Does Wayne Memorial Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Wayne Memorial Hospital. In a medical emergency, call 911.

Where is Wayne Memorial Hospital?

601 Park Street, Honesdale, PA 18431, in Wayne County, Pennsylvania.

What is the phone number of Wayne Memorial Hospital?

(570) 253-8100, as listed by Medicare (CMS).

What is the Medicare star rating of Wayne Memorial Hospital?

2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Wayne Memorial Hospital — Honesdale, PA

Quick answers

Does Wayne Memorial Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Wayne Memorial Hospital. In a medical emergency, call 911.
Where is Wayne Memorial Hospital?: 601 Park Street, Honesdale, PA 18431, in Wayne County, Pennsylvania.
What is the phone number of Wayne Memorial Hospital?: (570) 253-8100, as listed by Medicare (CMS).
What is the Medicare star rating of Wayne Memorial Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[5][11][15][22]}

Conditions treated^{[9][11][15][17][18][19][20][22]}

Heart attack
Chest pain
Stable angina
Stroke
Cardiac disease
Pulmonary disease
Chronic respiratory problems
Kidney disease
Cancer
Parkinson's disease
Multiple sclerosis
Osteoarthritis
Joint pain
Carpal tunnel syndrome
Fractures
Osteoporosis
Substance use disorders

Treatments^{[5][9][11][17][18][20][22]}

Wound Care
Infusion Clinic
Hospice Care
Nutritional Counseling
Intensive Care
Clot-busting drug for ischemic stroke
Telestroke neurology consultation
Medication-assisted treatment (MAT)
LSVT BIG and LSVT LOUD therapy
Physical therapy
Occupational therapy
Speech therapy
Cardiac rehabilitation (three phase program)
Pulmonary rehabilitation
Interventional radiology

Procedures^{[5][6][8][11][13][15][16]}

Cardiac Catheterization
Mammography
Imaging/Radiology
CT scan
MRI
Nuclear medicine
Bone density testing
Ultrasound
X-ray
Laboratory services
EKG
Echocardiogram
Stress testing
Holter monitoring
Percutaneous coronary intervention (PCI)
Joint injections
Fracture care
Laparoscopic surgery
Robotic surgery
Vascular surgery
Thoracic surgery
ENT surgery
Obstetrical-gynecological surgery

Programs and centers^{[5][6][9][14][16][18][19]}

Chest Pain Center
Cardiac Rehabilitation
Parkinson's Rehabilitation
Giving Birth (maternity)
Rehabilitation Services
Cancer Program accredited by the American College of Surgeons
Certified Primary Stroke Center
Heart & Vascular Center
Infusion clinic
Behavioral Health Center (outpatient)
Robotic surgery program

Emergency care (hospital website)^{[4][6][9][10][12]}

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Certified Primary Stroke Center

Visiting and practical information

Visiting	Visiting hours 9 a.m.-6 p.m.; main entrance closes at 6 p.m.; limits vary by unit; no visitors under 18 with exceptions^[7]
Patient portal	myWMH Patient Portal

Recognition^[4][6]

Certified Primary Stroke Center
American Heart Association Get With The Guidelines Stroke Gold Plus Quality Achievement Award (Oct. 1, 2026)
Rural Stroke Silver Destination Award (Oct. 1, 2026)
Corazon re-accreditation, Chest Pain Center and cardiac programs (Oct. 9, 2026)
Corazon re-accreditation for Chest Pain Center and cardiac programs 2026

Doctors and clinicians (500)

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

Main specialties

And 476 more: the button below opens the full list.

