Medicare: $64.65 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $120.99 AmeriHealth Caritas — Medicare: $67.13 Cigna — Commercial: $117.60 Cigna — Medicare: $3,782.02 Focus Healthcare — Disability/PPO/Auto: $159.60 Focus Healthcare — Workers Compensation: $341.66 Geisinger — Medicaid/CHIP: $107.72 Health Coalition Partners — PPO: $134.40
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US OB >14WEEKS SINGLE FETUS	$819	$491.40	$573.30 – $778.05
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans Cigna — Commercial: $573.30 Focus Healthcare — Disability/PPO/Auto: $778.05 Health Coalition Partners — PPO: $655.20 InterGroup — Commercial: $655.20 Multiplan — Auto/PPO/Worker's Compensation: $614.25
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL	$562	$337.20	$84.15 – $12,651.74
Transvaginal ultrasound: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $84.15 Aetna of PA — Medicare: $216.26 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $119.42 AmeriHealth Caritas — Medicare: $224.58 Cigna — Commercial: $393.40 Cigna — Medicare: $12,651.74 Focus Healthcare — Disability/PPO/Auto: $533.90 Focus Healthcare — Workers Compensation: $244.97 Geisinger — Medicaid/CHIP: $106.33 Health Coalition Partners — PPO: $449.60
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PF TRANSVAGINAL	$75	$45	$26.25 – $1,688.40
Transvaginal ultrasound: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $84.15 Aetna of PA — Medicare: $28.86 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $119.42 AmeriHealth Caritas — Medicare: $29.97 Cigna — Commercial: $52.50 Cigna — Medicare: $1,688.40 Focus Healthcare — Disability/PPO/Auto: $71.25 Focus Healthcare — Workers Compensation: $244.97 Geisinger — Medicaid/CHIP: $106.33 Health Coalition Partners — PPO: $60
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US TRANSVAGINAL	$562	$337.20	$393.40 – $533.90
Transvaginal ultrasound: rates for 5 insurance plans Cigna — Commercial: $393.40 Focus Healthcare — Disability/PPO/Auto: $533.90 Health Coalition Partners — PPO: $449.60 InterGroup — Commercial: $449.60 Multiplan — Auto/PPO/Worker's Compensation: $421.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA MAMMO DIGITAL RIGHT	$311	$186.60	$108.85 – $7,001.23
Diagnostic mammogram, one breast: 10 of 32 insurance plan rates Aetna — CHIP/Medicaid: $112.65 Aetna of PA — Medicare: $119.67 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $159.87 AmeriHealth Caritas — Medicare: $124.28 Cigna — Commercial: $217.70 Cigna — Medicare: $7,001.23 Focus Healthcare — Disability/PPO/Auto: $295.45 Geisinger — Medicaid/CHIP: $142.34 Health Coalition Partners — PPO: $248.80 Highmark BCBS of PA — Commercial - Indemnity: $437.89
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA MAMMO DIGITAL LEFT	$311	$186.60	$108.85 – $7,001.23
Diagnostic mammogram, one breast: 10 of 32 insurance plan rates Aetna — CHIP/Medicaid: $112.65 Aetna of PA — Medicare: $119.67 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $159.87 AmeriHealth Caritas — Medicare: $124.28 Cigna — Commercial: $217.70 Cigna — Medicare: $7,001.23 Focus Healthcare — Disability/PPO/Auto: $295.45 Geisinger — Medicaid/CHIP: $142.34 Health Coalition Partners — PPO: $248.80 Highmark BCBS of PA — Commercial - Indemnity: $437.89
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MA MAMMO DIGITAL RIGHT	$311	$186.60	$217.70 – $295.45
Diagnostic mammogram, one breast: rates for 5 insurance plans Cigna — Commercial: $217.70 Focus Healthcare — Disability/PPO/Auto: $295.45 Health Coalition Partners — PPO: $248.80 InterGroup — Commercial: $248.80 Multiplan — Auto/PPO/Worker's Compensation: $233.25
