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Acute Care Hospital

UPMC Northwest

Seneca, Pennsylvania · Venango County · Emergency services listed

Summary

UPMC Northwest is an acute care hospital in Seneca, Pennsylvania. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 125 services, specialties and programs. Medicare lists 334 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

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

Call(814) 676‑7600 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
4 of 5 stars4 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
334Doctors and clinicians
125Services listed

Quick answers

Does UPMC Northwest have an emergency room?
Yes. Medicare (CMS) data lists emergency services at UPMC Northwest. In a medical emergency, call 911.
Where is UPMC Northwest?
100 Fairfield Drive, Seneca, PA 16346, in Venango County, Pennsylvania.
What is the phone number of UPMC Northwest?
(814) 676-7600, as listed by Medicare (CMS).
What is the Medicare star rating of UPMC Northwest?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas[4][14]

Conditions treated[8][9][10][11][12][14][15][16]

Treatments[4][7][8][9][10][11][15]

  • Medical oncology
  • Image-guided radiation therapy (IMRT)
  • Robotic thoracic surgery
  • Stereotactic radiosurgery for lung cancer
  • Electrodiagnostic studies (EMG)
  • Pain pump management
  • Interventional pain management
  • Peripheral angioplasty and stenting
  • Sclerotherapy for varicose veins
  • Noninvasive vascular lab testing
  • Infusaport placement
  • Pacemaker placement
  • Peritoneal dialysis catheter placement
  • Feeding tube placement
  • Diagnostic and therapeutic bronchoscopy
  • Lymphedema treatment

Procedures[8][9][10][11]

  • Appendectomy
  • Gallbladder surgery
  • Colon resection
  • Hemorrhoid removal
  • Colon polyp removal
  • Lumpectomy
  • Mastectomy
  • Thyroid surgery
  • Adrenal surgery
  • Distal pancreatectomy
  • Lower extremity amputations
  • Pilonidal cyst removal
  • Skin lesion removal
  • Laparoscopic hernia repair
  • Anti-reflux surgery
  • Minimally invasive esophageal surgery
  • Minimally invasive lung surgery
  • Aortic surgery

Programs and centers[4][6][7][8][10][13][16][18][19]

  • Stroke Program
  • Lung Cancer Screenings
  • Pediatric Hospitalist Services
  • Teleconsult Center
  • Inpatient behavioral health (traditional acute and extended acute)
  • UPMC Hillman Cancer Center
  • UPMC Northwest Breast Care Program
  • Family Birthing Center (inpatient obstetrics)
  • Esophageal and Lung Surgery Center
  • Outpatient thoracic surgery clinic
  • Inpatient rehabilitation unit (UPMC Rehabilitation Institute at UPMC Northwest)
  • Same Day Surgery Unit
  • Palliative care services

Emergency care (hospital website)[4][13]

Emergency roomYes

Visiting and practical information

VisitingGeneral visiting hours are 11 a.m. to 8 p.m.; lobby hours vary by day[19][17]
Interpreters and languagesSign language and foreign language interpreters available; ask your nurse[19]
Patient portalMyUPMC

Doctors and clinicians (334)

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

Main specialties

Doctors with a page on this site (334)

And 310 more: the button below opens the full list.

Other emergency rooms nearby

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

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well4 of 5 stars
Doctors communicated well3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean4 of 5 stars
Quiet at night2 of 5 stars
Rated the hospital 9 or 10 out of 1069%National average: 72%
Would definitely recommend the hospital62%National average: 71%
Nurses “always” communicated well81%National average: 80%
Doctors “always” communicated well77%National average: 80%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean76%National average: 74%
Area around the room “always” quiet at night46%National average: 60%
Completed surveys529Response rate: 27%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.904No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)0.361No different from the national benchmark
Surgical site infections after colon surgeryNot reported to Medicare
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infections0.694No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.443Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients12.5%
Deaths within 30 days: heart failure patients8.5%
Deaths within 30 days: pneumonia patients13.5%
Deaths within 30 days: COPD patients8.7%
Deaths within 30 days: stroke patients11.4%
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.95No different from the national rate
Complications after hip or knee replacement3.8%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attack15.6%
Readmitted within 30 days: heart failure24.5%
Readmitted within 30 days: pneumonia19.4%
Readmitted within 30 days: COPD20.5%
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacement5.6%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)136 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)68%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in PennsylvaniaBest hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 67 common services exactly as UPMC Northwest 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 →

$ 1 amount is marked with “!”: it is 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. It is shown exactly as listed; ask the hospital before relying on it.

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99203 $469 $281.40 $36.08 – $398.65
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $187.60
  • Aetna — EBR FI: $281.40
  • Aetna — Home Depot Employer Group: $289.37
  • Aetna — Medicaid: $65.10
  • Aetna — Medicare: $117.25
  • Aetna — NBR ASO/FI: $295.47
  • Aetna — Neighborhood Network: $281.40
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.69
  • Cigna — Commercial: $63.91
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99203 $469 $281.40 $187.60 – $3,704
New patient office visit (about 30–44 minutes): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $187.60
  • Aetna — EBR FI: $272.02
  • Aetna — Home Depot Employer Group: $298.75
  • Aetna — NBR ASO/FI: $304.85
  • Aetna — Neighborhood Network: $290.78
  • Cigna — Commercial: $187.60
  • Cigna — New Business ASO: $304.85
  • Coventry/First Health — Commercial: $328.30
  • Humana — Commercial: $398.65
  • InterGroup — PPO: $304.85
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CLINIC VISIT NEW 99203 $469 $281.40 $36.08 – $398.65
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $187.60
  • Aetna — EBR FI: $281.40
  • Aetna — Home Depot Employer Group: $289.37
  • Aetna — Medicaid: $65.10
  • Aetna — Medicare: $117.25
  • Aetna — NBR ASO/FI: $295.47
  • Aetna — Neighborhood Network: $281.40
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.69
  • Cigna — Commercial: $63.91
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99204 $598 $358.80 $36.08 – $508.30
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $239.20
  • Aetna — EBR FI: $358.80
  • Aetna — Home Depot Employer Group: $368.97
  • Aetna — Medicaid: $108.44
  • Aetna — Medicare: $149.50
  • Aetna — NBR ASO/FI: $376.74
  • Aetna — Neighborhood Network: $358.80
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $141.08
  • Cigna — Commercial: $63.91
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99204 $598 $358.80 $239.20 – $3,704
New patient office visit (about 45–59 minutes): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $239.20
  • Aetna — EBR FI: $346.84
  • Aetna — Home Depot Employer Group: $380.93
  • Aetna — NBR ASO/FI: $388.70
  • Aetna — Neighborhood Network: $370.76
  • Cigna — Commercial: $239.20
  • Cigna — New Business ASO: $388.70
  • Coventry/First Health — Commercial: $418.60
  • Humana — Commercial: $508.30
  • InterGroup — PPO: $388.70
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CLINIC VISIT NEW 99204 $598 $358.80 $36.08 – $508.30
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $239.20
  • Aetna — EBR FI: $358.80
  • Aetna — Home Depot Employer Group: $368.97
  • Aetna — Medicaid: $108.44
  • Aetna — Medicare: $149.50
  • Aetna — NBR ASO/FI: $376.74
  • Aetna — Neighborhood Network: $358.80
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $141.08
  • Cigna — Commercial: $63.91
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99205 $877 $526.20 $36.08 – $745.45
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $350.80
  • Aetna — EBR FI: $526.20
  • Aetna — Home Depot Employer Group: $541.11
  • Aetna — Medicaid: $141.05
  • Aetna — Medicare: $219.25
  • Aetna — NBR ASO/FI: $552.51
  • Aetna — Neighborhood Network: $526.20
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $183.49
  • Cigna — Commercial: $63.91
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT NEW 99205 $877 $526.20 $350.80 – $3,704
New patient office visit (about 60–74 minutes): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $350.80
  • Aetna — EBR FI: $508.66
  • Aetna — Home Depot Employer Group: $558.65
  • Aetna — NBR ASO/FI: $570.05
  • Aetna — Neighborhood Network: $543.74
  • Cigna — Commercial: $350.80
  • Cigna — New Business ASO: $570.05
  • Coventry/First Health — Commercial: $613.90
  • Humana — Commercial: $745.45
  • InterGroup — PPO: $570.05
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25,PO In the file: CLINIC VISIT NEW 99205 W/PROC $877 $526.20 $36.08 – $745.45
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $350.80
  • Aetna — EBR FI: $526.20
  • Aetna — Home Depot Employer Group: $541.11
  • Aetna — Medicaid: $141.05
  • Aetna — Medicare: $219.25
  • Aetna — NBR ASO/FI: $552.51
  • Aetna — Neighborhood Network: $526.20
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $183.49
  • Cigna — Commercial: $63.91
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99213 $311 $186.60 $36.08 – $264.35
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $124.40
  • Aetna — EBR FI: $186.60
  • Aetna — Home Depot Employer Group: $191.89
  • Aetna — Medicaid: $42
  • Aetna — Medicare: $77.75
  • Aetna — NBR ASO/FI: $195.93
  • Aetna — Neighborhood Network: $186.60
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64
  • Cigna — Commercial: $63.91
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT EST PT 99213 $311 $186.60 $36.08 – $264.35
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $124.40
  • Aetna — EBR FI: $186.60
  • Aetna — Home Depot Employer Group: $191.89
  • Aetna — Medicaid: $42
  • Aetna — Medicare: $77.75
  • Aetna — NBR ASO/FI: $195.93
  • Aetna — Neighborhood Network: $186.60
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64
  • Cigna — Commercial: $63.91
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99213 $311 $186.60 $124.40 – $3,704
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $124.40
  • Aetna — EBR FI: $180.38
  • Aetna — Home Depot Employer Group: $198.11
  • Aetna — NBR ASO/FI: $202.15
  • Aetna — Neighborhood Network: $192.82
  • Cigna — Commercial: $124.40
  • Cigna — New Business ASO: $202.15
  • Coventry/First Health — Commercial: $217.70
  • Humana — Commercial: $264.35
  • InterGroup — PPO: $202.15
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99214 $336 $201.60 $36.08 – $285.60
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $134.40
  • Aetna — EBR FI: $201.60
  • Aetna — Home Depot Employer Group: $207.31
  • Aetna — Medicaid: $65.30
  • Aetna — Medicare: $84
  • Aetna — NBR ASO/FI: $211.68
  • Aetna — Neighborhood Network: $201.60
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96
  • Cigna — Commercial: $63.91
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CLINIC VISIT EST PT 99214 $336 $201.60 $36.08 – $285.60
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $134.40
  • Aetna — EBR FI: $201.60
  • Aetna — Home Depot Employer Group: $207.31
  • Aetna — Medicaid: $65.30
  • Aetna — Medicare: $84
  • Aetna — NBR ASO/FI: $211.68
  • Aetna — Neighborhood Network: $201.60
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96
  • Cigna — Commercial: $63.91
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CLINIC VISIT EST 99214 $336 $201.60 $134.40 – $3,704
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $134.40
  • Aetna — EBR FI: $194.88
  • Aetna — Home Depot Employer Group: $214.03
  • Aetna — NBR ASO/FI: $218.40
  • Aetna — Neighborhood Network: $208.32
  • Cigna — Commercial: $134.40
  • Cigna — New Business ASO: $218.40
  • Coventry/First Health — Commercial: $235.20
  • Humana — Commercial: $285.60
  • InterGroup — PPO: $218.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACUITY LEVEL 3 $561 $336.60 $62.31 – $476.85
Emergency room visit (moderate): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $224.40
  • Aetna — EBR FI: $336.60
  • Aetna — Home Depot Employer Group: $346.14
  • Aetna — Medicaid: $67.98
  • Aetna — Medicare: $271.90
  • Aetna — NBR ASO/FI: $353.43
  • Aetna — Neighborhood Network: $336.60
  • Aetna of PA — Medicare: $277.18
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $88.44
  • AmeriHealth Caritas — Medicare: $285.10
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ACUITY LEVEL 3 $561 $336.60 $224.40 – $3,704
Emergency room visit (moderate): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $224.40
  • Aetna — EBR FI: $325.38
  • Aetna — Home Depot Employer Group: $357.36
  • Aetna — NBR ASO/FI: $364.65
  • Aetna — Neighborhood Network: $347.82
  • Cigna — Commercial: $224.40
  • Cigna — New Business ASO: $364.65
  • Coventry/First Health — Commercial: $392.70
  • Humana — Commercial: $476.85
  • InterGroup — PPO: $364.65
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACUITY LEVEL 4 $950 $570 $104.86 – $807.50
Emergency room visit (moderately high): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $380
  • Aetna — EBR FI: $570
  • Aetna — Home Depot Employer Group: $586.15
  • Aetna — Medicaid: $114.40
  • Aetna — Medicare: $418.15
  • Aetna — NBR ASO/FI: $598.50
  • Aetna — Neighborhood Network: $570
  • Aetna of PA — Medicare: $426.27
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.82
  • AmeriHealth Caritas — Medicare: $438.45
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ACUITY LEVEL 4 $950 $570 $380 – $3,704
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $380
  • Aetna — EBR FI: $551
  • Aetna — Home Depot Employer Group: $605.15
  • Aetna — NBR ASO/FI: $617.50
  • Aetna — Neighborhood Network: $589
  • Cigna — Commercial: $380
  • Cigna — New Business ASO: $617.50
  • Coventry/First Health — Commercial: $665
  • Humana — Commercial: $807.50
  • InterGroup — PPO: $617.50
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACUITY LEVEL 5 $1,172 $703.20 $152.61 – $996.20
Emergency room visit (high): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $468.80
  • Aetna — EBR FI: $703.20
  • Aetna — Home Depot Employer Group: $723.12
  • Aetna — Medicaid: $166.49
  • Aetna — Medicare: $602.06
  • Aetna — NBR ASO/FI: $738.36
  • Aetna — Neighborhood Network: $703.20
  • Aetna of PA — Medicare: $613.75
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $216.59
  • AmeriHealth Caritas — Medicare: $631.28
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: ACUITY LEVEL 5 $1,172 $703.20 $468.80 – $3,704
Emergency room visit (high): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $468.80
  • Aetna — EBR FI: $679.76
  • Aetna — Home Depot Employer Group: $746.56
  • Aetna — NBR ASO/FI: $761.80
  • Aetna — Neighborhood Network: $726.64
  • Cigna — Commercial: $468.80
  • Cigna — New Business ASO: $761.80
  • Coventry/First Health — Commercial: $820.40
  • Humana — Commercial: $996.20
  • InterGroup — PPO: $761.80