Other emergency rooms nearby

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

Garnet Health Medical Center Catskills19 mi · Callicoon, NY · Critical Access Hospital
Lehigh Valley Hospital - Dickson City21 mi · Dickson City, PA · Acute Care Hospital
Regional Hospital of Scranton23 mi · Scranton, PA · Acute Care Hospital
Geisinger-Community Medical Center23 mi · Scranton, PA · Acute Care Hospital
Garnet Health Medical Center Catskills30 mi · Harris, NY · Acute Care Hospital

Other hospitals nearby

Allied Services Institute of Rehabilitation23 mi · Scranton, PA · Inpatient Rehabilitation Hospital
Clarks Summit State Hospital26 mi · Clarks Summit, PA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Ellen Memorial Rehabilitation and Healthcare Cente1.2 mi · Honesdale, PA · 2 of 5 stars
Wayne Woodlands Manor7.4 mi · Waymart, PA · 2 of 5 stars
Julia Ribaudo Extended Care Center10 mi · Lake Ariel, PA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Wayne Memorial Hospital Department of Home Health2.8 mi · Honesdale, PA · 5 of 5 stars
Revolutionary Hospice15 mi · Eynon, PA
Compassionate Care Hospice of Northwestern Pennsylvania, LLC19 mi · Olyphant, PA · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Revolutionary Home Health Inc15 mi · Eynon, PA · 5 of 5 stars
Aveanna Healthcare19 mi · Olyphant, PA
Home Health Care Professionals19 mi · Olyphant, PA

All home health agencies in the state →

Dialysis facilities

DaVita Honesdale Dialysis Center2.8 mi · Honesdale, PA · 4 of 5 stars
DaVita Eynon Dialysis15 mi · Eynon, PA · 2 of 5 stars
DaVita Dunmore Dialysis20 mi · Dunmore, PA · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Mountain Laurel Surgery Center, LLC2.8 mi · Honesdale, PA
The Scranton Endoscopy Center22 mi · Scranton, PA
Nei Ambulatory Surgery, LLC24 mi · Scranton, PA

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Women's Health Center0.1 mi · Honesdale, PA · Community health center
Honesdale Family Health Center0.5 mi · Honesdale, PA · Community health center
Together for Health Dental Center0.5 mi · Honesdale, PA · Community health center

Clinics and urgent care

Valley Integrated Urgent Care and Wellness Center Inc19 mi · Dickson Cty, PA · Urgent care center
Lake Scranton Urgent Care LLC24 mi · Scranton, PA · Urgent care center

Pharmacies

Wal-Mart Stores East LP2.8 mi · Honesdale, PA · Community/retail pharmacy
Wayne Memorial Hospital2.8 mi · Honesdale, PA · Pharmacy

Assisted living nearby

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

Bethany Village Senior Living Community2.8 mi · Bethany, PA
Forest City Personal Care13 mi · Forest City, PA

About the Medicare star rating

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

Medicare quality data

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

What patients said (patient survey)

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

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	1 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	60%National average: 72%
Would definitely recommend the hospital	56%National average: 71%
Nurses “always” communicated well	74%National average: 80%
Doctors “always” communicated well	73%National average: 80%
Staff “always” explained medicines before giving them	50%National average: 62%
Were given information about recovery at home	91%National average: 86%
Room and bathroom “always” clean	77%National average: 74%
Area around the room “always” quiet at night	54%National average: 60%
Completed surveys	298Response rate: 26%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	0No different from the national benchmark
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.461No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	12.3%
Deaths within 30 days: heart failure patients	11.5%
Deaths within 30 days: pneumonia patients	21.6%
Deaths within 30 days: COPD patients	10.7%
Deaths within 30 days: stroke patients	13.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.09No different from the national rate
Complications after hip or knee replacement	Too few cases to report

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.4%
Readmitted within 30 days: heart failure	20.4%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	19.5%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too few cases to report

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Medium (20,000–39,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	212 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	42%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in Pennsylvania Best hospitals in Pennsylvania