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA MAMMO DIGITAL BILATERAL	$398	$238.80	$116 – $8,959.78
Diagnostic mammogram, both breasts: 10 of 32 insurance plan rates Aetna — CHIP/Medicaid: $142.84 Aetna of PA — Medicare: $153.15 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $202.71 AmeriHealth Caritas — Medicare: $159.04 Cigna — Commercial: $278.60 Cigna — Medicare: $8,959.78 Focus Healthcare — Disability/PPO/Auto: $378.10 Geisinger — Medicaid/CHIP: $180.48 Health Coalition Partners — PPO: $318.40 Highmark BCBS of PA — Commercial - Indemnity: $558.21
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MA MAMMO DIGITAL BILATERAL	$398	$238.80	$278.60 – $378.10
Diagnostic mammogram, both breasts: rates for 5 insurance plans Cigna — Commercial: $278.60 Focus Healthcare — Disability/PPO/Auto: $378.10 Health Coalition Partners — PPO: $318.40 InterGroup — Commercial: $318.40 Multiplan — Auto/PPO/Worker's Compensation: $298.50
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA MAMMO SPECIAL	$94	$56.40	$32.90 – $2,116.13
Screening mammogram, both breasts: 10 of 32 insurance plan rates Aetna — CHIP/Medicaid: $115.17 Aetna of PA — Medicare: $36.17 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $163.45 AmeriHealth Caritas — Medicare: $37.56 Cigna — Commercial: $65.80 Cigna — Medicare: $2,116.13 Focus Healthcare — Disability/PPO/Auto: $89.30 Geisinger — Medicaid/CHIP: $145.52 Health Coalition Partners — PPO: $75.20 Highmark BCBS of PA — Commercial - Indemnity: $462.95
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MA MAMMO DIGITAL SCREEN	$291	$174.60	$101.85 – $6,550.99
Screening mammogram, both breasts: 10 of 32 insurance plan rates Aetna — CHIP/Medicaid: $115.17 Aetna of PA — Medicare: $111.98 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $163.45 AmeriHealth Caritas — Medicare: $116.28 Cigna — Commercial: $203.70 Cigna — Medicare: $6,550.99 Focus Healthcare — Disability/PPO/Auto: $276.45 Geisinger — Medicaid/CHIP: $145.52 Health Coalition Partners — PPO: $232.80 Highmark BCBS of PA — Commercial - Indemnity: $462.95
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MA MAMMO SPECIAL	$94	$56.40	$65.80 – $89.30
Screening mammogram, both breasts: rates for 5 insurance plans Cigna — Commercial: $65.80 Focus Healthcare — Disability/PPO/Auto: $89.30 Health Coalition Partners — PPO: $75.20 InterGroup — Commercial: $75.20 Multiplan — Auto/PPO/Worker's Compensation: $70.50

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTA THERAPEUTIC EXERCISES 15 MIN	$151	$90.60	$9.22 – $3,399.31
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $9.22 Aetna of PA — Medicare: $58.10 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08 AmeriHealth Caritas — Medicare: $60.34 Cigna — Commercial: $105.70 Cigna — Medicare: $3,399.31 Focus Healthcare — Disability/PPO/Auto: $143.45 Focus Healthcare — Workers Compensation: $47.97 Geisinger — Medicaid/CHIP: $11.65 Health Coalition Partners — PPO: $120.80
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTA CONTINUOUS PASSIVE MOTION	$151	$90.60	$9.22 – $3,399.31
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $9.22 Aetna of PA — Medicare: $58.10 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08 AmeriHealth Caritas — Medicare: $60.34 Cigna — Commercial: $105.70 Cigna — Medicare: $3,399.31 Focus Healthcare — Disability/PPO/Auto: $143.45 Focus Healthcare — Workers Compensation: $47.97 Geisinger — Medicaid/CHIP: $11.65 Health Coalition Partners — PPO: $120.80
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT THERAPEUTIC EXERCISES 15 MIN	$151	$90.60	$9.22 – $3,399.31