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $141 $84.60 $7.67 – $119.85
Basic metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $56.40
  • Aetna — EBR FI: $84.60
  • Aetna — Home Depot Employer Group: $87
  • Aetna — Medicaid: $11.23
  • Aetna — Medicare: $8.71
  • Aetna — NBR ASO/FI: $88.83
  • Aetna — Neighborhood Network: $84.60
  • Aetna of PA — Medicare: $8.88
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.61
  • AmeriHealth Caritas — Medicare: $9.14
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL $141 $84.60 $56.40 – $3,704
Basic metabolic panel (blood test): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $56.40
  • Aetna — EBR FI: $81.78
  • Aetna — Home Depot Employer Group: $89.82
  • Aetna — NBR ASO/FI: $91.65
  • Aetna — Neighborhood Network: $87.42
  • Cigna — Commercial: $56.40
  • Cigna — New Business ASO: $91.65
  • Coventry/First Health — Commercial: $98.70
  • Humana — Commercial: $119.85
  • InterGroup — PPO: $91.65
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL $211 $126.60 $9.58 – $179.35
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $84.40
  • Aetna — EBR FI: $126.60
  • Aetna — Home Depot Employer Group: $130.19
  • Aetna — Medicaid: $14.03
  • Aetna — Medicare: $10.88
  • Aetna — NBR ASO/FI: $132.93
  • Aetna — Neighborhood Network: $126.60
  • Aetna of PA — Medicare: $11.09
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.25
  • AmeriHealth Caritas — Medicare: $11.40
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOL PN P5147 $211 $126.60 $9.58 – $179.35
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $84.40
  • Aetna — EBR FI: $126.60
  • Aetna — Home Depot Employer Group: $130.19
  • Aetna — Medicaid: $14.03
  • Aetna — Medicare: $10.88
  • Aetna — NBR ASO/FI: $132.93
  • Aetna — Neighborhood Network: $126.60
  • Aetna of PA — Medicare: $11.09
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.25
  • AmeriHealth Caritas — Medicare: $11.40
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC PANEL $211 $126.60 $84.40 – $3,704
Comprehensive metabolic panel (blood test): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $84.40
  • Aetna — EBR FI: $122.38
  • Aetna — Home Depot Employer Group: $134.41
  • Aetna — NBR ASO/FI: $137.15
  • Aetna — Neighborhood Network: $130.82
  • Cigna — Commercial: $84.40
  • Cigna — New Business ASO: $137.15
  • Coventry/First Health — Commercial: $147.70
  • Humana — Commercial: $179.35
  • InterGroup — PPO: $137.15
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICS PANEL $991 $594.60 $13.20 – $842.35
Obstetric blood test panel: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $396.40
  • Aetna — EBR FI: $594.60
  • Aetna — Home Depot Employer Group: $611.45
  • Aetna — Medicaid: $14.40
  • Aetna — Medicare: $49.24
  • Aetna — NBR ASO/FI: $624.33
  • Aetna — Neighborhood Network: $594.60
  • Aetna of PA — Medicare: $50.20
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.73
  • AmeriHealth Caritas — Medicare: $51.63
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OBSTETRICS PANEL $991 $594.60 $396.40 – $3,704
Obstetric blood test panel: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $396.40
  • Aetna — EBR FI: $574.78
  • Aetna — Home Depot Employer Group: $631.27
  • Aetna — NBR ASO/FI: $644.15
  • Aetna — Neighborhood Network: $614.42
  • Cigna — Commercial: $396.40
  • Cigna — New Business ASO: $644.15
  • Coventry/First Health — Commercial: $693.70
  • Humana — Commercial: $842.35
  • InterGroup — PPO: $644.15
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PROFILE $222 $133.20 $12.14 – $188.70
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $88.80
  • Aetna — EBR FI: $133.20
  • Aetna — Home Depot Employer Group: $136.97
  • Aetna — Medicaid: $16.80
  • Aetna — Medicare: $13.79
  • Aetna — NBR ASO/FI: $139.86
  • Aetna — Neighborhood Network: $133.20
  • Aetna of PA — Medicare: $14.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86
  • AmeriHealth Caritas — Medicare: $14.46
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL W/RFX LDL $222 $133.20 $12.14 – $188.70
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $88.80
  • Aetna — EBR FI: $133.20
  • Aetna — Home Depot Employer Group: $136.97
  • Aetna — Medicaid: $16.80
  • Aetna — Medicare: $13.79
  • Aetna — NBR ASO/FI: $139.86
  • Aetna — Neighborhood Network: $133.20
  • Aetna of PA — Medicare: $14.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86
  • AmeriHealth Caritas — Medicare: $14.46
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARDIO IQ LIPID PANEL $222 $133.20 $12.14 – $188.70
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $88.80
  • Aetna — EBR FI: $133.20
  • Aetna — Home Depot Employer Group: $136.97
  • Aetna — Medicaid: $16.80
  • Aetna — Medicare: $13.79
  • Aetna — NBR ASO/FI: $139.86
  • Aetna — Neighborhood Network: $133.20
  • Aetna of PA — Medicare: $14.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86
  • AmeriHealth Caritas — Medicare: $14.46
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $175 $105 $7.87 – $148.75
Kidney function panel: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $70
  • Aetna — EBR FI: $105
  • Aetna — Home Depot Employer Group: $107.97
  • Aetna — Medicaid: $11.52
  • Aetna — Medicare: $8.94
  • Aetna — NBR ASO/FI: $110.25
  • Aetna — Neighborhood Network: $105
  • Aetna of PA — Medicare: $9.11
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.99
  • AmeriHealth Caritas — Medicare: $9.37
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL $175 $105 $70 – $3,704
Kidney function panel: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $70
  • Aetna — EBR FI: $101.50
  • Aetna — Home Depot Employer Group: $111.47
  • Aetna — NBR ASO/FI: $113.75
  • Aetna — Neighborhood Network: $108.50
  • Cigna — Commercial: $70
  • Cigna — New Business ASO: $113.75
  • Coventry/First Health — Commercial: $122.50
  • Humana — Commercial: $148.75
  • InterGroup — PPO: $113.75
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $331 $198.60 $7.41 – $281.35
Liver function panel: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $132.40
  • Aetna — EBR FI: $198.60
  • Aetna — Home Depot Employer Group: $204.23
  • Aetna — Medicaid: $10.84
  • Aetna — Medicare: $8.42
  • Aetna — NBR ASO/FI: $208.53
  • Aetna — Neighborhood Network: $198.60
  • Aetna of PA — Medicare: $8.58
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.10
  • AmeriHealth Caritas — Medicare: $8.82
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL P5144 $331 $198.60 $7.41 – $281.35
Liver function panel: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $132.40
  • Aetna — EBR FI: $198.60
  • Aetna — Home Depot Employer Group: $204.23
  • Aetna — Medicaid: $10.84
  • Aetna — Medicare: $8.42
  • Aetna — NBR ASO/FI: $208.53
  • Aetna — Neighborhood Network: $198.60
  • Aetna of PA — Medicare: $8.58
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.10
  • AmeriHealth Caritas — Medicare: $8.82
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL $331 $198.60 $132.40 – $3,704
Liver function panel: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $132.40
  • Aetna — EBR FI: $191.98
  • Aetna — Home Depot Employer Group: $210.85
  • Aetna — NBR ASO/FI: $215.15
  • Aetna — Neighborhood Network: $205.22
  • Cigna — Commercial: $132.40
  • Cigna — New Business ASO: $215.15
  • Coventry/First Health — Commercial: $231.70
  • Humana — Commercial: $281.35
  • InterGroup — PPO: $215.15
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS R & M $60 $36 $2.87 – $51
Urine test (automated, with microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $24
  • Aetna — EBR FI: $36
  • Aetna — Home Depot Employer Group: $37.02
  • Aetna — Medicaid: $3.60
  • Aetna — Medicare: $3.27
  • Aetna — NBR ASO/FI: $37.80
  • Aetna — Neighborhood Network: $36
  • Aetna of PA — Medicare: $3.33
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.68
  • AmeriHealth Caritas — Medicare: $3.42
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UR COMPL W/REFLEX TO CULTURE $60 $36 $2.87 – $51
Urine test (automated, with microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $24
  • Aetna — EBR FI: $36
  • Aetna — Home Depot Employer Group: $37.02
  • Aetna — Medicaid: $3.60
  • Aetna — Medicare: $3.27
  • Aetna — NBR ASO/FI: $37.80
  • Aetna — Neighborhood Network: $36
  • Aetna of PA — Medicare: $3.33
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.68
  • AmeriHealth Caritas — Medicare: $3.42
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS R & M $60 $36 $24 – $3,704 (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 11 insurance plan rates
  • Aetna — EBR ASO: $24
  • Aetna — EBR FI: $34.80
  • Aetna — Home Depot Employer Group: $38.22
  • Aetna — NBR ASO/FI: $39
  • Aetna — Neighborhood Network: $37.20
  • Cigna — Commercial: $24
  • Cigna — New Business ASO: $39
  • Coventry/First Health — Commercial: $42
  • Humana — Commercial: $51
  • InterGroup — PPO: $39
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS DIPSTICK $31 $18.60 $3.16 – $26.35
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $12.40
  • Aetna — EBR FI: $18.60
  • Aetna — Home Depot Employer Group: $19.13
  • Aetna — Medicaid: $4.28
  • Aetna — Medicare: $3.58
  • Aetna — NBR ASO/FI: $19.53
  • Aetna — Neighborhood Network: $18.60
  • Aetna of PA — Medicare: $3.65
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $5.57
  • AmeriHealth Caritas — Medicare: $3.76
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE DIP $31 $18.60 $3.16 – $26.35
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $12.40
  • Aetna — EBR FI: $18.60
  • Aetna — Home Depot Employer Group: $19.13
  • Aetna — Medicaid: $4.28
  • Aetna — Medicare: $3.58
  • Aetna — NBR ASO/FI: $19.53
  • Aetna — Neighborhood Network: $18.60
  • Aetna of PA — Medicare: $3.65
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $5.57
  • AmeriHealth Caritas — Medicare: $3.76
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NON AUTOMATED W/O MICRO P3632 $31 $18.60 $3.16 – $26.35
Urine test (manual, without microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $12.40
  • Aetna — EBR FI: $18.60
  • Aetna — Home Depot Employer Group: $19.13
  • Aetna — Medicaid: $4.28
  • Aetna — Medicare: $3.58
  • Aetna — NBR ASO/FI: $19.53
  • Aetna — Neighborhood Network: $18.60
  • Aetna of PA — Medicare: $3.65
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $5.57
  • AmeriHealth Caritas — Medicare: $3.76
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY URINE-C $29 $17.40 $2.04 – $24.65
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $11.60
  • Aetna — EBR FI: $17.40
  • Aetna — Home Depot Employer Group: $17.89
  • Aetna — Medicaid: $3.72
  • Aetna — Medicare: $2.32
  • Aetna — NBR ASO/FI: $18.27
  • Aetna — Neighborhood Network: $17.40
  • Aetna of PA — Medicare: $2.36
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84
  • AmeriHealth Caritas — Medicare: $2.43
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE MACRO $29 $17.40 $2.04 – $24.65
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $11.60
  • Aetna — EBR FI: $17.40
  • Aetna — Home Depot Employer Group: $17.89
  • Aetna — Medicaid: $3.72
  • Aetna — Medicare: $2.32
  • Aetna — NBR ASO/FI: $18.27
  • Aetna — Neighborhood Network: $17.40
  • Aetna of PA — Medicare: $2.36
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84
  • AmeriHealth Caritas — Medicare: $2.43
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE KETONE $29 $17.40 $2.04 – $24.65
Urine test (automated, without microscope): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $11.60
  • Aetna — EBR FI: $17.40
  • Aetna — Home Depot Employer Group: $17.89
  • Aetna — Medicaid: $3.72
  • Aetna — Medicare: $2.32
  • Aetna — NBR ASO/FI: $18.27
  • Aetna — Neighborhood Network: $17.40
  • Aetna of PA — Medicare: $2.36
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84
  • AmeriHealth Caritas — Medicare: $2.43
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC PSA $161 $96.60 $16.68 – $136.85
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $64.40
  • Aetna — EBR FI: $96.60
  • Aetna — Home Depot Employer Group: $99.34
  • Aetna — Medicaid: $29.23
  • Aetna — Medicare: $18.94
  • Aetna — NBR ASO/FI: $101.43
  • Aetna — Neighborhood Network: $96.60
  • Aetna of PA — Medicare: $19.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03
  • AmeriHealth Caritas — Medicare: $19.86
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA DIAGNOSTIC $161 $96.60 $16.68 – $136.85
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $64.40
  • Aetna — EBR FI: $96.60
  • Aetna — Home Depot Employer Group: $99.34
  • Aetna — Medicaid: $29.23
  • Aetna — Medicare: $18.94
  • Aetna — NBR ASO/FI: $101.43
  • Aetna — Neighborhood Network: $96.60
  • Aetna of PA — Medicare: $19.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03
  • AmeriHealth Caritas — Medicare: $19.86
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL PSA PNL 2770 $161 $96.60 $16.68 – $136.85
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $64.40
  • Aetna — EBR FI: $96.60
  • Aetna — Home Depot Employer Group: $99.34
  • Aetna — Medicaid: $29.23
  • Aetna — Medicare: $18.94
  • Aetna — NBR ASO/FI: $101.43
  • Aetna — Neighborhood Network: $96.60
  • Aetna of PA — Medicare: $19.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03
  • AmeriHealth Caritas — Medicare: $19.86
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE $149 $89.40 $15.24 – $126.65
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $59.60
  • Aetna — EBR FI: $89.40
  • Aetna — Home Depot Employer Group: $91.93
  • Aetna — Medicaid: $27.85
  • Aetna — Medicare: $17.30
  • Aetna — NBR ASO/FI: $93.87
  • Aetna — Neighborhood Network: $89.40
  • Aetna of PA — Medicare: $17.64
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23
  • AmeriHealth Caritas — Medicare: $18.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH W/FREE T4 RFX $149 $89.40 $15.24 – $126.65
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $59.60
  • Aetna — EBR FI: $89.40
  • Aetna — Home Depot Employer Group: $91.93
  • Aetna — Medicaid: $27.85
  • Aetna — Medicare: $17.30
  • Aetna — NBR ASO/FI: $93.87
  • Aetna — Neighborhood Network: $89.40
  • Aetna of PA — Medicare: $17.64
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23
  • AmeriHealth Caritas — Medicare: $18.14
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH THIRD GENERATION $149 $89.40 $15.24 – $126.65
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $59.60
  • Aetna — EBR FI: $89.40
  • Aetna — Home Depot Employer Group: $91.93
  • Aetna — Medicaid: $27.85
  • Aetna — Medicare: $17.30
  • Aetna — NBR ASO/FI: $93.87
  • Aetna — Neighborhood Network: $89.40
  • Aetna of PA — Medicare: $17.64
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23
  • AmeriHealth Caritas — Medicare: $18.14
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC & PLT & AUTO COMP DIFF $149 $89.40 $6.60 – $126.65
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $59.60
  • Aetna — EBR FI: $89.40
  • Aetna — Home Depot Employer Group: $91.93
  • Aetna — Medicaid: $7.20
  • Aetna — Medicare: $8
  • Aetna — NBR ASO/FI: $93.87
  • Aetna — Neighborhood Network: $89.40
  • Aetna of PA — Medicare: $8.16
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $9.37
  • AmeriHealth Caritas — Medicare: $8.39
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OXLDL $149 $89.40 $6.60 – $126.65
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $59.60
  • Aetna — EBR FI: $89.40
  • Aetna — Home Depot Employer Group: $91.93
  • Aetna — Medicaid: $7.20
  • Aetna — Medicare: $8
  • Aetna — NBR ASO/FI: $93.87
  • Aetna — Neighborhood Network: $89.40
  • Aetna of PA — Medicare: $8.16
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $9.37
  • AmeriHealth Caritas — Medicare: $8.39
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/DIFF & PLATELETS $149 $89.40 $6.60 – $126.65
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $59.60
  • Aetna — EBR FI: $89.40
  • Aetna — Home Depot Employer Group: $91.93
  • Aetna — Medicaid: $7.20
  • Aetna — Medicare: $8
  • Aetna — NBR ASO/FI: $93.87
  • Aetna — Neighborhood Network: $89.40
  • Aetna of PA — Medicare: $8.16
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $9.37
  • AmeriHealth Caritas — Medicare: $8.39
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC & PLT ONLY $85 $51 $5.87 – $72.25
Complete blood count (CBC), automated: 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $34
  • Aetna — EBR FI: $51
  • Aetna — Home Depot Employer Group: $52.45
  • Aetna — Medicaid: $9.02
  • Aetna — Medicare: $6.66
  • Aetna — NBR ASO/FI: $53.55
  • Aetna — Neighborhood Network: $51
  • Aetna of PA — Medicare: $6.79
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.74
  • AmeriHealth Caritas — Medicare: $6.99
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC & PLT ONLY $85 $51 $34 – $3,704
Complete blood count (CBC), automated: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $34
  • Aetna — EBR FI: $49.30
  • Aetna — Home Depot Employer Group: $54.15
  • Aetna — NBR ASO/FI: $55.25
  • Aetna — Neighborhood Network: $52.70
  • Cigna — Commercial: $34
  • Cigna — New Business ASO: $55.25
  • Coventry/First Health — Commercial: $59.50
  • Humana — Commercial: $72.25
  • InterGroup — PPO: $55.25
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT PROTHROMBIN TIME $58 $34.80 $3.61 – $49.30
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $23.20
  • Aetna — EBR FI: $34.80
  • Aetna — Home Depot Employer Group: $35.79
  • Aetna — Medicaid: $4.80
  • Aetna — Medicare: $4.42
  • Aetna — NBR ASO/FI: $36.54
  • Aetna — Neighborhood Network: $34.80
  • Aetna of PA — Medicare: $4.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24
  • AmeriHealth Caritas — Medicare: $4.63
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME P2680 $58 $34.80 $3.61 – $49.30
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $23.20
  • Aetna — EBR FI: $34.80
  • Aetna — Home Depot Employer Group: $35.79
  • Aetna — Medicaid: $4.80
  • Aetna — Medicare: $4.42
  • Aetna — NBR ASO/FI: $36.54
  • Aetna — Neighborhood Network: $34.80
  • Aetna of PA — Medicare: $4.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24
  • AmeriHealth Caritas — Medicare: $4.63
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $58 $34.80 $3.61 – $49.30
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $23.20
  • Aetna — EBR FI: $34.80
  • Aetna — Home Depot Employer Group: $35.79
  • Aetna — Medicaid: $4.80
  • Aetna — Medicare: $4.42
  • Aetna — NBR ASO/FI: $36.54
  • Aetna — Neighborhood Network: $34.80
  • Aetna of PA — Medicare: $4.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24
  • AmeriHealth Caritas — Medicare: $4.63
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ACTIVATED PTT $199 $119.40 $5.45 – $169.15
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $79.60
  • Aetna — EBR FI: $119.40
  • Aetna — Home Depot Employer Group: $122.78
  • Aetna — Medicaid: $9
  • Aetna — Medicare: $6.19
  • Aetna — NBR ASO/FI: $125.37
  • Aetna — Neighborhood Network: $119.40
  • Aetna of PA — Medicare: $6.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71
  • AmeriHealth Caritas — Medicare: $6.49
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT ACTIVATED $199 $119.40 $5.45 – $169.15
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $79.60
  • Aetna — EBR FI: $119.40
  • Aetna — Home Depot Employer Group: $122.78
  • Aetna — Medicaid: $9
  • Aetna — Medicare: $6.19
  • Aetna — NBR ASO/FI: $125.37
  • Aetna — Neighborhood Network: $119.40
  • Aetna of PA — Medicare: $6.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71
  • AmeriHealth Caritas — Medicare: $6.49
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPL TIME PARTL(PTT)P2441 $199 $119.40 $5.45 – $169.15
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates
  • Aetna — EBR ASO: $79.60
  • Aetna — EBR FI: $119.40
  • Aetna — Home Depot Employer Group: $122.78
  • Aetna — Medicaid: $9
  • Aetna — Medicare: $6.19
  • Aetna — NBR ASO/FI: $125.37
  • Aetna — Neighborhood Network: $119.40
  • Aetna of PA — Medicare: $6.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71
  • AmeriHealth Caritas — Medicare: $6.49