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 61 common services exactly as Wayne Memorial Hospital 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 →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL THREE ED	$721	$504.70	$288.40 – $576.80
Emergency room visit (moderate): 10 of 17 insurance plan rates AETNA — AETNA: $540.75 Ambetter — AMBETTER: $307.65 BLUE CROSS — BLUE CROSS: $288.40 CIGNA — CIGNA: $504.70 GEISINGER — GEISINGER: $497.49 HUMANA — HUMANA: $293.14 KeyStone First — KEYSTONE FIRST: $288.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $290.24 MultiPlan — MULTIPLAN: $576.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $307.65
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL THREE ED PC	$221	$154.70	$88.40 – $176.80
Emergency room visit (moderate): 10 of 16 insurance plan rates AETNA — AETNA: $165.75 Ambetter — AMBETTER: $307.65 BLUE CROSS — BLUE CROSS: $88.40 CIGNA — CIGNA: $154.70 GEISINGER — GEISINGER: $152.49 HUMANA — HUMANA: $293.14 KeyStone First — KEYSTONE FIRST: $88.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $290.24 MultiPlan — MULTIPLAN: $176.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $307.65
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEVEL THREE ED	$721	$504.70	$288.40 – $576.80
Emergency room visit (moderate): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $288.40 MultiPlan — MULTIPLAN: $576.80 PHCS — PHCS: $504.70 SELF-PAY — SELF-PAY: $504.70
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL FOUR ED	$1,131	$791.70	$452.40 – $904.80
Emergency room visit (moderately high): 10 of 17 insurance plan rates AETNA — AETNA: $848.25 Ambetter — AMBETTER: $470.26 BLUE CROSS — BLUE CROSS: $452.40 CIGNA — CIGNA: $791.70 GEISINGER — GEISINGER: $780.39 HUMANA — HUMANA: $448.08 KeyStone First — KEYSTONE FIRST: $452.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $443.64 MultiPlan — MULTIPLAN: $904.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $470.26
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL FOUR ED PC	$371	$259.70	$148.40 – $296.80
Emergency room visit (moderately high): 10 of 16 insurance plan rates AETNA — AETNA: $278.25 Ambetter — AMBETTER: $470.26 BLUE CROSS — BLUE CROSS: $148.40 CIGNA — CIGNA: $259.70 GEISINGER — GEISINGER: $255.99 HUMANA — HUMANA: $448.08 KeyStone First — KEYSTONE FIRST: $148.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $443.64 MultiPlan — MULTIPLAN: $296.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $470.26
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEVEL FOUR ED	$1,131	$791.70	$452.40 – $904.80
Emergency room visit (moderately high): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $452.40 MultiPlan — MULTIPLAN: $904.80 PHCS — PHCS: $791.70 SELF-PAY — SELF-PAY: $791.70
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL FIVE ED	$1,624	$1,136.80	$649.60 – $1,299.20
Emergency room visit (high): 10 of 17 insurance plan rates AETNA — AETNA: $1,218 Ambetter — AMBETTER: $671.17 BLUE CROSS — BLUE CROSS: $649.60 CIGNA — CIGNA: $1,136.80 GEISINGER — GEISINGER: $1,120.56 HUMANA — HUMANA: $639.51 KeyStone First — KEYSTONE FIRST: $649.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $633.18 MultiPlan — MULTIPLAN: $1,299.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $671.17
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEVEL FIVE ED PC	$540	$378	$216 – $432
Emergency room visit (high): 10 of 16 insurance plan rates AETNA — AETNA: $405 Ambetter — AMBETTER: $671.17 BLUE CROSS — BLUE CROSS: $216 CIGNA — CIGNA: $378 GEISINGER — GEISINGER: $372.60 HUMANA — HUMANA: $639.51 KeyStone First — KEYSTONE FIRST: $216 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $633.18 MultiPlan — MULTIPLAN: $432 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $671.17
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LEVEL FIVE ED	$1,624	$1,136.80	$649.60 – $1,299.20
Emergency room visit (high): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $649.60 MultiPlan — MULTIPLAN: $1,299.20 PHCS — PHCS: $1,136.80 SELF-PAY — SELF-PAY: $1,136.80