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $9.22 Aetna of PA — Medicare: $58.10 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08 AmeriHealth Caritas — Medicare: $60.34 Cigna — Commercial: $105.70 Cigna — Medicare: $3,399.31 Focus Healthcare — Disability/PPO/Auto: $143.45 Focus Healthcare — Workers Compensation: $47.97 Geisinger — Medicaid/CHIP: $11.65 Health Coalition Partners — PPO: $120.80
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL & TREAT LOW 20 MIN	$290	$174	$101.50 – $6,528.48
Physical therapy evaluation (low complexity): 10 of 29 insurance plan rates Aetna of PA — Medicare: $111.59 AmeriHealth Caritas — Medicare: $115.88 Cigna — Commercial: $203 Cigna — Medicare: $6,528.48 Focus Healthcare — Disability/PPO/Auto: $275.50 Focus Healthcare — Workers Compensation: $141.01 Geisinger — Medicaid/CHIP: $159.50 Health Coalition Partners — PPO: $232 Highmark BCBS of PA — Commercial - Indemnity: $519.73 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $424.31
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL & TREAT LOW 20 MIN	$290	$174	$203 – $275.50
Physical therapy evaluation (low complexity): rates for 5 insurance plans Cigna — Commercial: $203 Focus Healthcare — Disability/PPO/Auto: $275.50 Health Coalition Partners — PPO: $232 InterGroup — Commercial: $232 Multiplan — Auto/PPO/Worker's Compensation: $217.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL & TREAT MOD 30 MIN	$290	$174	$101.50 – $6,528.48
Physical therapy evaluation (moderate complexity): 10 of 29 insurance plan rates Aetna of PA — Medicare: $111.59 AmeriHealth Caritas — Medicare: $115.88 Cigna — Commercial: $203 Cigna — Medicare: $6,528.48 Focus Healthcare — Disability/PPO/Auto: $275.50 Focus Healthcare — Workers Compensation: $141.01 Geisinger — Medicaid/CHIP: $159.50 Health Coalition Partners — PPO: $232 Highmark BCBS of PA — Commercial - Indemnity: $519.73 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $424.31
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL & TREAT MOD 30 MIN	$290	$174	$203 – $275.50
Physical therapy evaluation (moderate complexity): rates for 5 insurance plans Cigna — Commercial: $203 Focus Healthcare — Disability/PPO/Auto: $275.50 Health Coalition Partners — PPO: $232 InterGroup — Commercial: $232 Multiplan — Auto/PPO/Worker's Compensation: $217.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL & TREAT HIGH 45 MIN	$290	$174	$101.50 – $6,528.48
Physical therapy evaluation (high complexity): 10 of 29 insurance plan rates Aetna of PA — Medicare: $111.59 AmeriHealth Caritas — Medicare: $115.88 Cigna — Commercial: $203 Cigna — Medicare: $6,528.48 Focus Healthcare — Disability/PPO/Auto: $275.50 Focus Healthcare — Workers Compensation: $141.01 Geisinger — Medicaid/CHIP: $159.50 Health Coalition Partners — PPO: $232 Highmark BCBS of PA — Commercial - Indemnity: $519.73 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $424.31
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PT EVAL & TREAT HIGH 45 MIN	$290	$174	$203 – $275.50
Physical therapy evaluation (high complexity): rates for 5 insurance plans Cigna — Commercial: $203 Focus Healthcare — Disability/PPO/Auto: $275.50 Health Coalition Partners — PPO: $232 InterGroup — Commercial: $232 Multiplan — Auto/PPO/Worker's Compensation: $217.50

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT	Not listed in the file	Not listed in the file	$4,895.36 – $23,862.54
Total hip replacement: rates for 7 insurance plans Focus Healthcare — Workers Compensation: $5,407.67 Highmark BCBS of PA — Commercial - Indemnity: $6,632.89 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $5,415.11 Highmark BCBS of PA — Managed Care: $6,632.89 Highmark BCBS of PA — Managed Care - Social Mission: $5,415.11 UPMC Health Plan — Commercial: $23,862.54 UPMC Work Partners — Workers Comp: $4,895.36