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD WO CONTRAST $2,044 $1,226.40 $91.94 – $1,737.40
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $817.60
  • Aetna — EBR FI: $1,226.40
  • Aetna — Home Depot Employer Group: $1,261.15
  • Aetna — Medicaid: $140.10
  • Aetna — Medicare: $104.42
  • Aetna — NBR ASO/FI: $1,287.72
  • Aetna — Neighborhood Network: $1,226.40
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.26
  • AmeriHealth Caritas — Medicare: $109.49
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD WO CONTRAST $2,044 $1,226.40 $817.60 – $3,704
CT scan of the head or brain, without contrast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $817.60
  • Aetna — EBR FI: $1,185.52
  • Aetna — Home Depot Employer Group: $1,302.03
  • Aetna — NBR ASO/FI: $1,328.60
  • Aetna — Neighborhood Network: $1,267.28
  • Cigna — Commercial: $817.60
  • Cigna — New Business ASO: $1,328.60
  • Coventry/First Health — Commercial: $1,430.80
  • Humana — Commercial: $1,737.40
  • InterGroup — PPO: $1,328.60
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR BRAIN W WO CON $6,379 $3,827.40 $308.78 – $5,422.15
MRI of the brain, before and after contrast: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $2,551.60
  • Aetna — EBR FI: $3,827.40
  • Aetna — Home Depot Employer Group: $3,935.84
  • Aetna — Medicaid: $406.80
  • Aetna — Medicare: $350.69
  • Aetna — NBR ASO/FI: $4,018.77
  • Aetna — Neighborhood Network: $3,827.40
  • Aetna of PA — Medicare: $357.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $529.21
  • AmeriHealth Caritas — Medicare: $367.72
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR BRAIN W WO CON $6,379 $3,827.40 $2,551.60 – $5,422.15
MRI of the brain, before and after contrast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $2,551.60
  • Aetna — EBR FI: $3,699.82
  • Aetna — Home Depot Employer Group: $4,063.42
  • Aetna — NBR ASO/FI: $4,146.35
  • Aetna — Neighborhood Network: $3,954.98
  • Cigna — Commercial: $2,551.60
  • Cigna — New Business ASO: $4,146.35
  • Coventry/First Health — Commercial: $4,465.30
  • Humana — Commercial: $5,422.15
  • InterGroup — PPO: $4,146.35
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST 2 VIEWS $235 $141 $26 – $199.75
Chest X-ray, 2 views: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $94
  • Aetna — EBR FI: $141
  • Aetna — Home Depot Employer Group: $145
  • Aetna — Medicaid: $28.37
  • Aetna — Medicare: $86.47
  • Aetna — NBR ASO/FI: $148.05
  • Aetna — Neighborhood Network: $141
  • Aetna of PA — Medicare: $88.15
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.90
  • AmeriHealth Caritas — Medicare: $90.67
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHEST 2 VIEWS $235 $141 $94 – $3,704
Chest X-ray, 2 views: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $94
  • Aetna — EBR FI: $136.30
  • Aetna — Home Depot Employer Group: $149.69
  • Aetna — NBR ASO/FI: $152.75
  • Aetna — Neighborhood Network: $145.70
  • Cigna — Commercial: $94
  • Cigna — New Business ASO: $152.75
  • Coventry/First Health — Commercial: $164.50
  • Humana — Commercial: $199.75
  • InterGroup — PPO: $152.75
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: CHEST 2 VIEWS $235 $141 $26 – $199.75
Chest X-ray, 2 views: 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $94
  • Aetna — EBR FI: $141
  • Aetna — Home Depot Employer Group: $145
  • Aetna — Medicaid: $28.37
  • Aetna — Medicare: $58.75
  • Aetna — NBR ASO/FI: $148.05
  • Aetna — Neighborhood Network: $141
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.90
  • Cigna — Commercial: $94
  • Cigna — New Business ASO: $148.05
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE LUMBOSAC MIN 4 VWS $429 $257.40 $40.28 – $364.65
X-ray of the lower spine, at least 4 views: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $171.60
  • Aetna — EBR FI: $257.40
  • Aetna — Home Depot Employer Group: $264.69
  • Aetna — Medicaid: $43.94
  • Aetna — Medicare: $104.42
  • Aetna — NBR ASO/FI: $270.27
  • Aetna — Neighborhood Network: $257.40
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $57.17
  • AmeriHealth Caritas — Medicare: $109.49
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINE LUMBOSAC MIN 4 VWS $429 $257.40 $171.60 – $3,704
X-ray of the lower spine, at least 4 views: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $171.60
  • Aetna — EBR FI: $248.82
  • Aetna — Home Depot Employer Group: $273.27
  • Aetna — NBR ASO/FI: $278.85
  • Aetna — Neighborhood Network: $265.98
  • Cigna — Commercial: $171.60
  • Cigna — New Business ASO: $278.85
  • Coventry/First Health — Commercial: $300.30
  • Humana — Commercial: $364.65
  • InterGroup — PPO: $278.85
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: SPINE LUMBOSAC MIN 4 VWS $429 $257.40 $40.28 – $364.65
X-ray of the lower spine, at least 4 views: 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $171.60
  • Aetna — EBR FI: $257.40
  • Aetna — Home Depot Employer Group: $264.69
  • Aetna — Medicaid: $43.94
  • Aetna — Medicare: $107.25
  • Aetna — NBR ASO/FI: $270.27
  • Aetna — Neighborhood Network: $257.40
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $57.17
  • Cigna — Commercial: $171.60
  • Cigna — New Business ASO: $270.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR SP CANAL LUMBAR WO $3,675 $2,205 $209 – $3,123.75
MRI of the lower back (lumbar spine), without contrast: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,470
  • Aetna — EBR FI: $2,205
  • Aetna — Home Depot Employer Group: $2,267.47
  • Aetna — Medicaid: $307.38
  • Aetna — Medicare: $237.36
  • Aetna — NBR ASO/FI: $2,315.25
  • Aetna — Neighborhood Network: $2,205
  • Aetna of PA — Medicare: $241.97
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $399.88
  • AmeriHealth Caritas — Medicare: $248.89
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR SP CANAL LUMBAR WO $3,675 $2,205 $1,470 – $3,704
MRI of the lower back (lumbar spine), without contrast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,470
  • Aetna — EBR FI: $2,131.50
  • Aetna — Home Depot Employer Group: $2,340.97
  • Aetna — NBR ASO/FI: $2,388.75
  • Aetna — Neighborhood Network: $2,278.50
  • Cigna — Commercial: $1,470
  • Cigna — New Business ASO: $2,388.75
  • Coventry/First Health — Commercial: $2,572.50
  • Humana — Commercial: $3,123.75
  • InterGroup — PPO: $2,388.75
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W CON $2,280 $1,368 $153.92 – $1,938
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $912
  • Aetna — EBR FI: $1,368
  • Aetna — Home Depot Employer Group: $1,406.76
  • Aetna — Medicaid: $168.11
  • Aetna — Medicare: $174.81
  • Aetna — NBR ASO/FI: $1,436.40
  • Aetna — Neighborhood Network: $1,368
  • Aetna of PA — Medicare: $178.21
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $218.69
  • AmeriHealth Caritas — Medicare: $183.30
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W CON $2,280 $1,368 $912 – $3,704
CT scan of the pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $912
  • Aetna — EBR FI: $1,322.40
  • Aetna — Home Depot Employer Group: $1,452.36
  • Aetna — NBR ASO/FI: $1,482
  • Aetna — Neighborhood Network: $1,413.60
  • Cigna — Commercial: $912
  • Cigna — New Business ASO: $1,482
  • Coventry/First Health — Commercial: $1,596
  • Humana — Commercial: $1,938
  • InterGroup — PPO: $1,482
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR LOW EXTREM ANY JNT WO $3,675 $2,205 $209 – $3,123.75
MRI of a leg joint (such as the knee), without contrast: 10 of 27 insurance plan rates
  • Aetna — EBR ASO: $1,470
  • Aetna — EBR FI: $2,205
  • Aetna — Home Depot Employer Group: $2,267.47
  • Aetna — Medicare: $237.36
  • Aetna — NBR ASO/FI: $2,315.25
  • Aetna — Neighborhood Network: $2,205
  • Aetna of PA — Medicare: $241.97
  • AmeriHealth Caritas — Medicare: $248.89
  • Cigna — Commercial: $1,470
  • Cigna — New Business ASO: $2,315.25
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR LOW EXTREM ANY JNT WO $3,675 $2,205 $1,470 – $3,704
MRI of a leg joint (such as the knee), without contrast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,470
  • Aetna — EBR FI: $2,131.50
  • Aetna — Home Depot Employer Group: $2,340.97
  • Aetna — NBR ASO/FI: $2,388.75
  • Aetna — Neighborhood Network: $2,278.50
  • Cigna — Commercial: $1,470
  • Cigna — New Business ASO: $2,388.75
  • Coventry/First Health — Commercial: $2,572.50
  • Humana — Commercial: $3,123.75
  • InterGroup — PPO: $2,388.75
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PLVS W CONTRAST $2,280 $1,368 $289.48 – $1,938
CT scan of the abdomen and pelvis, with contrast: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $912
  • Aetna — EBR FI: $1,368
  • Aetna — Home Depot Employer Group: $1,406.76
  • Aetna — Medicaid: $315.79
  • Aetna — Medicare: $350.69
  • Aetna — NBR ASO/FI: $1,436.40
  • Aetna — Neighborhood Network: $1,368
  • Aetna of PA — Medicare: $357.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $410.82
  • AmeriHealth Caritas — Medicare: $367.72
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABD & PLVS W CONTRAST $2,280 $1,368 $912 – $3,704
CT scan of the abdomen and pelvis, with contrast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $912
  • Aetna — EBR FI: $1,322.40
  • Aetna — Home Depot Employer Group: $1,452.36
  • Aetna — NBR ASO/FI: $1,482
  • Aetna — Neighborhood Network: $1,413.60
  • Cigna — Commercial: $912
  • Cigna — New Business ASO: $1,482
  • Coventry/First Health — Commercial: $1,596
  • Humana — Commercial: $1,938
  • InterGroup — PPO: $1,482
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMINAL COMPLETE $940 $564 $91.94 – $799
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $376
  • Aetna — EBR FI: $564
  • Aetna — Home Depot Employer Group: $579.98
  • Aetna — Medicaid: $114.32
  • Aetna — Medicare: $104.42
  • Aetna — NBR ASO/FI: $592.20
  • Aetna — Neighborhood Network: $564
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.73
  • AmeriHealth Caritas — Medicare: $109.49
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMINAL COMPLETE $940 $564 $376 – $3,704
Ultrasound of the abdomen, complete: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $376
  • Aetna — EBR FI: $545.20
  • Aetna — Home Depot Employer Group: $598.78
  • Aetna — NBR ASO/FI: $611
  • Aetna — Neighborhood Network: $582.80
  • Cigna — Commercial: $376
  • Cigna — New Business ASO: $611
  • Coventry/First Health — Commercial: $658
  • Humana — Commercial: $799
  • InterGroup — PPO: $611
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREGNANT UTERUS>14WKS $1,018 $610.80 $85.25 – $865.30
Pregnancy ultrasound (after the first trimester): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $407.20
  • Aetna — EBR FI: $610.80
  • Aetna — Home Depot Employer Group: $628.11
  • Aetna — Medicaid: $93
  • Aetna — Medicare: $104.42
  • Aetna — NBR ASO/FI: $641.34
  • Aetna — Neighborhood Network: $610.80
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $120.99
  • AmeriHealth Caritas — Medicare: $109.49
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US PREGNANT UTERUS>14WKS $1,018 $610.80 $407.20 – $3,704
Pregnancy ultrasound (after the first trimester): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $407.20
  • Aetna — EBR FI: $590.44
  • Aetna — Home Depot Employer Group: $648.47
  • Aetna — NBR ASO/FI: $661.70
  • Aetna — Neighborhood Network: $631.16
  • Cigna — Commercial: $407.20
  • Cigna — New Business ASO: $661.70
  • Coventry/First Health — Commercial: $712.60
  • Humana — Commercial: $865.30
  • InterGroup — PPO: $661.70
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $590 $354 $84.15 – $501.50
Transvaginal ultrasound: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $236
  • Aetna — EBR FI: $354
  • Aetna — Home Depot Employer Group: $364.03
  • Aetna — Medicaid: $91.80
  • Aetna — Medicare: $104.42
  • Aetna — NBR ASO/FI: $371.70
  • Aetna — Neighborhood Network: $354
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $119.42
  • AmeriHealth Caritas — Medicare: $109.49
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US TRANSVAGINAL $590 $354 $236 – $3,704
Transvaginal ultrasound: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $236
  • Aetna — EBR FI: $342.20
  • Aetna — Home Depot Employer Group: $375.83
  • Aetna — NBR ASO/FI: $383.50
  • Aetna — Neighborhood Network: $365.80
  • Cigna — Commercial: $236
  • Cigna — New Business ASO: $383.50
  • Coventry/First Health — Commercial: $413
  • Humana — Commercial: $501.50
  • InterGroup — PPO: $383.50
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DX UNI WWO CAD $812 $487.20 $112.65 – $690.20
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates
  • Aetna — EBR ASO: $324.80
  • Aetna — EBR FI: $487.20
  • Aetna — Home Depot Employer Group: $501
  • Aetna — Medicaid: $122.89
  • Aetna — Medicare: $203
  • Aetna — NBR ASO/FI: $511.56
  • Aetna — Neighborhood Network: $487.20
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $159.87
  • Cigna — Commercial: $324.80
  • Cigna — New Business ASO: $511.56
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DX UNI WWO CAD $812 $487.20 $324.80 – $3,704
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $324.80
  • Aetna — EBR FI: $470.96
  • Aetna — Home Depot Employer Group: $517.24
  • Aetna — NBR ASO/FI: $527.80
  • Aetna — Neighborhood Network: $503.44
  • Cigna — Commercial: $324.80
  • Cigna — New Business ASO: $527.80
  • Coventry/First Health — Commercial: $568.40
  • Humana — Commercial: $690.20
  • InterGroup — PPO: $527.80
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DX BILAT WWO CAD $986 $591.60 $142.84 – $838.10
Diagnostic mammogram, both breasts: 10 of 23 insurance plan rates
  • Aetna — EBR ASO: $394.40
  • Aetna — EBR FI: $591.60
  • Aetna — Home Depot Employer Group: $608.36
  • Aetna — Medicaid: $155.82
  • Aetna — Medicare: $246.50
  • Aetna — NBR ASO/FI: $621.18
  • Aetna — Neighborhood Network: $591.60
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $202.71
  • Cigna — Commercial: $394.40
  • Cigna — New Business ASO: $621.18
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIGITAL DX BILAT WWO CAD $986 $591.60 $394.40 – $3,704
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $394.40
  • Aetna — EBR FI: $571.88
  • Aetna — Home Depot Employer Group: $628.08
  • Aetna — NBR ASO/FI: $640.90
  • Aetna — Neighborhood Network: $611.32
  • Cigna — Commercial: $394.40
  • Cigna — New Business ASO: $640.90
  • Coventry/First Health — Commercial: $690.20
  • Humana — Commercial: $838.10
  • InterGroup — PPO: $640.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIGI SCR BILAT WWO CAD $342 $205.20 $85.50 – $348.04
Screening mammogram, both breasts: 10 of 23 insurance plan rates
  • Aetna — EBR ASO: $136.80
  • Aetna — EBR FI: $205.20
  • Aetna — Home Depot Employer Group: $211.01
  • Aetna — Medicaid: $125.64
  • Aetna — Medicare: $85.50
  • Aetna — NBR ASO/FI: $215.46
  • Aetna — Neighborhood Network: $205.20
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $163.45
  • Cigna — Commercial: $136.80
  • Cigna — New Business ASO: $215.46
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIGI SCR BILAT WWO CAD $342 $205.20 $136.80 – $3,704
Screening mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $136.80
  • Aetna — EBR FI: $198.36
  • Aetna — Home Depot Employer Group: $217.85
  • Aetna — NBR ASO/FI: $222.30
  • Aetna — Neighborhood Network: $212.04
  • Cigna — Commercial: $136.80
  • Cigna — New Business ASO: $222.30
  • Coventry/First Health — Commercial: $239.40
  • Humana — Commercial: $290.70
  • InterGroup — PPO: $222.30
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MAMMO DIGI SCR BILAT WWO CAD $342 $205.20 $85.50 – $348.04
Screening mammogram, both breasts: 10 of 23 insurance plan rates
  • Aetna — EBR ASO: $136.80
  • Aetna — EBR FI: $205.20
  • Aetna — Home Depot Employer Group: $211.01
  • Aetna — Medicaid: $125.64
  • Aetna — Medicare: $85.50
  • Aetna — NBR ASO/FI: $215.46
  • Aetna — Neighborhood Network: $205.20
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $163.45
  • Cigna — Commercial: $136.80
  • Cigna — New Business ASO: $215.46

