Medical emergency?Emergency? Call 911. Nearest emergency roomsNearest ERs

Español Near me My list Help
US Patient GuideUSA
Surprise me
Acute Care Hospital

UPMC Passavant

Also listed as: UPMC Passavant-McCandless

Pittsburgh, Pennsylvania · Allegheny County · Emergency services listed

UPMC Passavant is an acute care hospital at 9100 Babcock Boulevard, Pittsburgh, PA 15237. Phone: (412) 367-6700. It has an emergency department. Medicare overall rating: 4 of 5 stars (CMS, October 2026).

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

Summary

UPMC Passavant is an acute care hospital in Pittsburgh, Pennsylvania. Medicare data lists emergency services. CMS overall star rating: 4 of 5 stars. Its official website lists 36 services, specialties and programs. Medicare lists 1,298 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(412) 367‑6700 Directions Website Medicare profile
Compare

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
1,298Doctors and clinicians
36Services listed

Quick answers

Does UPMC Passavant have an emergency room?
Yes. Medicare (CMS) data lists emergency services at UPMC Passavant. In a medical emergency, call 911.
Where is UPMC Passavant?
9100 Babcock Boulevard, Pittsburgh, PA 15237, in Allegheny County, Pennsylvania.
What is the phone number of UPMC Passavant?
(412) 367-6700, as listed by Medicare (CMS).
What is the Medicare star rating of UPMC Passavant?
4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to UPMC Passavant for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for UPMC Passavant under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.0877; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4]

Conditions treated[4][5][8]

Treatments[4][5]

Procedures[4][5]

Programs and centers[4][5]

  • Stop Smoking Program
  • Healthy Living Center
  • Bloodless medicine
  • Inpatient rehabilitation
  • Nutrition
  • Outpatient services
  • Sleep Center

Emergency care (hospital website)[4][7][8]

Emergency roomYes
Open 24/7Yes
Stroke designationPrimary Stroke Center (PSC)

Visiting and practical information

ParkingParking available on-site in the main lot in front of the hospital[6]
Patient portalMyUPMC

Doctors and clinicians (1,298)

1,298 doctors and other clinicians list UPMC Passavant 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 (1,298)

And 1,274 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Pittsburgh

All hospitals in Pittsburgh · Hospitals in Allegheny County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics) 4 of 5 stars
Overall rating of the hospital4 of 5 stars
Would recommend the hospital5 of 5 stars
Nurses communicated well5 of 5 stars
Doctors communicated well4 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines3 of 5 stars
Information about recovery at home4 of 5 stars
Room and bathroom kept clean4 of 5 stars
Restfulness of Environment3 of 5 stars
Care Coordination4 of 5 stars
Symptoms After Stay4 of 5 stars
Rated the hospital 9 or 10 out of 1077%National average: 72%
Would definitely recommend the hospital78%National average: 71%
Nurses “always” communicated well86%National average: 80%
Doctors “always” communicated well81%National average: 80%
“Always” got help as soon as they wanted59%National average: 64%
Staff “always” explained medicines before giving them63%National average: 62%
Were given information about recovery at home89%National average: 86%
Room and bathroom “always” clean71%National average: 73%
Completed surveys504Response rate: 37%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.916No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.066No different from the national benchmark
Surgical site infections after colon surgery0.831No different from the national benchmark
MRSA bloodstream infections1.661No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.342No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients11.1%
Deaths within 30 days: heart failure patients10.5%
Deaths within 30 days: pneumonia patients14.7%
Deaths within 30 days: COPD patients8.5%
Deaths within 30 days: stroke patients10.6%
Deaths within 30 days: coronary bypass surgery (CABG)2.3%
Serious complications (patient safety indicator PSI-90)0.98No different from the national rate
Complications after hip or knee replacement4.2%

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)15.2%
Readmitted within 30 days: heart attack12.8%
Readmitted within 30 days: heart failure20.5%
Readmitted within 30 days: pneumonia17.8%
Readmitted within 30 days: COPD19.2%
Readmitted within 30 days: coronary bypass surgery10.5%
Readmitted within 30 days: hip or knee replacement5.2%

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)188 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)60%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score0.0877Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack1.0348More readmissions than expected
Heart failure1.0145More readmissions than expected
Pneumonia0.9536Fewer readmissions than expected
COPD (chronic lung disease)1.0002More readmissions than expected
Hip or knee replacement0.9320Fewer readmissions than expected
Coronary bypass surgery (CABG)1.0782More readmissions than expected

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score28.42 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)21.67 out of 100
Person and community engagement (patient survey)57.00 out of 100
Safety (infections and sepsis care)25.00 out of 100
Efficiency and cost reduction (Medicare spending)10.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio0.98Below the national median hospital (1.00): Medicare spent less

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

ER wait times and Medicare ratings nearby

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

ER wait times in PittsburghBest hospitals in Pittsburgh

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 63 common services exactly as UPMC Passavant lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 63 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW 99203 $398 $238.80 $36.08 – $448.71
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $99.50
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.69
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $278.60
  • Health Plan of Upper Ohio Valley — Commercial: $183.88
  • Highmark BCBS of PA — Commercial - Indemnity: $226.77
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $169.32
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $96.92
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW 99203 $398 $238.80 $143.28 – $370.14
New patient office visit (about 30–44 minutes): rates for 7 insurance plans
  • Cigna — Commercial: $159.20
  • Cigna — New Business ASO: $143.28
  • Coventry/First Health — Commercial: $278.60
  • Humana — Commercial: $370.14
  • InterGroup — PPO: $358.20
  • Multiplan — PPO (Includes Workers' Comp): $370.14
  • Private Health Care Systems — PPO: $370.14
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW 99204 $505 $303 $36.08 – $558.02
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $126.25
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $141.08
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $353.50
  • Health Plan of Upper Ohio Valley — Commercial: $233.31
  • Highmark BCBS of PA — Commercial - Indemnity: $282.02
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $210.57
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $124.28
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW 99204 $505 $303 $181.80 – $469.65
New patient office visit (about 45–59 minutes): rates for 7 insurance plans
  • Cigna — Commercial: $202
  • Cigna — New Business ASO: $181.80
  • Coventry/First Health — Commercial: $353.50
  • Humana — Commercial: $469.65
  • InterGroup — PPO: $454.50
  • Multiplan — PPO (Includes Workers' Comp): $469.65
  • Private Health Care Systems — PPO: $469.65
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: HC CLINIC VISIT NEW 99204 W/PROC $505 $303 $36.08 – $558.02
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $126.25
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $141.08
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $353.50
  • Health Plan of Upper Ohio Valley — Commercial: $233.31
  • Highmark BCBS of PA — Commercial - Indemnity: $282.02
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $210.57
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $124.28
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW 99205 $1,106 $663.60 $36.08 – $940.10
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $276.50
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $183.49
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $774.20
  • Health Plan of Upper Ohio Valley — Commercial: $510.97
  • Highmark BCBS of PA — Commercial - Indemnity: $335.10
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $250.21
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $150.85
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CLINIC VISIT NEW 99205 $1,106 $663.60 $398.16 – $1,028.58
New patient office visit (about 60–74 minutes): rates for 7 insurance plans
  • Cigna — Commercial: $442.40
  • Cigna — New Business ASO: $398.16
  • Coventry/First Health — Commercial: $774.20
  • Humana — Commercial: $1,028.58
  • InterGroup — PPO: $995.40
  • Multiplan — PPO (Includes Workers' Comp): $1,028.58
  • Private Health Care Systems — PPO: $1,028.58
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT EST 99213 $299 $179.40 $36.08 – $265.14
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $74.75
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $209.30
  • Health Plan of Upper Ohio Valley — Commercial: $138.14
  • Highmark BCBS of PA — Commercial - Indemnity: $134
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $100.05
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $54.38
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CLINIC VISIT EST 99213 $299 $179.40 $107.64 – $278.07
Established patient office visit (about 20–29 minutes): rates for 7 insurance plans
  • Cigna — Commercial: $119.60
  • Cigna — New Business ASO: $107.64
  • Coventry/First Health — Commercial: $209.30
  • Humana — Commercial: $278.07
  • InterGroup — PPO: $269.10
  • Multiplan — PPO (Includes Workers' Comp): $278.07
  • Private Health Care Systems — PPO: $278.07
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: HC CLINIC VISIT EST 99213 W/PROC $299 $179.40 $36.08 – $265.14
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $74.75
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $54.64
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $209.30
  • Health Plan of Upper Ohio Valley — Commercial: $138.14
  • Highmark BCBS of PA — Commercial - Indemnity: $134
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $100.05
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $54.38
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CLINIC VISIT EST 99214 $418 $250.80 $36.08 – $355.30
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $104.50
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $292.60
  • Health Plan of Upper Ohio Valley — Commercial: $193.12
  • Highmark BCBS of PA — Commercial - Indemnity: $161.34
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $120.47
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $63.73
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC F/U NURSE L4 RX $418 $250.80 $36.08 – $355.30
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $104.50
  • Aetna of PA — Medicare: $36.08
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $84.96
  • Cigna — Commercial: $63.91
  • Cigna — New Business ASO: $63.91
  • Coventry/First Health — Commercial: $292.60
  • Health Plan of Upper Ohio Valley — Commercial: $193.12
  • Highmark BCBS of PA — Commercial - Indemnity: $161.34
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $120.47
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $63.73
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CLINIC VISIT EST 99214 $418 $250.80 $150.48 – $388.74
Established patient office visit (about 30–39 minutes): rates for 7 insurance plans
  • Cigna — Commercial: $167.20
  • Cigna — New Business ASO: $150.48
  • Coventry/First Health — Commercial: $292.60
  • Humana — Commercial: $388.74
  • InterGroup — PPO: $376.20
  • Multiplan — PPO (Includes Workers' Comp): $388.74
  • Private Health Care Systems — PPO: $388.74
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ACUITY LEVEL 3 $1,272 $763.20 $62.31 – $1,081.20
Emergency room visit (moderate): 10 of 32 insurance plan rates
  • Aetna — Medicare: $290.38
  • Aetna of PA — Medicare: $277.18
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $88.44
  • AmeriHealth Caritas — Medicare: $285.10
  • Cigna — Commercial: $508.80
  • Cigna — New Business ASO: $432.48
  • Coventry/First Health — Commercial: $890.40
  • Health Plan of Upper Ohio Valley — Commercial: $587.66
  • Health Plan of Upper Ohio Valley — Medicaid: $263.98
  • Health Plan of Upper Ohio Valley — Medicare: $263.98
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ACUITY LEVEL 3 $1,272 $763.20 $457.92 – $1,182.96
Emergency room visit (moderate): rates for 7 insurance plans
  • Cigna — Commercial: $508.80
  • Cigna — New Business ASO: $457.92
  • Coventry/First Health — Commercial: $890.40
  • Humana — Commercial: $1,182.96
  • InterGroup — PPO: $1,144.80
  • Multiplan — PPO (Includes Workers' Comp): $1,182.96
  • Private Health Care Systems — PPO: $1,182.96
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ACUITY LEVEL 4 $1,910 $1,146 $104.86 – $1,623.50
Emergency room visit (moderately high): 10 of 32 insurance plan rates
  • Aetna — Medicare: $446.57
  • Aetna of PA — Medicare: $426.27
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.82
  • AmeriHealth Caritas — Medicare: $438.45
  • Cigna — Commercial: $764
  • Cigna — New Business ASO: $649.40
  • Coventry/First Health — Commercial: $1,337
  • Health Plan of Upper Ohio Valley — Commercial: $882.42
  • Health Plan of Upper Ohio Valley — Medicaid: $405.97
  • Health Plan of Upper Ohio Valley — Medicare: $405.97
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ACUITY LEVEL 4 $1,910 $1,146 $687.60 – $1,776.30
Emergency room visit (moderately high): rates for 7 insurance plans
  • Cigna — Commercial: $764
  • Cigna — New Business ASO: $687.60
  • Coventry/First Health — Commercial: $1,337
  • Humana — Commercial: $1,776.30
  • InterGroup — PPO: $1,719
  • Multiplan — PPO (Includes Workers' Comp): $1,776.30
  • Private Health Care Systems — PPO: $1,776.30
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ACUITY LEVEL 5 $2,997 $1,798.20 $152.61 – $2,547.45
Emergency room visit (high): 10 of 32 insurance plan rates
  • Aetna — Medicare: $642.97
  • Aetna of PA — Medicare: $613.75
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $216.59
  • AmeriHealth Caritas — Medicare: $631.28
  • Cigna — Commercial: $1,198.80
  • Cigna — New Business ASO: $1,018.98
  • Coventry/First Health — Commercial: $2,097.90
  • Health Plan of Upper Ohio Valley — Commercial: $1,384.61
  • Health Plan of Upper Ohio Valley — Medicaid: $584.52
  • Health Plan of Upper Ohio Valley — Medicare: $584.52
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC ACUITY LEVEL 5 $2,997 $1,798.20 $1,078.92 – $2,787.21
Emergency room visit (high): rates for 7 insurance plans
  • Cigna — Commercial: $1,198.80
  • Cigna — New Business ASO: $1,078.92
  • Coventry/First Health — Commercial: $2,097.90
  • Humana — Commercial: $2,787.21
  • InterGroup — PPO: $2,697.30
  • Multiplan — PPO (Includes Workers' Comp): $2,787.21
  • Private Health Care Systems — PPO: $2,787.21