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)	Not listed in the file	Not listed in the file	$5,409.72 – $23,862.54
Total knee replacement: rates for 8 insurance plans Focus Healthcare — Workers Compensation: $6,331.82 Highmark BCBS of PA — Commercial - Indemnity: $6,626.28 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $5,409.72 Highmark BCBS of PA — Managed Care: $6,626.28 Highmark BCBS of PA — Managed Care - Social Mission: $5,409.72 UPMC Health Plan — CHIP: $14,888.05 UPMC Health Plan — Commercial: $23,862.54 UPMC Work Partners — Workers Comp: $5,731.96
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY, WITH CORACOACROMIAL LIGAMENT (IE, ARCH) RELE	Not listed in the file	Not listed in the file	$724.40 – $2,655.58
Shoulder arthroscopy: shaving of shoulder bone: rates for 8 insurance plans Focus Healthcare — Workers Compensation: $2,363.03 Highmark BCBS of PA — Commercial - Indemnity: $887.30 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $724.40 Highmark BCBS of PA — Managed Care: $887.30 Highmark BCBS of PA — Managed Care - Social Mission: $724.40 UPMC Health Plan — CHIP: $2,655.58 UPMC Health Plan — Commercial: $1,955.50 UPMC Work Partners — Workers Comp: $2,139.16
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULA	Not listed in the file	Not listed in the file	$597.85 – $3,250.30
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 15 insurance plan rates Aetna — CHIP/Medicaid: $597.85 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $848.46 Focus Healthcare — Workers Compensation: $2,057.09 Geisinger — Medicaid/CHIP: $755.41 Highmark BCBS of PA — Commercial - Indemnity: $2,807.29 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $2,291.88 Highmark BCBS of PA — Managed Care: $2,807.29 Highmark BCBS of PA — Managed Care - Social Mission: $2,291.88 Highmark Wholecare (prev Gateway) — Medicaid: $806.01 PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $926.23
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD	$1,505	$903	$137.74 – $33,880.56
Upper GI endoscopy (diagnostic): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $137.74 Aetna of PA — Medicare: $579.12 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $195.48 AmeriHealth Caritas — Medicare: $601.40 Cigna — Commercial: $1,053.50 Cigna — Medicare: $33,880.56 Focus Healthcare — Disability/PPO/Auto: $1,429.75 Focus Healthcare — Workers Compensation: $693.40 Geisinger — Medicaid/CHIP: $174.04 Health Coalition Partners — PPO: $1,204
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD	$1,505	$903	$1,053.50 – $1,429.75
Upper GI endoscopy (diagnostic): rates for 5 insurance plans Cigna — Commercial: $1,053.50 Focus Healthcare — Disability/PPO/Auto: $1,429.75 Health Coalition Partners — PPO: $1,204 InterGroup — Commercial: $1,204 Multiplan — Auto/PPO/Worker's Compensation: $1,128.75
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD W/BIOPSY	$2,244	$1,346.40	$163.44 – $50,516.93
Upper GI endoscopy with biopsy: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $163.44 Aetna of PA — Medicare: $863.49 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $231.95 AmeriHealth Caritas — Medicare: $896.70 Cigna — Commercial: $1,570.80 Cigna — Medicare: $50,516.93 Focus Healthcare — Disability/PPO/Auto: $2,131.80 Focus Healthcare — Workers Compensation: $806.67 Geisinger — Medicaid/CHIP: $206.51 Health Coalition Partners — PPO: $1,795.20
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD W/BIOPSY	$2,244	$1,346.40	$1,570.80 – $2,131.80
Upper GI endoscopy with biopsy: rates for 5 insurance plans Cigna — Commercial: $1,570.80 Focus Healthcare — Disability/PPO/Auto: $2,131.80 Health Coalition Partners — PPO: $1,795.20 InterGroup — Commercial: $1,795.20 Multiplan — Auto/PPO/Worker's Compensation: $1,683