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W VENTRCLGRPHY $9,493 $5,695.80 $1,257.63 – $8,069.05
Left heart catheterization (diagnostic): 10 of 27 insurance plan rates
  • Aetna — EBR ASO: $3,797.20
  • Aetna — EBR FI: $5,695.80
  • Aetna — Home Depot Employer Group: $5,857.18
  • Aetna — Medicare: $3,158.45
  • Aetna — NBR ASO/FI: $5,980.59
  • Aetna — Neighborhood Network: $5,695.80
  • Aetna of PA — Medicare: $3,219.78
  • AmeriHealth Caritas — Medicare: $3,311.78
  • Cigna — Commercial: $3,797.20
  • Cigna — New Business ASO: $5,980.59
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEFT HRT CATH W VENTRCLGRPHY $9,493 $5,695.80 $3,704 – $8,069.05
Left heart catheterization (diagnostic): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $3,797.20
  • Aetna — EBR FI: $5,505.94
  • Aetna — Home Depot Employer Group: $6,047.04
  • Aetna — NBR ASO/FI: $6,170.45
  • Aetna — Neighborhood Network: $5,885.66
  • Cigna — Commercial: $3,797.20
  • Cigna — New Business ASO: $6,170.45
  • Coventry/First Health — Commercial: $6,645.10
  • Humana — Commercial: $8,069.05
  • InterGroup — PPO: $6,170.45