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$203	$142.10	$8.46 – $162.40
Basic metabolic panel (blood test): 10 of 16 insurance plan rates AETNA — AETNA: $152.25 Ambetter — AMBETTER: $8.97 BLUE CROSS — BLUE CROSS: $81.20 CIGNA — CIGNA: $142.10 GEISINGER — GEISINGER: $140.07 HUMANA — HUMANA: $8.54 KeyStone First — KEYSTONE FIRST: $81.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $8.46 MultiPlan — MULTIPLAN: $162.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $8.97
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$203	$142.10	$81.20 – $162.40
Basic metabolic panel (blood test): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $81.20 MultiPlan — MULTIPLAN: $162.40 PHCS — PHCS: $142.10 SELF-PAY — SELF-PAY: $142.10
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$331	$231.70	$10.56 – $264.80
Comprehensive metabolic panel (blood test): 10 of 16 insurance plan rates AETNA — AETNA: $248.25 Ambetter — AMBETTER: $11.19 BLUE CROSS — BLUE CROSS: $132.40 CIGNA — CIGNA: $231.70 GEISINGER — GEISINGER: $228.39 HUMANA — HUMANA: $10.67 KeyStone First — KEYSTONE FIRST: $132.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $10.56 MultiPlan — MULTIPLAN: $264.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $11.19
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$331	$231.70	$132.40 – $264.80
Comprehensive metabolic panel (blood test): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $132.40 MultiPlan — MULTIPLAN: $264.80 PHCS — PHCS: $231.70 SELF-PAY — SELF-PAY: $231.70
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PROFILE	$245	$171.50	$13.39 – $196
Cholesterol panel (lipid panel): 10 of 16 insurance plan rates AETNA — AETNA: $183.75 Ambetter — AMBETTER: $14.19 BLUE CROSS — BLUE CROSS: $98 CIGNA — CIGNA: $171.50 GEISINGER — GEISINGER: $169.05 HUMANA — HUMANA: $13.52 KeyStone First — KEYSTONE FIRST: $98 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $13.39 MultiPlan — MULTIPLAN: $196 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $14.19
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PROFILE	$245	$171.50	$98 – $196
Cholesterol panel (lipid panel): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $98 MultiPlan — MULTIPLAN: $196 PHCS — PHCS: $171.50 SELF-PAY — SELF-PAY: $171.50
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$208	$145.60	$8.68 – $166.40
Kidney function panel: 10 of 16 insurance plan rates AETNA — AETNA: $156 Ambetter — AMBETTER: $9.20 BLUE CROSS — BLUE CROSS: $83.20 CIGNA — CIGNA: $145.60 GEISINGER — GEISINGER: $143.52 HUMANA — HUMANA: $8.77 KeyStone First — KEYSTONE FIRST: $83.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $8.68 MultiPlan — MULTIPLAN: $166.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $9.20
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$208	$145.60	$83.20 – $166.40
Kidney function panel: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $83.20 MultiPlan — MULTIPLAN: $166.40 PHCS — PHCS: $145.60 SELF-PAY — SELF-PAY: $145.60
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$196	$137.20	$8.17 – $156.80
Liver function panel: 10 of 16 insurance plan rates AETNA — AETNA: $147 Ambetter — AMBETTER: $8.66 BLUE CROSS — BLUE CROSS: $78.40 CIGNA — CIGNA: $137.20 GEISINGER — GEISINGER: $135.24 HUMANA — HUMANA: $8.25 KeyStone First — KEYSTONE FIRST: $78.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $8.17 MultiPlan — MULTIPLAN: $156.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $8.66
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$196	$137.20	$78.40 – $156.80
Liver function panel: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $78.40 MultiPlan — MULTIPLAN: $156.80 PHCS — PHCS: $137.20 SELF-PAY — SELF-PAY: $137.20
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS-ROUTINE	$62	$43.40	$3.17 – $49.60