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY	$1,244	$746.40	$198.55 – $28,004.93
Colonoscopy (diagnostic): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $198.55 Aetna of PA — Medicare: $478.69 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $281.78 AmeriHealth Caritas — Medicare: $497.10 Cigna — Commercial: $870.80 Cigna — Medicare: $28,004.93 Focus Healthcare — Disability/PPO/Auto: $1,181.80 Focus Healthcare — Workers Compensation: $805.08 Geisinger — Medicaid/CHIP: $250.88 Health Coalition Partners — PPO: $995.20
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY	$1,244	$746.40	$870.80 – $1,181.80
Colonoscopy (diagnostic): rates for 5 insurance plans Cigna — Commercial: $870.80 Focus Healthcare — Disability/PPO/Auto: $1,181.80 Health Coalition Partners — PPO: $995.20 InterGroup — Commercial: $995.20 Multiplan — Auto/PPO/Worker's Compensation: $933
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY/BIOPSY/COLD F	$2,331	$1,398.60	$247.96 – $52,475.47
Colonoscopy with biopsy: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $247.96 Aetna of PA — Medicare: $896.97 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $351.90 AmeriHealth Caritas — Medicare: $931.47 Cigna — Commercial: $1,631.70 Cigna — Medicare: $52,475.47 Focus Healthcare — Disability/PPO/Auto: $2,214.45 Focus Healthcare — Workers Compensation: $929.39 Geisinger — Medicaid/CHIP: $313.31 Health Coalition Partners — PPO: $1,864.80
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY/BIOPSY/COLD F	$2,331	$1,398.60	$1,631.70 – $2,214.45
Colonoscopy with biopsy: rates for 5 insurance plans Cigna — Commercial: $1,631.70 Focus Healthcare — Disability/PPO/Auto: $2,214.45 Health Coalition Partners — PPO: $1,864.80 InterGroup — Commercial: $1,864.80 Multiplan — Auto/PPO/Worker's Compensation: $1,748.25
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONSCOPY/LESION REMOVE	$2,331	$1,398.60	$294.89 – $52,475.47
Colonoscopy with removal of polyps (snare): 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $294.89 Aetna of PA — Medicare: $896.97 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $418.50 AmeriHealth Caritas — Medicare: $931.47 Cigna — Commercial: $1,631.70 Cigna — Medicare: $52,475.47 Focus Healthcare — Disability/PPO/Auto: $2,214.45 Focus Healthcare — Workers Compensation: $1,273.16 Geisinger — Medicaid/CHIP: $372.60 Health Coalition Partners — PPO: $1,864.80
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONSCOPY/LESION REMOVE	$2,331	$1,398.60	$1,631.70 – $2,214.45
Colonoscopy with removal of polyps (snare): rates for 5 insurance plans Cigna — Commercial: $1,631.70 Focus Healthcare — Disability/PPO/Auto: $2,214.45 Health Coalition Partners — PPO: $1,864.80 InterGroup — Commercial: $1,864.80 Multiplan — Auto/PPO/Worker's Compensation: $1,748.25
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	Not listed in the file	Not listed in the file	$1,422.12 – $2,182.77
Screening colonoscopy (not high risk): rates for 6 insurance plans Highmark BCBS of PA — Commercial - Indemnity: $1,741.93 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,422.12 Highmark BCBS of PA — Managed Care: $1,741.93 Highmark BCBS of PA — Managed Care - Social Mission: $1,422.12 UPMC Health Plan — CHIP: $2,182.77 UPMC Health Plan — Commercial: $1,607.34
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	$3,081	$1,848.60	$98.45 – $69,359.47