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPEUTIC EXERCISE P/15M $175 $105 $9.22 – $148.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $70
  • Aetna — EBR FI: $105
  • Aetna — Home Depot Employer Group: $107.97
  • Aetna — Medicaid: $10.06
  • Aetna — Medicare: $43.75
  • Aetna — NBR ASO/FI: $110.25
  • Aetna — Neighborhood Network: $105
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08
  • Cigna — Commercial: $70
  • Cigna — New Business ASO: $110.25
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO,CO In the file: CO THERAPEUTIC EXERCISE P/15M $175 $105 $9.22 – $148.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $70
  • Aetna — EBR FI: $105
  • Aetna — Home Depot Employer Group: $107.97
  • Aetna — Medicaid: $10.06
  • Aetna — Medicare: $43.75
  • Aetna — NBR ASO/FI: $110.25
  • Aetna — Neighborhood Network: $105
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08
  • Cigna — Commercial: $70
  • Cigna — New Business ASO: $110.25
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO,PO In the file: THERAPEUTIC EXERCISE P/15M $175 $105 $9.22 – $148.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates
  • Aetna — EBR ASO: $70
  • Aetna — EBR FI: $105
  • Aetna — Home Depot Employer Group: $107.97
  • Aetna — Medicaid: $10.06
  • Aetna — Medicare: $43.75
  • Aetna — NBR ASO/FI: $110.25
  • Aetna — Neighborhood Network: $105
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08
  • Cigna — Commercial: $70
  • Cigna — New Business ASO: $110.25
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX $534 $320.40 $127.65 – $453.90
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $320.40
  • Aetna — Home Depot Employer Group: $329.48
  • Aetna — Medicare: $133.50
  • Aetna — NBR ASO/FI: $336.42
  • Aetna — Neighborhood Network: $320.40
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $336.42
  • Coventry/First Health — Commercial: $373.80
  • Health Coalition Partners — PPO: $384.48
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP,PO In the file: PT EVAL LOW COMPLEX $534 $320.40 $127.65 – $453.90
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $320.40
  • Aetna — Home Depot Employer Group: $329.48
  • Aetna — Medicare: $133.50
  • Aetna — NBR ASO/FI: $336.42
  • Aetna — Neighborhood Network: $320.40
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $336.42
  • Coventry/First Health — Commercial: $373.80
  • Health Coalition Partners — PPO: $384.48
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX $534 $320.40 $213.60 – $3,704
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $309.72
  • Aetna — Home Depot Employer Group: $340.16
  • Aetna — NBR ASO/FI: $347.10
  • Aetna — Neighborhood Network: $331.08
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $347.10
  • Coventry/First Health — Commercial: $373.80
  • Humana — Commercial: $453.90
  • InterGroup — PPO: $347.10
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX $534 $320.40 $127.65 – $453.90
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $320.40
  • Aetna — Home Depot Employer Group: $329.48
  • Aetna — Medicare: $133.50
  • Aetna — NBR ASO/FI: $336.42
  • Aetna — Neighborhood Network: $320.40
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $336.42
  • Coventry/First Health — Commercial: $373.80
  • Health Coalition Partners — PPO: $384.48
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP,PO In the file: PT EVAL MOD COMPLEX $534 $320.40 $127.65 – $453.90
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $320.40
  • Aetna — Home Depot Employer Group: $329.48
  • Aetna — Medicare: $133.50
  • Aetna — NBR ASO/FI: $336.42
  • Aetna — Neighborhood Network: $320.40
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $336.42
  • Coventry/First Health — Commercial: $373.80
  • Health Coalition Partners — PPO: $384.48
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX $534 $320.40 $213.60 – $3,704
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $309.72
  • Aetna — Home Depot Employer Group: $340.16
  • Aetna — NBR ASO/FI: $347.10
  • Aetna — Neighborhood Network: $331.08
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $347.10
  • Coventry/First Health — Commercial: $373.80
  • Humana — Commercial: $453.90
  • InterGroup — PPO: $347.10
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX $534 $320.40 $127.65 – $453.90
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $320.40
  • Aetna — Home Depot Employer Group: $329.48
  • Aetna — Medicare: $133.50
  • Aetna — NBR ASO/FI: $336.42
  • Aetna — Neighborhood Network: $320.40
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $336.42
  • Coventry/First Health — Commercial: $373.80
  • Health Coalition Partners — PPO: $384.48
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP,PO In the file: PT EVAL HIGH COMPLEX $534 $320.40 $127.65 – $453.90
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $320.40
  • Aetna — Home Depot Employer Group: $329.48
  • Aetna — Medicare: $133.50
  • Aetna — NBR ASO/FI: $336.42
  • Aetna — Neighborhood Network: $320.40
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $336.42
  • Coventry/First Health — Commercial: $373.80
  • Health Coalition Partners — PPO: $384.48
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX $534 $320.40 $213.60 – $3,704
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $213.60
  • Aetna — EBR FI: $309.72
  • Aetna — Home Depot Employer Group: $340.16
  • Aetna — NBR ASO/FI: $347.10
  • Aetna — Neighborhood Network: $331.08
  • Cigna — Commercial: $213.60
  • Cigna — New Business ASO: $347.10
  • Coventry/First Health — Commercial: $373.80
  • Humana — Commercial: $453.90
  • InterGroup — PPO: $347.10