Urine test (automated, with microscope): 10 of 16 insurance plan rates AETNA — AETNA: $46.50 Ambetter — AMBETTER: $3.36 BLUE CROSS — BLUE CROSS: $24.80 CIGNA — CIGNA: $43.40 GEISINGER — GEISINGER: $42.78 HUMANA — HUMANA: $3.20 KeyStone First — KEYSTONE FIRST: $24.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3.17 MultiPlan — MULTIPLAN: $49.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3.36
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS-ROUTINE	$62	$43.40	$24.80 – $49.60
Urine test (automated, with microscope): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $24.80 MultiPlan — MULTIPLAN: $49.60 PHCS — PHCS: $43.40 SELF-PAY — SELF-PAY: $43.40
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINE DIPSTICK ONLY	$38	$26.60	$3.48 – $30.40
Urine test (manual, without microscope): 10 of 16 insurance plan rates AETNA — AETNA: $28.50 Ambetter — AMBETTER: $3.69 BLUE CROSS — BLUE CROSS: $15.20 CIGNA — CIGNA: $26.60 GEISINGER — GEISINGER: $26.22 HUMANA — HUMANA: $3.51 KeyStone First — KEYSTONE FIRST: $15.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3.48 MultiPlan — MULTIPLAN: $30.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3.69
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY URINE (NON-AU	$38	$26.60	$3.48 – $30.40
Urine test (manual, without microscope): 10 of 16 insurance plan rates AETNA — AETNA: $28.50 Ambetter — AMBETTER: $3.69 BLUE CROSS — BLUE CROSS: $15.20 CIGNA — CIGNA: $26.60 GEISINGER — GEISINGER: $26.22 HUMANA — HUMANA: $3.51 KeyStone First — KEYSTONE FIRST: $15.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3.48 MultiPlan — MULTIPLAN: $30.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3.69
Urine test (manual, without microscope) CPT 81002 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINE DIPSTICK ONLY	$38	$26.60	$15.20 – $30.40
Urine test (manual, without microscope): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $15.20 MultiPlan — MULTIPLAN: $30.40 PHCS — PHCS: $26.60 SELF-PAY — SELF-PAY: $26.60
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O MICROSCOPY	$48	$33.60	$2.25 – $38.40
Urine test (automated, without microscope): 10 of 16 insurance plan rates AETNA — AETNA: $36 Ambetter — AMBETTER: $2.39 BLUE CROSS — BLUE CROSS: $19.20 CIGNA — CIGNA: $33.60 GEISINGER — GEISINGER: $33.12 HUMANA — HUMANA: $2.27 KeyStone First — KEYSTONE FIRST: $19.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $2.25 MultiPlan — MULTIPLAN: $38.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $2.39
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O MICROSCOPY	$48	$33.60	$19.20 – $38.40
Urine test (automated, without microscope): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $19.20 MultiPlan — MULTIPLAN: $38.40 PHCS — PHCS: $33.60 SELF-PAY — SELF-PAY: $33.60
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA, TOTAL	$322	$225.40	$18.39 – $257.60
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates AETNA — AETNA: $241.50 Ambetter — AMBETTER: $19.49 BLUE CROSS — BLUE CROSS: $128.80 CIGNA — CIGNA: $225.40 GEISINGER — GEISINGER: $222.18 HUMANA — HUMANA: $18.57 KeyStone First — KEYSTONE FIRST: $128.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $18.39 MultiPlan — MULTIPLAN: $257.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $19.49
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA HYPERSENSITIVE	$322	$225.40	$18.39 – $257.60
PSA (prostate specific antigen) blood test: 10 of 16 insurance plan rates AETNA — AETNA: $241.50 Ambetter — AMBETTER: $19.49 BLUE CROSS — BLUE CROSS: $128.80 CIGNA — CIGNA: $225.40 GEISINGER — GEISINGER: $222.18 HUMANA — HUMANA: $18.57 KeyStone First — KEYSTONE FIRST: $128.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $18.39 MultiPlan — MULTIPLAN: $257.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $19.49
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROSTATIC SP ANTIGEN TOTAL	$322	$225.40	$18.39 – $257.60
PSA (prostate specific antigen) blood test: 10 of 16 insurance plan rates AETNA — AETNA: $241.50 Ambetter — AMBETTER: $19.49 BLUE CROSS — BLUE CROSS: $128.80 CIGNA — CIGNA: $225.40 GEISINGER — GEISINGER: $222.18 HUMANA — HUMANA: $18.57 KeyStone First — KEYSTONE FIRST: $128.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $18.39 MultiPlan — MULTIPLAN: $257.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $19.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SNSCREEN TSH	$48	$33.60	$16.80 – $38.40