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: HC BASIC METABOLIC PANEL $338 $202.80 $7.86 – $287.30
Basic metabolic panel (blood test): 10 of 32 insurance plan rates
  • Aetna — Medicare: $9.31
  • Aetna of PA — Medicare: $8.88
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.61
  • AmeriHealth Caritas — Medicare: $9.14
  • Cigna — Commercial: $135.20
  • Cigna — New Business ASO: $114.92
  • Coventry/First Health — Commercial: $236.60
  • Health Plan of Upper Ohio Valley — Commercial: $156.16
  • Health Plan of Upper Ohio Valley — Medicaid: $8.46
  • Health Plan of Upper Ohio Valley — Medicare: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL $338 $202.80 $121.68 – $314.34
Basic metabolic panel (blood test): rates for 7 insurance plans
  • Cigna — Commercial: $135.20
  • Cigna — New Business ASO: $121.68
  • Coventry/First Health — Commercial: $236.60
  • Humana — Commercial: $314.34
  • InterGroup — PPO: $304.20
  • Multiplan — PPO (Includes Workers' Comp): $314.34
  • Private Health Care Systems — PPO: $314.34
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL $470 $282 $9.81 – $399.50
Comprehensive metabolic panel (blood test): 10 of 32 insurance plan rates
  • Aetna — Medicare: $11.62
  • Aetna of PA — Medicare: $11.09
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.25
  • AmeriHealth Caritas — Medicare: $11.40
  • Cigna — Commercial: $188
  • Cigna — New Business ASO: $159.80
  • Coventry/First Health — Commercial: $329
  • Health Plan of Upper Ohio Valley — Commercial: $217.14
  • Health Plan of Upper Ohio Valley — Medicaid: $10.56
  • Health Plan of Upper Ohio Valley — Medicare: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOL PN P5147 $470 $282 $9.81 – $399.50
Comprehensive metabolic panel (blood test): 10 of 32 insurance plan rates
  • Aetna — Medicare: $11.62
  • Aetna of PA — Medicare: $11.09
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.25
  • AmeriHealth Caritas — Medicare: $11.40
  • Cigna — Commercial: $188
  • Cigna — New Business ASO: $159.80
  • Coventry/First Health — Commercial: $329
  • Health Plan of Upper Ohio Valley — Commercial: $217.14
  • Health Plan of Upper Ohio Valley — Medicaid: $10.56
  • Health Plan of Upper Ohio Valley — Medicare: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPREHENSIVE METABOLIC PANEL $470 $282 $169.20 – $437.10
Comprehensive metabolic panel (blood test): rates for 7 insurance plans
  • Cigna — Commercial: $188
  • Cigna — New Business ASO: $169.20
  • Coventry/First Health — Commercial: $329
  • Humana — Commercial: $437.10
  • InterGroup — PPO: $423
  • Multiplan — PPO (Includes Workers' Comp): $437.10
  • Private Health Care Systems — PPO: $437.10
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC OBSTETRICS PANEL $708 $424.80 $13.20 – $601.80
Obstetric blood test panel: 10 of 32 insurance plan rates
  • Aetna — Medicare: $52.59
  • Aetna of PA — Medicare: $50.20
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $18.73
  • AmeriHealth Caritas — Medicare: $51.63
  • Cigna — Commercial: $283.20
  • Cigna — New Business ASO: $240.72
  • Coventry/First Health — Commercial: $495.60
  • Health Plan of Upper Ohio Valley — Commercial: $327.10
  • Health Plan of Upper Ohio Valley — Medicaid: $47.81
  • Health Plan of Upper Ohio Valley — Medicare: $47.81
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC OBSTETRICS PANEL $708 $424.80 $254.88 – $658.44
Obstetric blood test panel: rates for 7 insurance plans
  • Cigna — Commercial: $283.20
  • Cigna — New Business ASO: $254.88
  • Coventry/First Health — Commercial: $495.60
  • Humana — Commercial: $658.44
  • InterGroup — PPO: $637.20
  • Multiplan — PPO (Includes Workers' Comp): $658.44
  • Private Health Care Systems — PPO: $658.44
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL $504 $302.40 $12.44 – $428.40
Cholesterol panel (lipid panel): 10 of 32 insurance plan rates
  • Aetna — Medicare: $14.73
  • Aetna of PA — Medicare: $14.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86
  • AmeriHealth Caritas — Medicare: $14.46
  • Cigna — Commercial: $201.60
  • Cigna — New Business ASO: $171.36
  • Coventry/First Health — Commercial: $352.80
  • Health Plan of Upper Ohio Valley — Commercial: $232.85
  • Health Plan of Upper Ohio Valley — Medicaid: $13.39
  • Health Plan of Upper Ohio Valley — Medicare: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL P8100 $504 $302.40 $12.44 – $428.40
Cholesterol panel (lipid panel): 10 of 32 insurance plan rates
  • Aetna — Medicare: $14.73
  • Aetna of PA — Medicare: $14.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86
  • AmeriHealth Caritas — Medicare: $14.46
  • Cigna — Commercial: $201.60
  • Cigna — New Business ASO: $171.36
  • Coventry/First Health — Commercial: $352.80
  • Health Plan of Upper Ohio Valley — Commercial: $232.85
  • Health Plan of Upper Ohio Valley — Medicaid: $13.39
  • Health Plan of Upper Ohio Valley — Medicare: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PANEL P5181 $504 $302.40 $12.44 – $428.40
Cholesterol panel (lipid panel): 10 of 32 insurance plan rates
  • Aetna — Medicare: $14.73
  • Aetna of PA — Medicare: $14.06
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $21.86
  • AmeriHealth Caritas — Medicare: $14.46
  • Cigna — Commercial: $201.60
  • Cigna — New Business ASO: $171.36
  • Coventry/First Health — Commercial: $352.80
  • Health Plan of Upper Ohio Valley — Commercial: $232.85
  • Health Plan of Upper Ohio Valley — Medicaid: $13.39
  • Health Plan of Upper Ohio Valley — Medicare: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL $354 $212.40 $8.07 – $300.90
Kidney function panel: 10 of 32 insurance plan rates
  • Aetna — Medicare: $9.55
  • Aetna of PA — Medicare: $9.11
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.99
  • AmeriHealth Caritas — Medicare: $9.37
  • Cigna — Commercial: $141.60
  • Cigna — New Business ASO: $120.36
  • Coventry/First Health — Commercial: $247.80
  • Health Plan of Upper Ohio Valley — Commercial: $163.55
  • Health Plan of Upper Ohio Valley — Medicaid: $8.68
  • Health Plan of Upper Ohio Valley — Medicare: $8.68
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL $354 $212.40 $127.44 – $329.22
Kidney function panel: rates for 7 insurance plans
  • Cigna — Commercial: $141.60
  • Cigna — New Business ASO: $127.44
  • Coventry/First Health — Commercial: $247.80
  • Humana — Commercial: $329.22
  • InterGroup — PPO: $318.60
  • Multiplan — PPO (Includes Workers' Comp): $329.22
  • Private Health Care Systems — PPO: $329.22
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL $335 $201 $7.59 – $284.75
Liver function panel: 10 of 32 insurance plan rates
  • Aetna — Medicare: $8.99
  • Aetna of PA — Medicare: $8.58
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.10
  • AmeriHealth Caritas — Medicare: $8.82
  • Cigna — Commercial: $134
  • Cigna — New Business ASO: $113.90
  • Coventry/First Health — Commercial: $234.50
  • Health Plan of Upper Ohio Valley — Commercial: $154.77
  • Health Plan of Upper Ohio Valley — Medicaid: $8.17
  • Health Plan of Upper Ohio Valley — Medicare: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL P5144 $335 $201 $7.59 – $284.75
Liver function panel: 10 of 32 insurance plan rates
  • Aetna — Medicare: $8.99
  • Aetna of PA — Medicare: $8.58
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $14.10
  • AmeriHealth Caritas — Medicare: $8.82
  • Cigna — Commercial: $134
  • Cigna — New Business ASO: $113.90
  • Coventry/First Health — Commercial: $234.50
  • Health Plan of Upper Ohio Valley — Commercial: $154.77
  • Health Plan of Upper Ohio Valley — Medicaid: $8.17
  • Health Plan of Upper Ohio Valley — Medicare: $8.17
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL $335 $201 $120.60 – $311.55
Liver function panel: rates for 7 insurance plans
  • Cigna — Commercial: $134
  • Cigna — New Business ASO: $120.60
  • Coventry/First Health — Commercial: $234.50
  • Humana — Commercial: $311.55
  • InterGroup — PPO: $301.50
  • Multiplan — PPO (Includes Workers' Comp): $311.55
  • Private Health Care Systems — PPO: $311.55
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/MICRO $219 $131.40 $2.95 – $186.15
Urine test (automated, with microscope): 10 of 32 insurance plan rates
  • Aetna — Medicare: $3.49
  • Aetna of PA — Medicare: $3.33
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.68
  • AmeriHealth Caritas — Medicare: $3.42
  • Cigna — Commercial: $87.60
  • Cigna — New Business ASO: $74.46
  • Coventry/First Health — Commercial: $153.30
  • Health Plan of Upper Ohio Valley — Commercial: $101.18
  • Health Plan of Upper Ohio Valley — Medicaid: $3.17
  • Health Plan of Upper Ohio Valley — Medicare: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/MICRO $219 $131.40 $78.84 – $203.67
Urine test (automated, with microscope): rates for 7 insurance plans
  • Cigna — Commercial: $87.60
  • Cigna — New Business ASO: $78.84
  • Coventry/First Health — Commercial: $153.30
  • Humana — Commercial: $203.67
  • InterGroup — PPO: $197.10
  • Multiplan — PPO (Includes Workers' Comp): $203.67
  • Private Health Care Systems — PPO: $203.67
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINANALYSIS DIPSTICK WO MICRO $45 $27 $3.23 – $38.25
Urine test (manual, without microscope): 10 of 32 insurance plan rates
  • Aetna — Medicare: $3.83
  • Aetna of PA — Medicare: $3.65
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $5.57
  • AmeriHealth Caritas — Medicare: $3.76
  • Cigna — Commercial: $18
  • Cigna — New Business ASO: $15.30
  • Coventry/First Health — Commercial: $31.50
  • Health Plan of Upper Ohio Valley — Commercial: $20.79
  • Health Plan of Upper Ohio Valley — Medicaid: $3.48
  • Health Plan of Upper Ohio Valley — Medicare: $3.48
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINANALYSIS DIPSTICK WO MICRO $45 $27 $16.20 – $41.85
Urine test (manual, without microscope): rates for 7 insurance plans
  • Cigna — Commercial: $18
  • Cigna — New Business ASO: $16.20
  • Coventry/First Health — Commercial: $31.50
  • Humana — Commercial: $41.85
  • InterGroup — PPO: $40.50
  • Multiplan — PPO (Includes Workers' Comp): $41.85
  • Private Health Care Systems — PPO: $41.85
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED $119 $71.40 $2.09 – $101.15
Urine test (automated, without microscope): 10 of 32 insurance plan rates
  • Aetna — Medicare: $2.48
  • Aetna of PA — Medicare: $2.36
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84
  • AmeriHealth Caritas — Medicare: $2.43
  • Cigna — Commercial: $47.60
  • Cigna — New Business ASO: $40.46
  • Coventry/First Health — Commercial: $83.30
  • Health Plan of Upper Ohio Valley — Commercial: $54.98
  • Health Plan of Upper Ohio Valley — Medicaid: $2.25
  • Health Plan of Upper Ohio Valley — Medicare: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTO W/O MICRO $119 $71.40 $2.09 – $101.15
Urine test (automated, without microscope): 10 of 32 insurance plan rates
  • Aetna — Medicare: $2.48
  • Aetna of PA — Medicare: $2.36
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $4.84
  • AmeriHealth Caritas — Medicare: $2.43
  • Cigna — Commercial: $47.60
  • Cigna — New Business ASO: $40.46
  • Coventry/First Health — Commercial: $83.30