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LESION, NIPPLE OR AREOLAR LESION (EXCEPT 19 Not listed in the file Not listed in the file $190.30 – $4,015.84
Removal of breast growth (open surgery): 10 of 20 insurance plan rates
  • Aetna — Medicaid: $207.60
  • Aetna — Medicare: $3,760.28
  • Aetna of PA — Medicare: $3,833.30
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $270.07
  • AmeriHealth Caritas — Medicare: $3,942.82
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,676.36
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $2,172.24
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $3,650.76
  • Highmark Wholecare (prev Gateway) — Medicaid: $256.56
  • Highmark Wholecare (prev Gateway) — Medicare: $3,942.46
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 $5,007.31 – $16,375.20
Total hip replacement: 10 of 14 insurance plan rates
  • Aetna — Medicare: $12,634.98
  • Aetna of PA — Medicare: $12,880.32
  • AmeriHealth Caritas — Medicare: $13,248.33
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $7,896.11
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $6,408.79
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $12,266.97
  • Highmark Wholecare (prev Gateway) — Medicare: $13,247.10
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $13,248.33
  • United Healthcare — Unison Advantage Non Special Needs: $12,880.32
  • United Healthcare — Unison Advantage Special Needs: $13,493.67
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 $5,733.59 – $16,375.20
Total knee replacement: 10 of 14 insurance plan rates
  • Aetna — Medicare: $12,634.98
  • Aetna of PA — Medicare: $12,880.32
  • AmeriHealth Caritas — Medicare: $13,248.33
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $8,523.37
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $6,917.90
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $12,266.97
  • Highmark Wholecare (prev Gateway) — Medicare: $13,247.10
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $13,248.33
  • United Healthcare — Unison Advantage Non Special Needs: $12,880.32
  • United Healthcare — Unison Advantage Special Needs: $13,493.67
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 $1,254.48 – $2,676.36
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,676.36
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $2,172.24
  • UPMC Health Plan — Commercial: $1,254.48
  • UPMC Work Partners — Workers Comp: $2,378.87
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 – $3,402.68
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates
  • Aetna — Medicaid: $652.20
  • Aetna — Medicare: $3,186.15
  • Aetna of PA — Medicare: $3,248.02
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $848.46
  • AmeriHealth Caritas — Medicare: $3,340.82
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $3,296.72
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $2,675.75
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $3,093.35
  • Highmark Wholecare (prev Gateway) — Medicaid: $806.01
  • Highmark Wholecare (prev Gateway) — Medicare: $3,340.51
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12 Not listed in the file Not listed in the file $643.11 – $6,203.86
Removal of tonsils and adenoids (under age 12): 10 of 14 insurance plan rates
  • Aetna — Medicare: $5,809.07
  • Aetna of PA — Medicare: $5,921.86
  • AmeriHealth Caritas — Medicare: $6,091.06
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $5,216.84
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $4,234.19
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $5,639.87
  • Highmark Wholecare (prev Gateway) — Medicare: $6,090.50
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $6,091.06
  • United Healthcare — Unison Advantage Non Special Needs: $5,921.86
  • United Healthcare — Unison Advantage Special Needs: $6,203.86
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD W/WO BRUSHINGS $2,597 $1,558.20 $137.74 – $2,207.45
Upper GI endoscopy (diagnostic): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,038.80
  • Aetna — EBR FI: $1,558.20
  • Aetna — Home Depot Employer Group: $1,602.35
  • Aetna — Medicaid: $150.26
  • Aetna — Medicare: $920.67
  • Aetna — NBR ASO/FI: $1,636.11
  • Aetna — Neighborhood Network: $1,558.20
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $195.48
  • AmeriHealth Caritas — Medicare: $965.36
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD W/WO BRUSHINGS $2,597 $1,558.20 $1,038.80 – $3,704
Upper GI endoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,038.80
  • Aetna — EBR FI: $1,506.26
  • Aetna — Home Depot Employer Group: $1,654.29
  • Aetna — NBR ASO/FI: $1,688.05
  • Aetna — Neighborhood Network: $1,610.14
  • Cigna — Commercial: $1,038.80
  • Cigna — New Business ASO: $1,688.05
  • Coventry/First Health — Commercial: $1,817.90
  • Humana — Commercial: $2,207.45
  • InterGroup — PPO: $1,688.05
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEP Not listed in the file Not listed in the file $137.74 – $1,742.87
Upper GI endoscopy (diagnostic): 10 of 20 insurance plan rates
  • Aetna — Medicaid: $150.26
  • Aetna — Medicare: $920.67
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $195.48
  • AmeriHealth Caritas — Medicare: $965.36
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $1,742.87
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,414.58
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $893.85
  • Highmark Wholecare (prev Gateway) — Medicaid: $185.70
  • Highmark Wholecare (prev Gateway) — Medicare: $965.27
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD W/BIOPSY SINGLE/MULT $3,554 $2,132.40 $163.44 – $3,020.90
Upper GI endoscopy with biopsy: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,421.60
  • Aetna — EBR FI: $2,132.40
  • Aetna — Home Depot Employer Group: $2,192.82
  • Aetna — Medicaid: $178.30
  • Aetna — Medicare: $920.67
  • Aetna — NBR ASO/FI: $2,239.02
  • Aetna — Neighborhood Network: $2,132.40
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $231.95
  • AmeriHealth Caritas — Medicare: $965.36
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EGD W/BIOPSY SINGLE/MULT $3,554 $2,132.40 $1,421.60 – $3,704
Upper GI endoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,421.60
  • Aetna — EBR FI: $2,061.32
  • Aetna — Home Depot Employer Group: $2,263.90
  • Aetna — NBR ASO/FI: $2,310.10
  • Aetna — Neighborhood Network: $2,203.48
  • Cigna — Commercial: $1,421.60
  • Cigna — New Business ASO: $2,310.10
  • Coventry/First Health — Commercial: $2,487.80
  • Humana — Commercial: $3,020.90
  • InterGroup — PPO: $2,310.10
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE Not listed in the file Not listed in the file $163.44 – $2,333.69
Upper GI endoscopy with biopsy: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $178.30
  • Aetna — Medicare: $920.67
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $231.95
  • AmeriHealth Caritas — Medicare: $965.36
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,333.69
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,894.12
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $893.85
  • Highmark Wholecare (prev Gateway) — Medicaid: $220.34
  • Highmark Wholecare (prev Gateway) — Medicare: $965.27
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAG W/WO BRUSHING $2,500 $1,500 $198.55 – $2,333.69
Colonoscopy (diagnostic): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,000
  • Aetna — EBR FI: $1,500
  • Aetna — Home Depot Employer Group: $1,542.50
  • Aetna — Medicaid: $216.60
  • Aetna — Medicare: $895.29
  • Aetna — NBR ASO/FI: $1,575
  • Aetna — Neighborhood Network: $1,500
  • Aetna of PA — Medicare: $912.67
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $281.78
  • AmeriHealth Caritas — Medicare: $938.75
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY DIAG W/WO BRUSHING $2,500 $1,500 $1,000 – $3,704
Colonoscopy (diagnostic): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,000
  • Aetna — EBR FI: $1,450
  • Aetna — Home Depot Employer Group: $1,592.50
  • Aetna — NBR ASO/FI: $1,625
  • Aetna — Neighborhood Network: $1,550
  • Cigna — Commercial: $1,000
  • Cigna — New Business ASO: $1,625
  • Coventry/First Health — Commercial: $1,750
  • Humana — Commercial: $2,125
  • InterGroup — PPO: $1,625
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE) Not listed in the file Not listed in the file $198.55 – $2,333.69
Colonoscopy (diagnostic): 10 of 20 insurance plan rates
  • Aetna — Medicaid: $216.60
  • Aetna — Medicare: $895.29
  • Aetna of PA — Medicare: $912.67
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $281.78
  • AmeriHealth Caritas — Medicare: $938.75
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,333.69
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,894.12
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $869.21
  • Highmark Wholecare (prev Gateway) — Medicaid: $267.68
  • Highmark Wholecare (prev Gateway) — Medicare: $938.66
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BX SINGLE/MULT $3,554 $2,132.40 $247.96 – $3,020.90
Colonoscopy with biopsy: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,421.60
  • Aetna — EBR FI: $2,132.40
  • Aetna — Home Depot Employer Group: $2,192.82
  • Aetna — Medicaid: $270.50
  • Aetna — Medicare: $1,157.83
  • Aetna — NBR ASO/FI: $2,239.02
  • Aetna — Neighborhood Network: $2,132.40
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $351.90
  • AmeriHealth Caritas — Medicare: $1,214.04
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/BX SINGLE/MULT $3,554 $2,132.40 $1,421.60 – $3,704
Colonoscopy with biopsy: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,421.60
  • Aetna — EBR FI: $2,061.32
  • Aetna — Home Depot Employer Group: $2,263.90
  • Aetna — NBR ASO/FI: $2,310.10
  • Aetna — Neighborhood Network: $2,203.48
  • Cigna — Commercial: $1,421.60
  • Cigna — New Business ASO: $2,310.10
  • Coventry/First Health — Commercial: $2,487.80
  • Humana — Commercial: $3,020.90
  • InterGroup — PPO: $2,310.10
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE Not listed in the file Not listed in the file $247.96 – $2,333.69
Colonoscopy with biopsy: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $270.50
  • Aetna — Medicare: $1,157.83
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $351.90
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,333.69
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,894.12
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,124.11
  • Highmark Wholecare (prev Gateway) — Medicaid: $334.30
  • Highmark Wholecare (prev Gateway) — Medicare: $1,213.93
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/SNARE TECHNIQUE $3,554 $2,132.40 $294.89 – $3,020.90
Colonoscopy with removal of polyps (snare): 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,421.60
  • Aetna — EBR FI: $2,132.40
  • Aetna — Home Depot Employer Group: $2,192.82
  • Aetna — Medicaid: $321.70
  • Aetna — Medicare: $1,157.83
  • Aetna — NBR ASO/FI: $2,239.02
  • Aetna — Neighborhood Network: $2,132.40
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $418.50
  • AmeriHealth Caritas — Medicare: $1,214.04
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COLONOSCOPY W/SNARE TECHNIQUE $3,554 $2,132.40 $1,421.60 – $3,704
Colonoscopy with removal of polyps (snare): 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,421.60
  • Aetna — EBR FI: $2,061.32
  • Aetna — Home Depot Employer Group: $2,263.90
  • Aetna — NBR ASO/FI: $2,310.10
  • Aetna — Neighborhood Network: $2,203.48
  • Cigna — Commercial: $1,421.60
  • Cigna — New Business ASO: $2,310.10
  • Coventry/First Health — Commercial: $2,487.80
  • Humana — Commercial: $3,020.90
  • InterGroup — PPO: $2,310.10
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE Not listed in the file Not listed in the file $294.89 – $2,333.69
Colonoscopy with removal of polyps (snare): 10 of 20 insurance plan rates
  • Aetna — Medicaid: $321.70
  • Aetna — Medicare: $1,157.83
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $418.50
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,333.69
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,894.12
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,124.11
  • Highmark Wholecare (prev Gateway) — Medicaid: $397.56
  • Highmark Wholecare (prev Gateway) — Medicare: $1,213.93
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 $788.29 – $2,641.34
Screening colonoscopy (not high risk): 10 of 13 insurance plan rates
  • Aetna — Medicare: $895.29
  • Aetna of PA — Medicare: $912.67
  • AmeriHealth Caritas — Medicare: $938.75
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $1,984.31
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,610.54
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $869.21
  • Highmark Wholecare (prev Gateway) — Medicare: $938.66
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $938.75
  • United Healthcare — Unison Advantage Non Special Needs: $912.67
  • United Healthcare — Unison Advantage Special Needs: $956.13
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY Not listed in the file Not listed in the file $1,414.39 – $6,118.60
Gallbladder removal by laparoscope: 10 of 14 insurance plan rates
  • Aetna — Medicare: $5,729.23
  • Aetna of PA — Medicare: $5,840.48
  • AmeriHealth Caritas — Medicare: $6,007.35
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $5,216.84
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $4,234.19
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $5,562.36
  • Highmark Wholecare (prev Gateway) — Medicare: $6,006.79
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $6,007.35
  • United Healthcare — Unison Advantage Non Special Needs: $5,840.48
  • United Healthcare — Unison Advantage Special Needs: $6,118.60
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE Not listed in the file Not listed in the file $349.25 – $3,700.99
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $381
  • Aetna — Medicare: $3,465.48
  • Aetna of PA — Medicare: $3,532.77
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $495.65
  • AmeriHealth Caritas — Medicare: $3,633.70
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $3,296.72
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $2,675.75
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $3,364.54
  • Highmark Wholecare (prev Gateway) — Medicaid: $470.85
  • Highmark Wholecare (prev Gateway) — Medicare: $3,633.37
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH Not listed in the file Not listed in the file $98.45 – $2,333.69
Prostate biopsy: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $107.40
  • Aetna — Medicare: $2,011.60
  • Aetna of PA — Medicare: $2,050.66
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $139.72
  • AmeriHealth Caritas — Medicare: $2,109.25
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,333.69
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,894.12
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,953.01
  • Highmark Wholecare (prev Gateway) — Medicaid: $132.73
  • Highmark Wholecare (prev Gateway) — Medicare: $2,109.06
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D & C Not listed in the file Not listed in the file $577.87 – $3,334.43
Hysteroscopy with biopsy of the uterus lining: 10 of 14 insurance plan rates
  • Aetna — Medicare: $3,122.24
  • Aetna of PA — Medicare: $3,182.86
  • AmeriHealth Caritas — Medicare: $3,273.80
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,870.84
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $2,330.09
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $3,031.30
  • Highmark Wholecare (prev Gateway) — Medicare: $3,273.50
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $3,273.80
  • United Healthcare — Unison Advantage Non Special Needs: $3,182.86
  • United Healthcare — Unison Advantage Special Needs: $3,334.43
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTRLMNR LUM/SAC W/IMG GDE $5,422 $3,253.20 $89.45 – $4,608.70
Spinal injection, lower back (epidural), with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $2,168.80
  • Aetna — EBR FI: $3,253.20
  • Aetna — Home Depot Employer Group: $3,345.37
  • Aetna — Medicaid: $97.58
  • Aetna — Medicare: $680.04
  • Aetna — NBR ASO/FI: $3,415.86
  • Aetna — Neighborhood Network: $3,253.20
  • Aetna of PA — Medicare: $693.24
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $126.95
  • AmeriHealth Caritas — Medicare: $713.05
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: NJX INTRLMNR LUM/SAC W/IMG GDE $5,422 $3,253.20 $2,168.80 – $4,608.70
Spinal injection, lower back (epidural), with imaging guidance: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $2,168.80
  • Aetna — EBR FI: $3,144.76
  • Aetna — Home Depot Employer Group: $3,453.81
  • Aetna — NBR ASO/FI: $3,524.30
  • Aetna — Neighborhood Network: $3,361.64
  • Cigna — Commercial: $2,168.80
  • Cigna — New Business ASO: $3,524.30
  • Coventry/First Health — Commercial: $3,795.40
  • Humana — Commercial: $4,608.70
  • InterGroup — PPO: $3,524.30
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 – $1,322.06
Spinal injection, lower back (epidural), with imaging guidance: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $97.58
  • Aetna — Medicare: $680.04
  • Aetna of PA — Medicare: $693.24
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $126.95
  • AmeriHealth Caritas — Medicare: $713.05
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $491.32
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $398.78
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $660.23
  • Highmark Wholecare (prev Gateway) — Medicaid: $120.60
  • Highmark Wholecare (prev Gateway) — Medicare: $712.98
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ TRANSFRMN EPI LUM/SAC SNGL $4,458 $2,674.80 $104.54 – $3,789.30
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,783.20
  • Aetna — EBR FI: $2,674.80
  • Aetna — Home Depot Employer Group: $2,750.59
  • Aetna — Medicaid: $114.05
  • Aetna — Medicare: $874.24
  • Aetna — NBR ASO/FI: $2,808.54
  • Aetna — Neighborhood Network: $2,674.80
  • Aetna of PA — Medicare: $891.22
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.37
  • AmeriHealth Caritas — Medicare: $916.68
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJ ANES LUM/SA TRANSF SNG LEV $4,458 $2,674.80 $104.54 – $3,789.30
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — EBR ASO: $1,783.20
  • Aetna — EBR FI: $2,674.80
  • Aetna — Home Depot Employer Group: $2,750.59
  • Aetna — Medicaid: $114.05
  • Aetna — Medicare: $874.24
  • Aetna — NBR ASO/FI: $2,808.54
  • Aetna — Neighborhood Network: $2,674.80
  • Aetna of PA — Medicare: $891.22
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.37
  • AmeriHealth Caritas — Medicare: $916.68
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INJ TRANSFRMN EPI LUM/SAC SNGL $4,458 $2,674.80 $1,783.20 – $3,789.30
Nerve root injection, lower back, with imaging guidance: 10 of 11 insurance plan rates
  • Aetna — EBR ASO: $1,783.20
  • Aetna — EBR FI: $2,585.64
  • Aetna — Home Depot Employer Group: $2,839.75
  • Aetna — NBR ASO/FI: $2,897.70
  • Aetna — Neighborhood Network: $2,763.96
  • Cigna — Commercial: $1,783.20
  • Cigna — New Business ASO: $2,897.70
  • Coventry/First Health — Commercial: $3,120.60
  • Humana — Commercial: $3,789.30
  • InterGroup — PPO: $2,897.70
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL Not listed in the file Not listed in the file $330 – $2,333.69
Carpal tunnel release: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $360
  • Aetna — Medicare: $1,917.58
  • Aetna of PA — Medicare: $1,954.82
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $468.33
  • AmeriHealth Caritas — Medicare: $2,010.67
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $2,333.69
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $1,894.12
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $1,861.73
  • Highmark Wholecare (prev Gateway) — Medicaid: $444.90
  • Highmark Wholecare (prev Gateway) — Medicare: $2,010.48
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGA Not listed in the file Not listed in the file $662.78 – $4,618.47
Cataract removal with lens implant: 10 of 20 insurance plan rates
  • Aetna — Medicaid: $723.04
  • Aetna — Medicare: $2,239.63
  • Aetna of PA — Medicare: $2,283.12
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $940.61
  • AmeriHealth Caritas — Medicare: $2,348.35
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $4,618.47
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $3,748.53
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $2,174.40
  • Highmark Wholecare (prev Gateway) — Medicaid: $893.55
  • Highmark Wholecare (prev Gateway) — Medicare: $2,348.13