Prostate biopsy: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $98.45 Aetna of PA — Medicare: $1,185.57 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $139.72 AmeriHealth Caritas — Medicare: $1,231.17 Cigna — Commercial: $2,156.70 Cigna — Medicare: $69,359.47 Focus Healthcare — Disability/PPO/Auto: $2,926.95 Focus Healthcare — Workers Compensation: $384.53 Geisinger — Medicaid/CHIP: $124.40 Health Coalition Partners — PPO: $2,464.80
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	$3,081	$1,848.60	$2,156.70 – $2,926.95
Prostate biopsy: rates for 5 insurance plans Cigna — Commercial: $2,156.70 Focus Healthcare — Disability/PPO/Auto: $2,926.95 Health Coalition Partners — PPO: $2,464.80 InterGroup — Commercial: $2,464.80 Multiplan — Auto/PPO/Worker's Compensation: $2,310.75
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF NJX DX/THER SBST INTRLMNR LMBR/SAC W/	$1,741	$1,044.60	$89.45 – $39,193.39
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $89.45 Aetna of PA — Medicare: $669.94 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $126.95 AmeriHealth Caritas — Medicare: $695.70 Cigna — Commercial: $1,218.70 Cigna — Medicare: $39,193.39 Focus Healthcare — Disability/PPO/Auto: $1,653.95 Focus Healthcare — Workers Compensation: $344.44 Geisinger — Medicaid/CHIP: $113.03 Health Coalition Partners — PPO: $1,392.80
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TF NJX DX/THER SBST INTRLMNR LMBR/SAC W/	$1,741	$1,044.60	$1,218.70 – $1,653.95
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans Cigna — Commercial: $1,218.70 Focus Healthcare — Disability/PPO/Auto: $1,653.95 Health Coalition Partners — PPO: $1,392.80 InterGroup — Commercial: $1,392.80 Multiplan — Auto/PPO/Worker's Compensation: $1,305.75
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION(S), OF DIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) (EG, ANESTHETIC, ANTISPASMODIC, OPIOID, STEROID, OTHER SOLUTION), NOT INCLUDING NEUR	Not listed in the file	Not listed in the file	$89.45 – $1,834.56
Spinal injection, lower back (epidural), with imaging guidance: 10 of 15 insurance plan rates Aetna — CHIP/Medicaid: $89.45 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $126.95 Focus Healthcare — Workers Compensation: $344.44 Geisinger — Medicaid/CHIP: $113.03 Highmark BCBS of PA — Commercial - Indemnity: $1,314.46 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,073.13 Highmark BCBS of PA — Managed Care: $1,314.46 Highmark BCBS of PA — Managed Care - Social Mission: $1,073.13 Highmark Wholecare (prev Gateway) — Medicaid: $120.60 PA Health & Wellness — Community Health Choices/PA Medicaid HMO: $138.59
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TF INJ ANES/STEROID EPIDURL LUMB/SAC 1 L	$1,407	$844.20	$104.54 – $31,674.38
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates Aetna — CHIP/Medicaid: $104.54 Aetna of PA — Medicare: $541.41 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.37 AmeriHealth Caritas — Medicare: $562.24 Cigna — Commercial: $984.90 Cigna — Medicare: $31,674.38 Focus Healthcare — Disability/PPO/Auto: $1,336.65 Focus Healthcare — Workers Compensation: $457.21 Geisinger — Medicaid/CHIP: $132.10 Health Coalition Partners — PPO: $1,125.60
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TF INJ ANES/STEROID EPIDURL LUMB/SAC 1 L	$1,407	$844.20	$984.90 – $1,336.65
Nerve root injection, lower back, with imaging guidance: rates for 5 insurance plans Cigna — Commercial: $984.90 Focus Healthcare — Disability/PPO/Auto: $1,336.65 Health Coalition Partners — PPO: $1,125.60 InterGroup — Commercial: $1,125.60 Multiplan — Auto/PPO/Worker's Compensation: $1,055.25
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY/TRANS/M NERVE	$2,684	$1,610.40	$330 – $60,422.21