  • Health Plan of Upper Ohio Valley — Commercial: $54.98
  • Health Plan of Upper Ohio Valley — Medicaid: $2.25
  • Health Plan of Upper Ohio Valley — Medicare: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC URINALYSIS AUTOMATED $119 $71.40 $42.84 – $110.67
Urine test (automated, without microscope): rates for 7 insurance plans
  • Cigna — Commercial: $47.60
  • Cigna — New Business ASO: $42.84
  • Coventry/First Health — Commercial: $83.30
  • Humana — Commercial: $110.67
  • InterGroup — PPO: $107.10
  • Multiplan — PPO (Includes Workers' Comp): $110.67
  • Private Health Care Systems — PPO: $110.67
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROSTATIC SPECIFIC ANTIGEN TOTAL $219 $131.40 $17.09 – $186.15
PSA (prostate specific antigen) blood test: 10 of 32 insurance plan rates
  • Aetna — Medicare: $20.23
  • Aetna of PA — Medicare: $19.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03
  • AmeriHealth Caritas — Medicare: $19.86
  • Cigna — Commercial: $87.60
  • Cigna — New Business ASO: $74.46
  • Coventry/First Health — Commercial: $153.30
  • Health Plan of Upper Ohio Valley — Commercial: $101.18
  • Health Plan of Upper Ohio Valley — Medicaid: $18.39
  • Health Plan of Upper Ohio Valley — Medicare: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSA POST-PROSTECTOMY HAMA $207 $124.20 $17.09 – $175.95
PSA (prostate specific antigen) blood test: 10 of 32 insurance plan rates
  • Aetna — Medicare: $20.23
  • Aetna of PA — Medicare: $19.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03
  • AmeriHealth Caritas — Medicare: $19.86
  • Cigna — Commercial: $82.80
  • Cigna — New Business ASO: $70.38
  • Coventry/First Health — Commercial: $144.90
  • Health Plan of Upper Ohio Valley — Commercial: $95.63
  • Health Plan of Upper Ohio Valley — Medicaid: $18.39
  • Health Plan of Upper Ohio Valley — Medicare: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC DIAGNOSTIC PSA $207 $124.20 $17.09 – $175.95
PSA (prostate specific antigen) blood test: 10 of 32 insurance plan rates
  • Aetna — Medicare: $20.23
  • Aetna of PA — Medicare: $19.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $38.03
  • AmeriHealth Caritas — Medicare: $19.86
  • Cigna — Commercial: $82.80
  • Cigna — New Business ASO: $70.38
  • Coventry/First Health — Commercial: $144.90
  • Health Plan of Upper Ohio Valley — Commercial: $95.63
  • Health Plan of Upper Ohio Valley — Medicaid: $18.39
  • Health Plan of Upper Ohio Valley — Medicare: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE (TSH) $668 $400.80 $15.61 – $567.80
Thyroid stimulating hormone (TSH) test: 10 of 32 insurance plan rates
  • Aetna — Medicare: $18.48
  • Aetna of PA — Medicare: $17.64
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23
  • AmeriHealth Caritas — Medicare: $18.14
  • Cigna — Commercial: $267.20
  • Cigna — New Business ASO: $227.12
  • Coventry/First Health — Commercial: $467.60
  • Health Plan of Upper Ohio Valley — Commercial: $308.62
  • Health Plan of Upper Ohio Valley — Medicaid: $16.80
  • Health Plan of Upper Ohio Valley — Medicare: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE $595 $357 $15.61 – $505.75
Thyroid stimulating hormone (TSH) test: 10 of 32 insurance plan rates
  • Aetna — Medicare: $18.48
  • Aetna of PA — Medicare: $17.64
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.23
  • AmeriHealth Caritas — Medicare: $18.14
  • Cigna — Commercial: $238
  • Cigna — New Business ASO: $202.30
  • Coventry/First Health — Commercial: $416.50
  • Health Plan of Upper Ohio Valley — Commercial: $274.89
  • Health Plan of Upper Ohio Valley — Medicaid: $16.80
  • Health Plan of Upper Ohio Valley — Medicare: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC THYROID STIMULATING HORMONE (TSH) $668 $400.80 $240.48 – $621.24
Thyroid stimulating hormone (TSH) test: rates for 7 insurance plans
  • Cigna — Commercial: $267.20
  • Cigna — New Business ASO: $240.48
  • Coventry/First Health — Commercial: $467.60
  • Humana — Commercial: $621.24
  • InterGroup — PPO: $601.20
  • Multiplan — PPO (Includes Workers' Comp): $621.24
  • Private Health Care Systems — PPO: $621.24
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BLOOD COUNT CBC AUTO W/AUTO DIFF $392 $235.20 $6.60 – $333.20
Complete blood count (CBC) with differential: 10 of 32 insurance plan rates
  • Aetna — Medicare: $8.55
  • Aetna of PA — Medicare: $8.16
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $9.37
  • AmeriHealth Caritas — Medicare: $8.39
  • Cigna — Commercial: $156.80
  • Cigna — New Business ASO: $133.28
  • Coventry/First Health — Commercial: $274.40
  • Health Plan of Upper Ohio Valley — Commercial: $181.10
  • Health Plan of Upper Ohio Valley — Medicaid: $7.77
  • Health Plan of Upper Ohio Valley — Medicare: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CBC & PLT & AUTO COMP DIFF $392 $235.20 $6.60 – $333.20
Complete blood count (CBC) with differential: 10 of 32 insurance plan rates
  • Aetna — Medicare: $8.55
  • Aetna of PA — Medicare: $8.16
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $9.37
  • AmeriHealth Caritas — Medicare: $8.39
  • Cigna — Commercial: $156.80
  • Cigna — New Business ASO: $133.28
  • Coventry/First Health — Commercial: $274.40
  • Health Plan of Upper Ohio Valley — Commercial: $181.10
  • Health Plan of Upper Ohio Valley — Medicaid: $7.77
  • Health Plan of Upper Ohio Valley — Medicare: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC BLOOD COUNT CBC AUTO W/AUTO DIFF $392 $235.20 $141.12 – $364.56
Complete blood count (CBC) with differential: rates for 7 insurance plans
  • Cigna — Commercial: $156.80
  • Cigna — New Business ASO: $141.12
  • Coventry/First Health — Commercial: $274.40
  • Humana — Commercial: $364.56
  • InterGroup — PPO: $352.80
  • Multiplan — PPO (Includes Workers' Comp): $364.56
  • Private Health Care Systems — PPO: $364.56
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BLOOD COUNT CBC AUTO W/O DIFF $245 $147 $6.01 – $208.25
Complete blood count (CBC), automated: 10 of 32 insurance plan rates
  • Aetna — Medicare: $7.12
  • Aetna of PA — Medicare: $6.79
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.74
  • AmeriHealth Caritas — Medicare: $6.99
  • Cigna — Commercial: $98
  • Cigna — New Business ASO: $83.30
  • Coventry/First Health — Commercial: $171.50
  • Health Plan of Upper Ohio Valley — Commercial: $113.19
  • Health Plan of Upper Ohio Valley — Medicaid: $6.47
  • Health Plan of Upper Ohio Valley — Medicare: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CBC & PLT ONLY $245 $147 $6.01 – $208.25
Complete blood count (CBC), automated: 10 of 32 insurance plan rates
  • Aetna — Medicare: $7.12
  • Aetna of PA — Medicare: $6.79
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.74
  • AmeriHealth Caritas — Medicare: $6.99
  • Cigna — Commercial: $98
  • Cigna — New Business ASO: $83.30
  • Coventry/First Health — Commercial: $171.50
  • Health Plan of Upper Ohio Valley — Commercial: $113.19
  • Health Plan of Upper Ohio Valley — Medicaid: $6.47
  • Health Plan of Upper Ohio Valley — Medicare: $6.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HB CBC & PLT ONLY $245 $147 $6.01 – $208.25
Complete blood count (CBC), automated: 10 of 32 insurance plan rates
  • Aetna — Medicare: $7.12
  • Aetna of PA — Medicare: $6.79
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.74
  • AmeriHealth Caritas — Medicare: $6.99
  • Cigna — Commercial: $98
  • Cigna — New Business ASO: $83.30
  • Coventry/First Health — Commercial: $171.50
  • Health Plan of Upper Ohio Valley — Commercial: $113.19
  • Health Plan of Upper Ohio Valley — Medicaid: $6.47
  • Health Plan of Upper Ohio Valley — Medicare: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME $160 $96 $3.61 – $136
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates
  • Aetna — Medicare: $4.72
  • Aetna of PA — Medicare: $4.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24
  • AmeriHealth Caritas — Medicare: $4.63
  • Cigna — Commercial: $64
  • Cigna — New Business ASO: $54.40
  • Coventry/First Health — Commercial: $112
  • Health Plan of Upper Ohio Valley — Commercial: $73.92
  • Health Plan of Upper Ohio Valley — Medicaid: $4.29
  • Health Plan of Upper Ohio Valley — Medicare: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ISTAT PT/INR $160 $96 $3.61 – $136
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates
  • Aetna — Medicare: $4.72
  • Aetna of PA — Medicare: $4.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24
  • AmeriHealth Caritas — Medicare: $4.63
  • Cigna — Commercial: $64
  • Cigna — New Business ASO: $54.40
  • Coventry/First Health — Commercial: $112
  • Health Plan of Upper Ohio Valley — Commercial: $73.92
  • Health Plan of Upper Ohio Valley — Medicaid: $4.29
  • Health Plan of Upper Ohio Valley — Medicare: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME (PT) $160 $96 $3.61 – $136
Blood clotting time test (prothrombin time, PT): 10 of 32 insurance plan rates
  • Aetna — Medicare: $4.72
  • Aetna of PA — Medicare: $4.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $6.24
  • AmeriHealth Caritas — Medicare: $4.63
  • Cigna — Commercial: $64
  • Cigna — New Business ASO: $54.40
  • Coventry/First Health — Commercial: $112
  • Health Plan of Upper Ohio Valley — Commercial: $73.92
  • Health Plan of Upper Ohio Valley — Medicaid: $4.29
  • Health Plan of Upper Ohio Valley — Medicare: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PARTIAL THROMBOPLASTIN TIME (PTT) $219 $131.40 $5.59 – $186.15
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates
  • Aetna — Medicare: $6.61
  • Aetna of PA — Medicare: $6.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71
  • AmeriHealth Caritas — Medicare: $6.49
  • Cigna — Commercial: $87.60
  • Cigna — New Business ASO: $74.46
  • Coventry/First Health — Commercial: $153.30
  • Health Plan of Upper Ohio Valley — Commercial: $101.18
  • Health Plan of Upper Ohio Valley — Medicaid: $6.01
  • Health Plan of Upper Ohio Valley — Medicare: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PTT ACTIVATED $219 $131.40 $5.59 – $186.15
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates
  • Aetna — Medicare: $6.61
  • Aetna of PA — Medicare: $6.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71
  • AmeriHealth Caritas — Medicare: $6.49
  • Cigna — Commercial: $87.60
  • Cigna — New Business ASO: $74.46
  • Coventry/First Health — Commercial: $153.30
  • Health Plan of Upper Ohio Valley — Commercial: $101.18
  • Health Plan of Upper Ohio Valley — Medicaid: $6.01
  • Health Plan of Upper Ohio Valley — Medicare: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ACTIVATED PTT $219 $131.40 $5.59 – $186.15
Blood clotting test (partial thromboplastin time, PTT): 10 of 32 insurance plan rates
  • Aetna — Medicare: $6.61
  • Aetna of PA — Medicare: $6.31
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $11.71
  • AmeriHealth Caritas — Medicare: $6.49
  • Cigna — Commercial: $87.60
  • Cigna — New Business ASO: $74.46
  • Coventry/First Health — Commercial: $153.30
  • Health Plan of Upper Ohio Valley — Commercial: $101.18
  • Health Plan of Upper Ohio Valley — Medicaid: $6.01
  • Health Plan of Upper Ohio Valley — Medicare: $6.01