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $3,704 – $119,024.84
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 14 insurance plan rates
  • Aetna — Medicare: $72,829.03
  • Aetna of PA — Medicare: $74,243.19
  • AmeriHealth Caritas — Medicare: $76,364.42
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $119,024.84
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $96,615.50
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $70,707.80
  • Highmark Wholecare (prev Gateway) — Medicare: $76,357.35
  • InterGroup — PPO: $3,704
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $76,364.42
  • United Healthcare — Unison Advantage Non Special Needs: $74,243.19
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DRG Grouper 12 (10/1/1994): DRG 216: BIOPSIES OF MUSCULOSKELETAL SYSTEM Not listed in the file Not listed in the file $9,223.57
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $9,223.57
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Not listed in the file Not listed in the file $3,704
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • InterGroup — PPO: $3,704
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DRG Grouper 12 (10/1/1994): DRG 460: NON-EXTENSIVE BURNS W/O O.R. Not listed in the file Not listed in the file $9,223.57
Spinal fusion (not neck), without major complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $9,223.57
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 $3,704 – $20,930.88
Hip or knee replacement (major joint of the leg), without major complications: 10 of 14 insurance plan rates
  • Aetna — Medicare: $14,678.87
  • Aetna of PA — Medicare: $14,963.90
  • AmeriHealth Caritas — Medicare: $15,391.44
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $20,930.88
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $16,990.13
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $14,251.33
  • Highmark Wholecare (prev Gateway) — Medicare: $15,390.01
  • InterGroup — PPO: $3,704
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $15,391.44
  • United Healthcare — Unison Advantage Non Special Needs: $14,963.90
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DRG Grouper 12 (10/1/1994): DRG 470: **UNGROUPABLE Not listed in the file Not listed in the file $9,223.57
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $9,223.57
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 $3,704 – $26,935.92
Neck (cervical) spinal fusion, without complications: 10 of 14 insurance plan rates
  • Aetna — Medicare: $18,472.68
  • Aetna of PA — Medicare: $18,831.37
  • AmeriHealth Caritas — Medicare: $19,369.41
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $26,935.92
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $21,864.58
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $17,934.64
  • Highmark Wholecare (prev Gateway) — Medicare: $19,367.62
  • InterGroup — PPO: $3,704
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $19,369.41
  • United Healthcare — Unison Advantage Non Special Needs: $18,831.37
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: DRG Grouper 12 (10/1/1994): DRG 473: ACUTE LEUKEMIA W/O MAJOR O.R. Not listed in the file Not listed in the file $9,223.57
Neck (cervical) spinal fusion, without complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $9,223.57
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 $3,704 – $15,151.46
Uterus and ovary surgery (not for cancer), without complications: 10 of 14 insurance plan rates
  • Aetna — Medicare: $9,583.45
  • Aetna of PA — Medicare: $9,769.54
  • AmeriHealth Caritas — Medicare: $10,048.67
  • Highmark BCBS of PA — Commercial - Indemnity/Managed Care: $15,151.46
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity/Managed Care - Social : $12,298.82
  • Highmark BCBS of PA — Community Blue Medicare Advantage/Complete Blue Medicare Adv: $9,304.32
  • Highmark Wholecare (prev Gateway) — Medicare: $10,047.74
  • InterGroup — PPO: $3,704
  • PA Health & Wellness — Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell : $10,048.67
  • United Healthcare — Unison Advantage Non Special Needs: $9,769.54