Carpal tunnel release: 10 of 34 insurance plan rates Aetna — CHIP/Medicaid: $330 Aetna of PA — Medicare: $1,032.80 AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $468.33 AmeriHealth Caritas — Medicare: $1,072.53 Cigna — Commercial: $1,878.80 Cigna — Medicare: $60,422.21 Focus Healthcare — Disability/PPO/Auto: $2,549.80 Focus Healthcare — Workers Compensation: $1,017.55 Geisinger — Medicaid/CHIP: $416.97 Health Coalition Partners — PPO: $2,147.20
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NEUROPLASTY/TRANS/M NERVE	$2,684	$1,610.40	$1,878.80 – $2,549.80
Carpal tunnel release: rates for 5 insurance plans Cigna — Commercial: $1,878.80 Focus Healthcare — Disability/PPO/Auto: $2,549.80 Health Coalition Partners — PPO: $2,147.20 InterGroup — Commercial: $2,147.20 Multiplan — Auto/PPO/Worker's Compensation: $2,013

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$3,082.11 – $123,453.88
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 7 insurance plans Highmark BCBS of PA — Commercial - Indemnity: $123,453.88 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $100,796.55 Highmark BCBS of PA — Managed Care: $123,453.88 Highmark BCBS of PA — Managed Care - Social Mission: $100,796.55 Highmark Wholecare (prev Gateway) — Medicare: $3,082.11 United Healthcare — Commercial: $83,075.54 UPMC Health Plan — Commercial: $119,394.34
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	$3,082.11 – $23,325.63
Hip or knee replacement (major joint of the leg), without major complications: rates for 8 insurance plans Aetna — Commercial: $15,761 Highmark BCBS of PA — Commercial - Indemnity: $21,709.74 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $17,725.38 Highmark BCBS of PA — Managed Care: $21,709.74 Highmark BCBS of PA — Managed Care - Social Mission: $17,725.38 Highmark Wholecare (prev Gateway) — Medicare: $3,082.11 United Healthcare — Commercial: $16,380.22 UPMC Health Plan — Commercial: $23,325.63
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	$3,082.11 – $29,287.25
Neck (cervical) spinal fusion, without complications: rates for 7 insurance plans Highmark BCBS of PA — Commercial - Indemnity: $27,938.23 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $22,810.77 Highmark BCBS of PA — Managed Care: $27,938.23 Highmark BCBS of PA — Managed Care - Social Mission: $22,810.77 Highmark Wholecare (prev Gateway) — Medicare: $3,082.11 United Healthcare — Commercial: $20,731.52 UPMC Health Plan — Commercial: $29,287.25
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	$3,082.11 – $15,715.26
Uterus and ovary surgery (not for cancer), without complications: rates for 7 insurance plans Highmark BCBS of PA — Commercial - Indemnity: $15,715.26 Highmark BCBS of PA — Commercial - Social Mission Indemnity: $12,831.06 Highmark BCBS of PA — Managed Care: $15,715.26 Highmark BCBS of PA — Managed Care - Social Mission: $12,831.06 Highmark Wholecare (prev Gateway) — Medicare: $3,082.11 United Healthcare — Commercial: $10,536.02 UPMC Health Plan — Commercial: $14,829.19

Source: UPMC Kane’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 type	Critical Access Hospital
Address	4372 Route 6, Kane, PA 16735
County	McKean County
State	Pennsylvania
Phone	(814) 837‑8585
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	391318
Name in Medicare records	UPMC KANE
Profile level	Medicare data + hospital website
Official website	upmc.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

UPMC Kane — upmc.com
Rehabilitation Services | UPMC Kane — upmc.com
Clinical Services | UPMC Kane | Kane, Pa — upmc.com
Acute Care Unit | UPMC Kane — upmc.com
Gastroenterology | UPMC Kane — upmc.com
Occupational Health Services at UPMC Kane — upmc.com
Locations, Directions, & Parking | UPMC Kane | Kane, Pa — upmc.com

UPMC Kane

Summary

Profile from official sources

At a glance