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: HC CT HEAD WO CONTRAST $2,993 $1,795.80 $94.21 – $2,544.05
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates
  • Aetna — Medicare: $111.52
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $182.26
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $1,197.20
  • Cigna — New Business ASO: $1,017.62
  • Coventry/First Health — Commercial: $2,095.10
  • Health Plan of Upper Ohio Valley — Commercial: $1,382.77
  • Health Plan of Upper Ohio Valley — Medicaid: $101.38
  • Health Plan of Upper Ohio Valley — Medicare: $101.38
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT HEAD WO CONTRAST $2,993 $1,795.80 $1,077.48 – $2,783.49
CT scan of the head or brain, without contrast: rates for 7 insurance plans
  • Cigna — Commercial: $1,197.20
  • Cigna — New Business ASO: $1,077.48
  • Coventry/First Health — Commercial: $2,095.10
  • Humana — Commercial: $2,783.49
  • InterGroup — PPO: $2,693.70
  • Multiplan — PPO (Includes Workers' Comp): $2,783.49
  • Private Health Care Systems — PPO: $2,783.49
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MR BRAIN W WO CON $9,999 $5,999.40 $316.41 – $8,499.15
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates
  • Aetna — Medicare: $374.53
  • Aetna of PA — Medicare: $357.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $529.21
  • AmeriHealth Caritas — Medicare: $367.72
  • Cigna — Commercial: $3,999.60
  • Cigna — New Business ASO: $3,399.66
  • Coventry/First Health — Commercial: $6,999.30
  • Health Plan of Upper Ohio Valley — Commercial: $4,619.54
  • Health Plan of Upper Ohio Valley — Medicaid: $340.48
  • Health Plan of Upper Ohio Valley — Medicare: $340.48
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MR BRAIN W WO CON $9,999 $5,999.40 $3,599.64 – $9,299.07
MRI of the brain, before and after contrast: rates for 7 insurance plans
  • Cigna — Commercial: $3,999.60
  • Cigna — New Business ASO: $3,599.64
  • Coventry/First Health — Commercial: $6,999.30
  • Humana — Commercial: $9,299.07
  • InterGroup — PPO: $8,999.10
  • Multiplan — PPO (Includes Workers' Comp): $9,299.07
  • Private Health Care Systems — PPO: $9,299.07
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CHEST 2 VIEWS $699 $419.40 $11.90 – $594.15
Chest X-ray, 2 views: 10 of 32 insurance plan rates
  • Aetna — Medicare: $92.34
  • Aetna of PA — Medicare: $88.15
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $36.90
  • AmeriHealth Caritas — Medicare: $90.67
  • Cigna — Commercial: $279.60
  • Cigna — New Business ASO: $237.66
  • Coventry/First Health — Commercial: $489.30
  • Health Plan of Upper Ohio Valley — Commercial: $322.94
  • Health Plan of Upper Ohio Valley — Medicaid: $83.95
  • Health Plan of Upper Ohio Valley — Medicare: $83.95
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CHEST 2 VIEWS $699 $419.40 $251.64 – $650.07
Chest X-ray, 2 views: rates for 7 insurance plans
  • Cigna — Commercial: $279.60
  • Cigna — New Business ASO: $251.64
  • Coventry/First Health — Commercial: $489.30
  • Humana — Commercial: $650.07
  • InterGroup — PPO: $629.10
  • Multiplan — PPO (Includes Workers' Comp): $650.07
  • Private Health Care Systems — PPO: $650.07
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SPINE LUMBOSAC MIN 4 VWS $1,111 $666.60 $40.28 – $944.35
X-ray of the lower spine, at least 4 views: 10 of 32 insurance plan rates
  • Aetna — Medicare: $111.52
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $57.17
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $444.40
  • Cigna — New Business ASO: $377.74
  • Coventry/First Health — Commercial: $777.70
  • Health Plan of Upper Ohio Valley — Commercial: $513.28
  • Health Plan of Upper Ohio Valley — Medicaid: $101.38
  • Health Plan of Upper Ohio Valley — Medicare: $101.38
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC SPINE LUMBOSAC MIN 4 VWS $1,111 $666.60 $399.96 – $1,033.23
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans
  • Cigna — Commercial: $444.40
  • Cigna — New Business ASO: $399.96
  • Coventry/First Health — Commercial: $777.70
  • Humana — Commercial: $1,033.23
  • InterGroup — PPO: $999.90
  • Multiplan — PPO (Includes Workers' Comp): $1,033.23
  • Private Health Care Systems — PPO: $1,033.23
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MR SP CANAL LUMBAR WO $6,336 $3,801.60 $214.16 – $5,385.60
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates
  • Aetna — Medicare: $253.50
  • Aetna of PA — Medicare: $241.97
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $399.88
  • AmeriHealth Caritas — Medicare: $248.89
  • Cigna — Commercial: $2,534.40
  • Cigna — New Business ASO: $2,154.24
  • Coventry/First Health — Commercial: $4,435.20
  • Health Plan of Upper Ohio Valley — Commercial: $2,927.23
  • Health Plan of Upper Ohio Valley — Medicaid: $230.45
  • Health Plan of Upper Ohio Valley — Medicare: $230.45
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MR SP CANAL LUMBAR WO $6,336 $3,801.60 $2,280.96 – $5,892.48
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans
  • Cigna — Commercial: $2,534.40
  • Cigna — New Business ASO: $2,280.96
  • Coventry/First Health — Commercial: $4,435.20
  • Humana — Commercial: $5,892.48
  • InterGroup — PPO: $5,702.40
  • Multiplan — PPO (Includes Workers' Comp): $5,892.48
  • Private Health Care Systems — PPO: $5,892.48
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS W CON $4,424 $2,654.40 $154.10 – $3,760.40
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates
  • Aetna — Medicare: $186.69
  • Aetna of PA — Medicare: $178.21
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $218.69
  • AmeriHealth Caritas — Medicare: $183.30
  • Cigna — Commercial: $1,769.60
  • Cigna — New Business ASO: $1,504.16
  • Coventry/First Health — Commercial: $3,096.80
  • Health Plan of Upper Ohio Valley — Commercial: $2,043.89
  • Health Plan of Upper Ohio Valley — Medicaid: $169.72
  • Health Plan of Upper Ohio Valley — Medicare: $169.72
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT PELVIS W CON $4,424 $2,654.40 $1,592.64 – $4,114.32
CT scan of the pelvis, with contrast: rates for 7 insurance plans
  • Cigna — Commercial: $1,769.60
  • Cigna — New Business ASO: $1,592.64
  • Coventry/First Health — Commercial: $3,096.80
  • Humana — Commercial: $4,114.32
  • InterGroup — PPO: $3,981.60
  • Multiplan — PPO (Includes Workers' Comp): $4,114.32
  • Private Health Care Systems — PPO: $4,114.32
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MR LOW EXTREM ANY JNT WO $6,336 $3,801.60 $214.16 – $5,385.60
MRI of a leg joint (such as the knee), without contrast: 10 of 29 insurance plan rates
  • Aetna — Medicare: $253.50
  • Aetna of PA — Medicare: $241.97
  • AmeriHealth Caritas — Medicare: $248.89
  • Cigna — Commercial: $2,534.40
  • Cigna — New Business ASO: $2,154.24
  • Coventry/First Health — Commercial: $4,435.20
  • Health Plan of Upper Ohio Valley — Commercial: $2,927.23
  • Health Plan of Upper Ohio Valley — Medicaid: $230.45
  • Health Plan of Upper Ohio Valley — Medicare: $230.45
  • Highmark BCBS of PA — Commercial - Indemnity: $2,004.17
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MR LOW EXTREM ANY JNT WO $6,336 $3,801.60 $2,280.96 – $5,892.48
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans
  • Cigna — Commercial: $2,534.40
  • Cigna — New Business ASO: $2,280.96
  • Coventry/First Health — Commercial: $4,435.20
  • Humana — Commercial: $5,892.48
  • InterGroup — PPO: $5,702.40
  • Multiplan — PPO (Includes Workers' Comp): $5,892.48
  • Private Health Care Systems — PPO: $5,892.48
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABD & PLVS W CONTRAST $9,061 $5,436.60 $289.48 – $7,701.85
CT scan of the abdomen and pelvis, with contrast: 10 of 32 insurance plan rates
  • Aetna — Medicare: $374.53
  • Aetna of PA — Medicare: $357.50
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $410.82
  • AmeriHealth Caritas — Medicare: $367.72
  • Cigna — Commercial: $3,624.40
  • Cigna — New Business ASO: $3,080.74
  • Coventry/First Health — Commercial: $6,342.70
  • Health Plan of Upper Ohio Valley — Commercial: $4,186.18
  • Health Plan of Upper Ohio Valley — Medicaid: $340.48
  • Health Plan of Upper Ohio Valley — Medicare: $340.48
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CT ABD & PLVS W CONTRAST $9,061 $5,436.60 $3,261.96 – $8,426.73
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans
  • Cigna — Commercial: $3,624.40
  • Cigna — New Business ASO: $3,261.96
  • Coventry/First Health — Commercial: $6,342.70
  • Humana — Commercial: $8,426.73
  • InterGroup — PPO: $8,154.90
  • Multiplan — PPO (Includes Workers' Comp): $8,426.73
  • Private Health Care Systems — PPO: $8,426.73
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US ABDOMINAL COMPLETE $3,476 $2,085.60 $94.21 – $2,954.60
Ultrasound of the abdomen, complete: 10 of 32 insurance plan rates
  • Aetna — Medicare: $111.52
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.73
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $1,390.40
  • Cigna — New Business ASO: $1,181.84
  • Coventry/First Health — Commercial: $2,433.20
  • Health Plan of Upper Ohio Valley — Commercial: $1,605.91
  • Health Plan of Upper Ohio Valley — Medicaid: $101.38
  • Health Plan of Upper Ohio Valley — Medicare: $101.38
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US ABDOMINAL COMPLETE $3,476 $2,085.60 $1,251.36 – $3,232.68
Ultrasound of the abdomen, complete: rates for 7 insurance plans
  • Cigna — Commercial: $1,390.40
  • Cigna — New Business ASO: $1,251.36
  • Coventry/First Health — Commercial: $2,433.20
  • Humana — Commercial: $3,232.68
  • InterGroup — PPO: $3,128.40
  • Multiplan — PPO (Includes Workers' Comp): $3,232.68
  • Private Health Care Systems — PPO: $3,232.68
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US PREGNANT UTERUS>14WKS $2,558 $1,534.80 $85.25 – $2,174.30
Pregnancy ultrasound (after the first trimester): 10 of 32 insurance plan rates
  • Aetna — Medicare: $111.52
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $120.99
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $1,023.20
  • Cigna — New Business ASO: $869.72
  • Coventry/First Health — Commercial: $1,790.60
  • Health Plan of Upper Ohio Valley — Commercial: $1,181.80
  • Health Plan of Upper Ohio Valley — Medicaid: $101.38
  • Health Plan of Upper Ohio Valley — Medicare: $101.38
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US PREGNANT UTERUS>14WKS $2,558 $1,534.80 $920.88 – $2,378.94
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans
  • Cigna — Commercial: $1,023.20
  • Cigna — New Business ASO: $920.88
  • Coventry/First Health — Commercial: $1,790.60
  • Humana — Commercial: $2,378.94
  • InterGroup — PPO: $2,302.20
  • Multiplan — PPO (Includes Workers' Comp): $2,378.94
  • Private Health Care Systems — PPO: $2,378.94
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL $2,490 $1,494 $84.15 – $2,116.50
Transvaginal ultrasound: 10 of 32 insurance plan rates
  • Aetna — Medicare: $111.52
  • Aetna of PA — Medicare: $106.45
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $119.42
  • AmeriHealth Caritas — Medicare: $109.49
  • Cigna — Commercial: $996
  • Cigna — New Business ASO: $846.60
  • Coventry/First Health — Commercial: $1,743
  • Health Plan of Upper Ohio Valley — Commercial: $1,150.38
  • Health Plan of Upper Ohio Valley — Medicaid: $101.38
  • Health Plan of Upper Ohio Valley — Medicare: $101.38
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL $2,490 $1,494 $896.40 – $2,315.70
Transvaginal ultrasound: rates for 7 insurance plans
  • Cigna — Commercial: $996
  • Cigna — New Business ASO: $896.40
  • Coventry/First Health — Commercial: $1,743
  • Humana — Commercial: $2,315.70
  • InterGroup — PPO: $2,241
  • Multiplan — PPO (Includes Workers' Comp): $2,315.70
  • Private Health Care Systems — PPO: $2,315.70
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO DIGITAL DX UNI WWO CAD $712 $427.20 $58.27 – $605.20
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates
  • Aetna — Medicare: $178
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $159.87
  • Cigna — Commercial: $284.80
  • Cigna — New Business ASO: $242.08
  • Coventry/First Health — Commercial: $498.40
  • Health Plan of Upper Ohio Valley — Commercial: $328.94
  • Highmark BCBS of PA — Commercial - Indemnity: $216.59
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $161.72
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $58.27
  • Highmark BCBS of PA — Managed Care: $173.74
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC MAMMO DIGITAL DX UNI WWO CAD $712 $427.20 $256.32 – $662.16
Diagnostic mammogram, one breast: rates for 7 insurance plans
  • Cigna — Commercial: $284.80
  • Cigna — New Business ASO: $256.32
  • Coventry/First Health — Commercial: $498.40
  • Humana — Commercial: $662.16
  • InterGroup — PPO: $640.80
  • Multiplan — PPO (Includes Workers' Comp): $662.16
  • Private Health Care Systems — PPO: $662.16