Source: UPMC Northwest’s standard charges file (dam.upmc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 6, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital typeAcute Care Hospital
Address100 Fairfield Drive, Seneca, PA 16346
CountyVenango County
StatePennsylvania
Phone(814) 676‑7600
Emergency servicesYes
OwnershipVoluntary non-profit - Other
Medicare overall rating4 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number390091
Name in Medicare recordsUPMC NORTHWEST
Profile levelMedicare data + hospital website
Official websiteupmc.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. UPMC Northwest — upmc.com
  2. Inpatient Care | UPMC Northwest Behavioral Health — upmc.com
  3. Cancer Care at UPMC Northwest | Seneca, Cranberry Township, PA — upmc.com
  4. Esophageal and Lung Surgery Services | UPMC Northwest | Pittsburgh PA — upmc.com
  5. General Surgery at UPMC Northwest — upmc.com
  6. Thoracic Surgery | UPMC Northwest — upmc.com
  7. Vascular Surgery | UPMC Northwest — upmc.com
  8. Behavioral Health | UPMC Northwest | Seneca, Pa — upmc.com
  9. Behavioral Health Referrals | UPMC Northwest — upmc.com
  10. Pediatric Hospitalist Services at UPMC Northwest | Seneca, PA — upmc.com
  11. Physical Medicine and Rehabilitation — upmc.com
  12. Post-Acute Rehabilitation | UPMC Northwest | Seneca, PA — upmc.com
  13. Patient & Visitor Resources | UPMC Northwest | Seneca, Pa — upmc.com
  14. Before Your Stay | UPMC Northwest | Seneca, Pa — upmc.com
  15. During Your Stay | UPMC Northwest | Seneca, Pa — upmc.com