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: HC LEFT HRT CATH W VENTRCLGRPHY $23,070 $13,842 $1,056.32 – $19,609.50
Left heart catheterization (diagnostic): 10 of 28 insurance plan rates
  • Aetna — Medicare: $3,373.11
  • Aetna of PA — Medicare: $3,219.78
  • AmeriHealth Caritas — Medicare: $3,311.78
  • Cigna — Commercial: $9,228
  • Cigna — New Business ASO: $7,843.80
  • Coventry/First Health — Commercial: $16,149
  • Health Plan of Upper Ohio Valley — Commercial: $10,658.34
  • Health Plan of Upper Ohio Valley — Medicaid: $3,066.46
  • Health Plan of Upper Ohio Valley — Medicare: $3,066.46
  • Highmark BCBS of PA — Commercial - Indemnity: $3,926.59
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC LEFT HRT CATH W VENTRCLGRPHY $23,070 $13,842 $8,305.20 – $21,455.10
Left heart catheterization (diagnostic): rates for 7 insurance plans
  • Cigna — Commercial: $9,228
  • Cigna — New Business ASO: $8,305.20
  • Coventry/First Health — Commercial: $16,149
  • Humana — Commercial: $21,455.10
  • InterGroup — PPO: $20,763
  • Multiplan — PPO (Includes Workers' Comp): $21,455.10
  • Private Health Care Systems — PPO: $21,455.10
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPRE EP EVAL WO INDUCTION $9,622 $5,773.20 $730.54 – $8,178.70
Heart rhythm study (electrophysiology evaluation): 10 of 28 insurance plan rates
  • Aetna — Medicare: $7,957.77
  • Aetna of PA — Medicare: $7,596.06
  • AmeriHealth Caritas — Medicare: $7,813.09
  • Cigna — Commercial: $3,848.80
  • Cigna — New Business ASO: $3,271.48
  • Coventry/First Health — Commercial: $6,735.40
  • Health Plan of Upper Ohio Valley — Commercial: $4,445.36
  • Health Plan of Upper Ohio Valley — Medicaid: $7,234.34
  • Health Plan of Upper Ohio Valley — Medicare: $7,234.34
  • Highmark BCBS of PA — Commercial - Indemnity: $2,715.59
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COMPRE EP EVAL WO INDUCTION $9,622 $5,773.20 $3,463.92 – $8,948.46
Heart rhythm study (electrophysiology evaluation): rates for 7 insurance plans
  • Cigna — Commercial: $3,848.80
  • Cigna — New Business ASO: $3,463.92
  • Coventry/First Health — Commercial: $6,735.40
  • Humana — Commercial: $8,948.46
  • InterGroup — PPO: $8,659.80
  • Multiplan — PPO (Includes Workers' Comp): $8,948.46
  • Private Health Care Systems — PPO: $8,948.46
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC TX ATRIAL FIB PULM VEN ISOL $80,306 $48,183.60 $940.93 – $68,260.10
Heart rhythm study with ablation for atrial fibrillation: 10 of 28 insurance plan rates
  • Aetna — Medicare: $25,727.46
  • Aetna of PA — Medicare: $24,558.03
  • AmeriHealth Caritas — Medicare: $25,259.69
  • Cigna — Commercial: $32,122.40
  • Cigna — New Business ASO: $27,304.04
  • Coventry/First Health — Commercial: $56,214.20
  • Health Plan of Upper Ohio Valley — Commercial: $37,101.37
  • Health Plan of Upper Ohio Valley — Medicaid: $23,388.60
  • Health Plan of Upper Ohio Valley — Medicare: $23,388.60
  • Highmark BCBS of PA — Commercial - Indemnity: $3,497.67
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC TX ATRIAL FIB PULM VEN ISOL $80,306 $48,183.60 $28,910.16 – $74,684.58
Heart rhythm study with ablation for atrial fibrillation: rates for 7 insurance plans
  • Cigna — Commercial: $32,122.40
  • Cigna — New Business ASO: $28,910.16
  • Coventry/First Health — Commercial: $56,214.20
  • Humana — Commercial: $74,684.58
  • InterGroup — PPO: $72,275.40
  • Multiplan — PPO (Includes Workers' Comp): $74,684.58
  • Private Health Care Systems — PPO: $74,684.58
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSG 4+PARAM ATTENDED $13,956 $8,373.60 $381.22 – $11,862.60
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates
  • Aetna — Medicare: $1,066.96
  • Aetna of PA — Medicare: $1,018.46
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $541.01
  • AmeriHealth Caritas — Medicare: $1,047.56
  • Cigna — Commercial: $5,582.40
  • Cigna — New Business ASO: $4,745.04
  • Coventry/First Health — Commercial: $9,769.20
  • Health Plan of Upper Ohio Valley — Commercial: $6,447.67
  • Health Plan of Upper Ohio Valley — Medicaid: $969.96
  • Health Plan of Upper Ohio Valley — Medicare: $969.96
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSG 9+PARAM ATTENDED $13,956 $8,373.60 $381.22 – $11,862.60
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates
  • Aetna — Medicare: $1,066.96
  • Aetna of PA — Medicare: $1,018.46
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $541.01
  • AmeriHealth Caritas — Medicare: $1,047.56
  • Cigna — Commercial: $5,582.40
  • Cigna — New Business ASO: $4,745.04
  • Coventry/First Health — Commercial: $9,769.20
  • Health Plan of Upper Ohio Valley — Commercial: $6,447.67
  • Health Plan of Upper Ohio Valley — Medicaid: $969.96
  • Health Plan of Upper Ohio Valley — Medicare: $969.96
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC PSG 4+PARAM ATTENDED $13,956 $8,373.60 $5,024.16 – $12,979.08
Sleep study (overnight, in a sleep lab): rates for 7 insurance plans
  • Cigna — Commercial: $5,582.40
  • Cigna — New Business ASO: $5,024.16
  • Coventry/First Health — Commercial: $9,769.20
  • Humana — Commercial: $12,979.08
  • InterGroup — PPO: $12,560.40
  • Multiplan — PPO (Includes Workers' Comp): $12,979.08
  • Private Health Care Systems — PPO: $12,979.08

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CQ THERAPEUTIC EXERCISE P/15M $184 $110.40 $9.22 – $156.40
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $46
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08
  • Cigna — Commercial: $73.60
  • Cigna — New Business ASO: $62.56
  • Coventry/First Health — Commercial: $128.80
  • Health Plan of Upper Ohio Valley — Commercial: $85.01
  • Highmark BCBS of PA — Commercial - Indemnity: $95.63
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $71.41
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $25.73
  • Highmark BCBS of PA — Managed Care: $59.83
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CO THERAPEUTIC EXERCISE P/15M $184 $110.40 $9.22 – $156.40
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 24 insurance plan rates
  • Aetna — Medicare: $46
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $13.08
  • Cigna — Commercial: $73.60
  • Cigna — New Business ASO: $62.56
  • Coventry/First Health — Commercial: $128.80
  • Health Plan of Upper Ohio Valley — Commercial: $85.01
  • Highmark BCBS of PA — Commercial - Indemnity: $95.63
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $71.41
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $25.73
  • Highmark BCBS of PA — Managed Care: $59.83
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CQ THERAPEUTIC EXERCISE P/15M $184 $110.40 $66.24 – $171.12
Physical therapy: therapeutic exercise (each 15 minutes): rates for 7 insurance plans
  • Cigna — Commercial: $73.60
  • Cigna — New Business ASO: $66.24
  • Coventry/First Health — Commercial: $128.80
  • Humana — Commercial: $171.12
  • InterGroup — PPO: $165.60
  • Multiplan — PPO (Includes Workers' Comp): $171.12
  • Private Health Care Systems — PPO: $171.12
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CQ PT EVAL LOW COMPLEX $575 $345 $52.05 – $488.75
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates
  • Aetna — Medicare: $143.75
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $195.50
  • Coventry/First Health — Commercial: $402.50
  • Health Plan of Upper Ohio Valley — Commercial: $265.65
  • Highmark BCBS of PA — Commercial - Indemnity: $193.50
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $144.48
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $52.05
  • Highmark BCBS of PA — Managed Care: $121.07
  • Highmark BCBS of PA — Managed Care - Social Mission: $90.40
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CQ PT EVAL LOW COMPLEX $575 $345 $207 – $534.75
Physical therapy evaluation (low complexity): rates for 7 insurance plans
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $207
  • Coventry/First Health — Commercial: $402.50
  • Humana — Commercial: $534.75
  • InterGroup — PPO: $517.50
  • Multiplan — PPO (Includes Workers' Comp): $534.75
  • Private Health Care Systems — PPO: $534.75
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PT EVAL LOW COMPLEX $575 $345 $52.05 – $488.75
Physical therapy evaluation (low complexity): 10 of 20 insurance plan rates
  • Aetna — Medicare: $143.75
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $195.50
  • Coventry/First Health — Commercial: $402.50
  • Health Plan of Upper Ohio Valley — Commercial: $265.65
  • Highmark BCBS of PA — Commercial - Indemnity: $193.50
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $144.48
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $52.05
  • Highmark BCBS of PA — Managed Care: $121.07
  • Highmark BCBS of PA — Managed Care - Social Mission: $90.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CQ PT EVAL MOD COMPLEX $575 $345 $52.05 – $488.75
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates
  • Aetna — Medicare: $143.75
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $195.50
  • Coventry/First Health — Commercial: $402.50
  • Health Plan of Upper Ohio Valley — Commercial: $265.65
  • Highmark BCBS of PA — Commercial - Indemnity: $193.50
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $144.48
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $52.05
  • Highmark BCBS of PA — Managed Care: $121.07
  • Highmark BCBS of PA — Managed Care - Social Mission: $90.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CQ PT EVAL MOD COMPLEX $575 $345 $207 – $534.75
Physical therapy evaluation (moderate complexity): rates for 7 insurance plans
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $207
  • Coventry/First Health — Commercial: $402.50
  • Humana — Commercial: $534.75
  • InterGroup — PPO: $517.50
  • Multiplan — PPO (Includes Workers' Comp): $534.75
  • Private Health Care Systems — PPO: $534.75
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PT EVAL MOD COMPLEX $575 $345 $52.05 – $488.75
Physical therapy evaluation (moderate complexity): 10 of 20 insurance plan rates
  • Aetna — Medicare: $143.75
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $195.50
  • Coventry/First Health — Commercial: $402.50
  • Health Plan of Upper Ohio Valley — Commercial: $265.65
  • Highmark BCBS of PA — Commercial - Indemnity: $193.50
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $144.48
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $52.05
  • Highmark BCBS of PA — Managed Care: $121.07
  • Highmark BCBS of PA — Managed Care - Social Mission: $90.40
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CQ PT EVAL HIGH COMPLEX $575 $345 $52.05 – $488.75
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates
  • Aetna — Medicare: $143.75
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $195.50
  • Coventry/First Health — Commercial: $402.50
  • Health Plan of Upper Ohio Valley — Commercial: $265.65
  • Highmark BCBS of PA — Commercial - Indemnity: $193.50
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $144.48
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $52.05
  • Highmark BCBS of PA — Managed Care: $121.07
  • Highmark BCBS of PA — Managed Care - Social Mission: $90.40
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CQ PT EVAL HIGH COMPLEX $575 $345 $207 – $534.75
Physical therapy evaluation (high complexity): rates for 7 insurance plans
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $207
  • Coventry/First Health — Commercial: $402.50
  • Humana — Commercial: $534.75
  • InterGroup — PPO: $517.50
  • Multiplan — PPO (Includes Workers' Comp): $534.75
  • Private Health Care Systems — PPO: $534.75
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: HC PT EVAL HIGH COMPLEX $575 $345 $52.05 – $488.75
Physical therapy evaluation (high complexity): 10 of 20 insurance plan rates
  • Aetna — Medicare: $143.75
  • Cigna — Commercial: $230
  • Cigna — New Business ASO: $195.50
  • Coventry/First Health — Commercial: $402.50
  • Health Plan of Upper Ohio Valley — Commercial: $265.65
  • Highmark BCBS of PA — Commercial - Indemnity: $193.50
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $144.48
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $52.05
  • Highmark BCBS of PA — Managed Care: $121.07
  • Highmark BCBS of PA — Managed Care - Social Mission: $90.40

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT Not listed in the file Not listed in the file $2,492.82 – $19,556.35
Total hip replacement: 10 of 19 insurance plan rates
  • Aetna — Medicare: $13,493.67
  • Aetna of PA — Medicare: $12,880.32
  • AmeriHealth Caritas — Medicare: $13,248.33
  • Health Plan of Upper Ohio Valley — Medicaid: $12,266.97
  • Health Plan of Upper Ohio Valley — Medicare: $12,266.97
  • Highmark BCBS of PA — Commercial - Indemnity: $9,266.40
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $6,918.91
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $2,492.82
  • Highmark BCBS of PA — Managed Care: $7,433.29
  • Highmark BCBS of PA — Managed Care - Social Mission: $5,550.22
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 $2,690.84 – $19,556.35
Total knee replacement: 10 of 19 insurance plan rates
  • Aetna — Medicare: $13,493.67
  • Aetna of PA — Medicare: $12,880.32
  • AmeriHealth Caritas — Medicare: $13,248.33
  • Health Plan of Upper Ohio Valley — Medicaid: $12,266.97
  • Health Plan of Upper Ohio Valley — Medicare: $12,266.97
  • Highmark BCBS of PA — Commercial - Indemnity: $10,002.51
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $7,468.55
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $2,690.84
  • Highmark BCBS of PA — Managed Care: $8,023.78
  • Highmark BCBS of PA — Managed Care - Social Mission: $5,991.13
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 $844.93 – $5,038.97
Shoulder arthroscopy: shaving of shoulder bone: rates for 9 insurance plans
  • Highmark BCBS of PA — Commercial - Indemnity: $3,140.81
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $2,345.14
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $844.93
  • Highmark BCBS of PA — Managed Care: $2,519.49
  • Highmark BCBS of PA — Managed Care - Social Mission: $1,881.23
  • Highmark BCBS of PA — UPMC Emergent: $5,038.97
  • Private Health Care Systems — Workers' Comp: $2,862.98
  • UPMC Health Plan — Commercial: $1,200.32
  • UPMC Work Partners — Workers Comp: $2,462.16
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EGD W/WO BRUSHINGS $3,159 $1,895.40 $137.74 – $3,281.43
Upper GI endoscopy (diagnostic): 10 of 32 insurance plan rates
  • Aetna — Medicare: $983.24
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $195.48
  • AmeriHealth Caritas — Medicare: $965.36
  • Cigna — Commercial: $1,263.60
  • Cigna — New Business ASO: $1,074.06
  • Coventry/First Health — Commercial: $2,211.30
  • Health Plan of Upper Ohio Valley — Commercial: $1,459.46
  • Health Plan of Upper Ohio Valley — Medicaid: $893.85
  • Health Plan of Upper Ohio Valley — Medicare: $893.85
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EGD W/WO BRUSHINGS $3,159 $1,895.40 $1,137.24 – $2,937.87
Upper GI endoscopy (diagnostic): rates for 7 insurance plans
  • Cigna — Commercial: $1,263.60
  • Cigna — New Business ASO: $1,137.24
  • Coventry/First Health — Commercial: $2,211.30
  • Humana — Commercial: $2,937.87
  • InterGroup — PPO: $2,843.10
  • Multiplan — PPO (Includes Workers' Comp): $2,937.87
  • Private Health Care Systems — PPO: $2,937.87
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 – $3,281.43
Upper GI endoscopy (diagnostic): 10 of 24 insurance plan rates
  • Aetna — Medicare: $983.24
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $195.48
  • AmeriHealth Caritas — Medicare: $965.36
  • Health Plan of Upper Ohio Valley — Medicaid: $893.85
  • Health Plan of Upper Ohio Valley — Medicare: $893.85
  • Highmark BCBS of PA — Commercial - Indemnity: $2,045.33
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $1,527.18
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $550.23
  • Highmark BCBS of PA — Managed Care: $1,640.71
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EGD W/BIOPSY SINGLE/MULT $3,690 $2,214 $163.44 – $4,393.81
Upper GI endoscopy with biopsy: 10 of 32 insurance plan rates
  • Aetna — Medicare: $983.24
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $231.95
  • AmeriHealth Caritas — Medicare: $965.36
  • Cigna — Commercial: $1,476
  • Cigna — New Business ASO: $1,254.60
  • Coventry/First Health — Commercial: $2,583
  • Health Plan of Upper Ohio Valley — Commercial: $1,704.78
  • Health Plan of Upper Ohio Valley — Medicaid: $893.85
  • Health Plan of Upper Ohio Valley — Medicare: $893.85
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC EGD W/BIOPSY SINGLE/MULT $3,690 $2,214 $1,328.40 – $3,431.70
Upper GI endoscopy with biopsy: rates for 7 insurance plans
  • Cigna — Commercial: $1,476
  • Cigna — New Business ASO: $1,328.40
  • Coventry/First Health — Commercial: $2,583
  • Humana — Commercial: $3,431.70
  • InterGroup — PPO: $3,321
  • Multiplan — PPO (Includes Workers' Comp): $3,431.70
  • Private Health Care Systems — PPO: $3,431.70
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 – $4,393.81
Upper GI endoscopy with biopsy: 10 of 24 insurance plan rates
  • Aetna — Medicare: $983.24
  • Aetna of PA — Medicare: $938.54
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $231.95
  • AmeriHealth Caritas — Medicare: $965.36
  • Health Plan of Upper Ohio Valley — Medicaid: $893.85
  • Health Plan of Upper Ohio Valley — Medicare: $893.85
  • Highmark BCBS of PA — Commercial - Indemnity: $2,738.68
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $2,044.88
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $736.75
  • Highmark BCBS of PA — Managed Care: $2,196.91
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY DIAG W/WO BRUSHING $2,500 $1,500 $198.55 – $4,393.81
Colonoscopy (diagnostic): 10 of 32 insurance plan rates
  • Aetna — Medicare: $956.13
  • Aetna of PA — Medicare: $912.67
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $281.78
  • AmeriHealth Caritas — Medicare: $938.75
  • Cigna — Commercial: $1,000
  • Cigna — New Business ASO: $850
  • Coventry/First Health — Commercial: $1,750
  • Health Plan of Upper Ohio Valley — Commercial: $1,155
  • Health Plan of Upper Ohio Valley — Medicaid: $869.21
  • Health Plan of Upper Ohio Valley — Medicare: $869.21
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY DIAG W/WO BRUSHING $2,500 $1,500 $900 – $2,325
Colonoscopy (diagnostic): rates for 7 insurance plans
  • Cigna — Commercial: $1,000
  • Cigna — New Business ASO: $900
  • Coventry/First Health — Commercial: $1,750
  • Humana — Commercial: $2,325
  • InterGroup — PPO: $2,250
  • Multiplan — PPO (Includes Workers' Comp): $2,325
  • Private Health Care Systems — PPO: $2,325
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY W/BX SINGLE/MULT $3,690 $2,214 $247.96 – $4,393.81
Colonoscopy with biopsy: 10 of 32 insurance plan rates
  • Aetna — Medicare: $1,236.52
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $351.90
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Cigna — Commercial: $1,476
  • Cigna — New Business ASO: $1,254.60
  • Coventry/First Health — Commercial: $2,583
  • Health Plan of Upper Ohio Valley — Commercial: $1,704.78
  • Health Plan of Upper Ohio Valley — Medicaid: $1,124.11
  • Health Plan of Upper Ohio Valley — Medicare: $1,124.11
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY W/BX SINGLE/MULT $3,690 $2,214 $1,328.40 – $3,431.70
Colonoscopy with biopsy: rates for 7 insurance plans
  • Cigna — Commercial: $1,476
  • Cigna — New Business ASO: $1,328.40
  • Coventry/First Health — Commercial: $2,583
  • Humana — Commercial: $3,431.70
  • InterGroup — PPO: $3,321
  • Multiplan — PPO (Includes Workers' Comp): $3,431.70
  • Private Health Care Systems — PPO: $3,431.70
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY W/SNARE TECHNIQUE $7,842 $4,705.20 $294.89 – $6,665.70
Colonoscopy with removal of polyps (snare): 10 of 32 insurance plan rates
  • Aetna — Medicare: $1,236.52
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $418.50
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Cigna — Commercial: $3,136.80
  • Cigna — New Business ASO: $2,666.28
  • Coventry/First Health — Commercial: $5,489.40
  • Health Plan of Upper Ohio Valley — Commercial: $3,623
  • Health Plan of Upper Ohio Valley — Medicaid: $1,124.11
  • Health Plan of Upper Ohio Valley — Medicare: $1,124.11
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY W/SNARE TECHNIQUE $7,842 $4,705.20 $2,823.12 – $7,293.06
Colonoscopy with removal of polyps (snare): rates for 7 insurance plans
  • Cigna — Commercial: $3,136.80
  • Cigna — New Business ASO: $2,823.12
  • Coventry/First Health — Commercial: $5,489.40
  • Humana — Commercial: $7,293.06
  • InterGroup — PPO: $7,057.80
  • Multiplan — PPO (Includes Workers' Comp): $7,293.06
  • Private Health Care Systems — PPO: $7,293.06
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY WITH USN $6,251 $3,750.60 $241.22 – $5,313.35
Ultrasound of the lower bowel by endoscope: 10 of 32 insurance plan rates
  • Aetna — Medicare: $1,236.52
  • Aetna of PA — Medicare: $1,180.32
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $342.33
  • AmeriHealth Caritas — Medicare: $1,214.04
  • Cigna — Commercial: $2,500.40
  • Cigna — New Business ASO: $2,125.34
  • Coventry/First Health — Commercial: $4,375.70
  • Health Plan of Upper Ohio Valley — Commercial: $2,887.96
  • Health Plan of Upper Ohio Valley — Medicaid: $1,124.11
  • Health Plan of Upper Ohio Valley — Medicare: $1,124.11
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY WITH USN $6,251 $3,750.60 $2,250.36 – $5,813.43
Ultrasound of the lower bowel by endoscope: rates for 7 insurance plans
  • Cigna — Commercial: $2,500.40
  • Cigna — New Business ASO: $2,250.36
  • Coventry/First Health — Commercial: $4,375.70
  • Humana — Commercial: $5,813.43
  • InterGroup — PPO: $5,625.90
  • Multiplan — PPO (Includes Workers' Comp): $5,813.43
  • Private Health Care Systems — PPO: $5,813.43
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COLONOSCOPY SCREEN AVG RISK $3,000 $1,800 $626.45 – $3,736
Screening colonoscopy (not high risk): 10 of 26 insurance plan rates
  • Aetna — Medicare: $956.13
  • Aetna of PA — Medicare: $912.67
  • AmeriHealth Caritas — Medicare: $938.75
  • Cigna — Commercial: $1,200
  • Cigna — New Business ASO: $1,020
  • Coventry/First Health — Commercial: $2,100
  • Health Plan of Upper Ohio Valley — Commercial: $1,386
  • Health Plan of Upper Ohio Valley — Medicaid: $869.21
  • Health Plan of Upper Ohio Valley — Medicare: $869.21
  • Highmark BCBS of PA — Commercial - Indemnity: $2,328.67
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC COLONOSCOPY SCREEN AVG RISK $3,000 $1,800 $1,080 – $2,790
Screening colonoscopy (not high risk): rates for 7 insurance plans
  • Cigna — Commercial: $1,200
  • Cigna — New Business ASO: $1,080
  • Coventry/First Health — Commercial: $2,100
  • Humana — Commercial: $2,790
  • InterGroup — PPO: $2,700
  • Multiplan — PPO (Includes Workers' Comp): $2,790
  • Private Health Care Systems — PPO: $2,790
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 – $9,822.12
Gallbladder removal by laparoscope: 10 of 19 insurance plan rates
  • Aetna — Medicare: $6,118.60
  • Aetna of PA — Medicare: $5,840.48
  • AmeriHealth Caritas — Medicare: $6,007.35
  • Health Plan of Upper Ohio Valley — Medicaid: $5,562.36
  • Health Plan of Upper Ohio Valley — Medicare: $5,562.36
  • Highmark BCBS of PA — Commercial - Indemnity: $6,122.17
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $4,571.22
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $1,646.97
  • Highmark BCBS of PA — Managed Care: $4,911.06
  • Highmark BCBS of PA — Managed Care - Social Mission: $3,666.95
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RPR INIT ING HERNIA >5YRS/RE $8,870 $5,322 $349.25 – $7,539.50
Groin (inguinal) hernia repair, age 5 or older: 10 of 32 insurance plan rates
  • Aetna — Medicare: $3,700.99
  • Aetna of PA — Medicare: $3,532.77
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $495.65
  • AmeriHealth Caritas — Medicare: $3,633.70
  • Cigna — Commercial: $3,548
  • Cigna — New Business ASO: $3,015.80
  • Coventry/First Health — Commercial: $6,209
  • Health Plan of Upper Ohio Valley — Commercial: $4,097.94
  • Health Plan of Upper Ohio Valley — Medicaid: $3,364.54
  • Health Plan of Upper Ohio Valley — Medicare: $3,364.54
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC RPR INIT ING HERNIA >5YRS/RE $8,870 $5,322 $3,193.20 – $8,249.10
Groin (inguinal) hernia repair, age 5 or older: rates for 7 insurance plans
  • Cigna — Commercial: $3,548
  • Cigna — New Business ASO: $3,193.20
  • Coventry/First Health — Commercial: $6,209
  • Humana — Commercial: $8,249.10
  • InterGroup — PPO: $7,983
  • Multiplan — PPO (Includes Workers' Comp): $8,249.10
  • Private Health Care Systems — PPO: $8,249.10
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC NJX INTRLMNR LUM/SAC W/IMG GDE $3,480 $2,088 $89.45 – $2,958
Spinal injection, lower back (epidural), with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — Medicare: $726.25
  • Aetna of PA — Medicare: $693.24
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $126.95
  • AmeriHealth Caritas — Medicare: $713.05
  • Cigna — Commercial: $1,392
  • Cigna — New Business ASO: $1,183.20
  • Coventry/First Health — Commercial: $2,436
  • Health Plan of Upper Ohio Valley — Commercial: $1,607.76
  • Health Plan of Upper Ohio Valley — Medicaid: $660.23
  • Health Plan of Upper Ohio Valley — Medicare: $660.23
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC NJX INTRLMNR LUM/SAC W/IMG GDE $3,480 $2,088 $1,252.80 – $3,236.40
Spinal injection, lower back (epidural), with imaging guidance: rates for 7 insurance plans
  • Cigna — Commercial: $1,392
  • Cigna — New Business ASO: $1,252.80
  • Coventry/First Health — Commercial: $2,436
  • Humana — Commercial: $3,236.40
  • InterGroup — PPO: $3,132
  • Multiplan — PPO (Includes Workers' Comp): $3,236.40
  • Private Health Care Systems — PPO: $3,236.40
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC EPIDURAL LUMBAR/SACRAL SINGLE $4,596 $2,757.60 $104.54 – $3,906.60
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — Medicare: $933.66
  • Aetna of PA — Medicare: $891.22
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.37
  • AmeriHealth Caritas — Medicare: $916.68
  • Cigna — Commercial: $1,838.40
  • Cigna — New Business ASO: $1,562.64
  • Coventry/First Health — Commercial: $3,217.20
  • Health Plan of Upper Ohio Valley — Commercial: $2,123.35
  • Health Plan of Upper Ohio Valley — Medicaid: $848.78
  • Health Plan of Upper Ohio Valley — Medicare: $848.78
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ EPIDURAL LUMB/SAC SINGLE $4,596 $2,757.60 $104.54 – $3,906.60
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — Medicare: $933.66
  • Aetna of PA — Medicare: $891.22
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.37
  • AmeriHealth Caritas — Medicare: $916.68
  • Cigna — Commercial: $1,838.40
  • Cigna — New Business ASO: $1,562.64
  • Coventry/First Health — Commercial: $3,217.20
  • Health Plan of Upper Ohio Valley — Commercial: $2,123.35
  • Health Plan of Upper Ohio Valley — Medicaid: $848.78
  • Health Plan of Upper Ohio Valley — Medicare: $848.78
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC INJ ANES LUM/SA TRANSF SNG LEV $4,596 $2,757.60 $104.54 – $3,906.60
Nerve root injection, lower back, with imaging guidance: 10 of 32 insurance plan rates
  • Aetna — Medicare: $933.66
  • Aetna of PA — Medicare: $891.22
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $148.37
  • AmeriHealth Caritas — Medicare: $916.68
  • Cigna — Commercial: $1,838.40
  • Cigna — New Business ASO: $1,562.64
  • Coventry/First Health — Commercial: $3,217.20
  • Health Plan of Upper Ohio Valley — Commercial: $2,123.35
  • Health Plan of Upper Ohio Valley — Medicaid: $848.78
  • Health Plan of Upper Ohio Valley — Medicare: $848.78
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CARPAL TUNNEL RELEASE $6,597 $3,958.20 $330 – $5,607.45
Carpal tunnel release: 10 of 32 insurance plan rates
  • Aetna — Medicare: $2,047.90
  • Aetna of PA — Medicare: $1,954.82
  • AmeriHealth Caritas — Community HealthChoices (CHC)/Medicaid: $468.33
  • AmeriHealth Caritas — Medicare: $2,010.67
  • Cigna — Commercial: $2,638.80
  • Cigna — New Business ASO: $2,242.98
  • Coventry/First Health — Commercial: $4,617.90
  • Health Plan of Upper Ohio Valley — Commercial: $3,047.81
  • Health Plan of Upper Ohio Valley — Medicaid: $1,861.73
  • Health Plan of Upper Ohio Valley — Medicare: $1,861.73
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HC CARPAL TUNNEL RELEASE $6,597 $3,958.20 $2,374.92 – $6,135.21
Carpal tunnel release: rates for 7 insurance plans
  • Cigna — Commercial: $2,638.80
  • Cigna — New Business ASO: $2,374.92
  • Coventry/First Health — Commercial: $4,617.90
  • Humana — Commercial: $6,135.21
  • InterGroup — PPO: $5,937.30
  • Multiplan — PPO (Includes Workers' Comp): $6,135.21
  • Private Health Care Systems — PPO: $6,135.21

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $69,885.83 – $323,052.40
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 18 insurance plan rates
  • Aetna — Medicare: $76,874.41
  • Aetna of PA — Medicare: $73,380.12
  • AmeriHealth Caritas — Medicare: $75,476.70
  • Health Plan of Upper Ohio Valley — Commercial: $127,197.94
  • Health Plan of Upper Ohio Valley — Medicaid: $69,885.83
  • Health Plan of Upper Ohio Valley — Medicare: $69,885.83
  • Highmark BCBS of PA — Commercial - Indemnity: $192,354.90
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $143,762.06
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $69,885.83
  • Highmark BCBS of PA — Managed Care: $161,526.13
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 $10,292.55 – $25,188.02
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 2 insurance plans
  • Private Health Care Systems — Workers' Comp: $25,188.02
  • UPMC Work Partners — Workers Comp: $10,292.55
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 $10,292.55 – $11,995.61
Spinal fusion (not neck), without major complications: rates for 2 insurance plans
  • Private Health Care Systems — Workers' Comp: $11,995.61
  • UPMC Work Partners — Workers Comp: $10,292.55
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $13,779.57 – $56,809.74
Hip or knee replacement (major joint of the leg), without major complications: 10 of 18 insurance plan rates
  • Aetna — Medicare: $15,157.53
  • Aetna of PA — Medicare: $14,468.55
  • AmeriHealth Caritas — Medicare: $14,881.94
  • Health Plan of Upper Ohio Valley — Commercial: $32,502.01
  • Health Plan of Upper Ohio Valley — Medicaid: $13,779.57
  • Health Plan of Upper Ohio Valley — Medicare: $13,779.57
  • Highmark BCBS of PA — Commercial - Indemnity: $33,826.19
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $25,280.99
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $13,779.57
  • Highmark BCBS of PA — Managed Care: $28,404.86
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 $10,292.55
Hip or knee replacement (major joint of the leg), without major complications: rates for 1 insurance plan
  • UPMC Work Partners — Workers Comp: $10,292.55
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 $7,529.42 – $73,108.39
Neck (cervical) spinal fusion, without complications: 10 of 18 insurance plan rates
  • Aetna — Medicare: $19,184.03
  • Aetna of PA — Medicare: $18,312.03
  • AmeriHealth Caritas — Medicare: $18,835.23
  • Health Plan of Upper Ohio Valley — Commercial: $7,529.42
  • Health Plan of Upper Ohio Valley — Medicaid: $17,440.03
  • Health Plan of Upper Ohio Valley — Medicare: $17,440.03
  • Highmark BCBS of PA — Commercial - Indemnity: $43,530.88
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $32,534.08
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $17,440.03
  • Highmark BCBS of PA — Managed Care: $36,554.18
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 $10,292.55 – $43,228.70
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans
  • Private Health Care Systems — Workers' Comp: $43,228.70
  • UPMC Work Partners — Workers Comp: $10,292.55
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $7,529.42 – $41,123.47
Uterus and ovary surgery (not for cancer), without complications: 10 of 18 insurance plan rates
  • Aetna — Medicare: $9,749.55
  • Aetna of PA — Medicare: $9,306.39
  • AmeriHealth Caritas — Medicare: $9,572.29
  • Health Plan of Upper Ohio Valley — Commercial: $7,529.42
  • Health Plan of Upper Ohio Valley — Medicaid: $8,863.23
  • Health Plan of Upper Ohio Valley — Medicare: $8,863.23
  • Highmark BCBS of PA — Commercial - Indemnity: $24,486.12
  • Highmark BCBS of PA — Commercial - Social Mission Indemnity: $18,300.42
  • Highmark BCBS of PA — Complete Blue Medicare Advantage/Freedom Blue Medicare Advan: $8,863.23
  • Highmark BCBS of PA — Managed Care: $20,561.73

Source: UPMC Passavant’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 7, 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
Address9100 Babcock Boulevard, Pittsburgh, PA 15237
CountyAllegheny County
StatePennsylvania
Phone(412) 367‑6700
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall rating4 of 5 stars
CMS Certification Number390107
Name in Medicare recordsUPMC PASSAVANT
Profile levelMedicare data + hospital website
Name on the hospital’s websiteUPMC Passavant-McCandless
Official websiteupmc.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. UPMC Passavant-McCandless — upmc.com
  2. Clinical Services | UPMC Passavant – McCandless — upmc.com
  3. UPMC Magee Specialty Services | McCandless – Pittsburgh, Pa — upmc.com
  4. Emergency Services at UPMC Passavant - McCandless, Cranberry, PA — upmc.com
  5. UPMC Passavant–McCandless ED | McCandless – Pittsburgh, Pa — upmc.com