Thyroid stimulating hormone (TSH) test: 10 of 16 insurance plan rates AETNA — AETNA: $36 Ambetter — AMBETTER: $17.81 BLUE CROSS — BLUE CROSS: $19.20 CIGNA — CIGNA: $33.60 GEISINGER — GEISINGER: $33.12 HUMANA — HUMANA: $16.97 KeyStone First — KEYSTONE FIRST: $19.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $16.80 MultiPlan — MULTIPLAN: $38.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $17.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$224	$156.80	$16.80 – $179.20
Thyroid stimulating hormone (TSH) test: 10 of 16 insurance plan rates AETNA — AETNA: $168 Ambetter — AMBETTER: $17.81 BLUE CROSS — BLUE CROSS: $89.60 CIGNA — CIGNA: $156.80 GEISINGER — GEISINGER: $154.56 HUMANA — HUMANA: $16.97 KeyStone First — KEYSTONE FIRST: $89.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $16.80 MultiPlan — MULTIPLAN: $179.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $17.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SNSCREEN TSH	$48	$33.60	$19.20 – $38.40
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $19.20 MultiPlan — MULTIPLAN: $38.40 PHCS — PHCS: $33.60 SELF-PAY — SELF-PAY: $33.60
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC &PLT	$86	$60.20	$7.77 – $68.80
Complete blood count (CBC) with differential: 10 of 16 insurance plan rates AETNA — AETNA: $64.50 Ambetter — AMBETTER: $8.24 BLUE CROSS — BLUE CROSS: $34.40 CIGNA — CIGNA: $60.20 GEISINGER — GEISINGER: $59.34 HUMANA — HUMANA: $7.85 KeyStone First — KEYSTONE FIRST: $34.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $7.77 MultiPlan — MULTIPLAN: $68.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $8.24
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC &PLT	$86	$60.20	$34.40 – $68.80
Complete blood count (CBC) with differential: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $34.40 MultiPlan — MULTIPLAN: $68.80 PHCS — PHCS: $60.20 SELF-PAY — SELF-PAY: $60.20
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC(WITHOUT DIFF)	$48	$33.60	$6.47 – $38.40
Complete blood count (CBC), automated: 10 of 16 insurance plan rates AETNA — AETNA: $36 Ambetter — AMBETTER: $6.86 BLUE CROSS — BLUE CROSS: $19.20 CIGNA — CIGNA: $33.60 GEISINGER — GEISINGER: $33.12 HUMANA — HUMANA: $6.53 KeyStone First — KEYSTONE FIRST: $19.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $6.47 MultiPlan — MULTIPLAN: $38.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $6.86
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC(WITHOUT DIFF)	$48	$33.60	$19.20 – $38.40
Complete blood count (CBC), automated: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $19.20 MultiPlan — MULTIPLAN: $38.40 PHCS — PHCS: $33.60 SELF-PAY — SELF-PAY: $33.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUPUS COMPREHENSIVE PROTIME	$31	$21.70	$4.29 – $24.80
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates AETNA — AETNA: $23.25 Ambetter — AMBETTER: $4.55 BLUE CROSS — BLUE CROSS: $12.40 CIGNA — CIGNA: $21.70 GEISINGER — GEISINGER: $21.39 HUMANA — HUMANA: $4.33 KeyStone First — KEYSTONE FIRST: $12.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $4.29 MultiPlan — MULTIPLAN: $24.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $4.55
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$60	$42	$4.29 – $48
Blood clotting time test (prothrombin time, PT): 10 of 16 insurance plan rates AETNA — AETNA: $45 Ambetter — AMBETTER: $4.55 BLUE CROSS — BLUE CROSS: $24 CIGNA — CIGNA: $42 GEISINGER — GEISINGER: $41.40 HUMANA — HUMANA: $4.33 KeyStone First — KEYSTONE FIRST: $24 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $4.29 MultiPlan — MULTIPLAN: $48 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $4.55
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT WITH HEPARIN NEUTRAL.	$419	$293.30	$4.29 – $335.20
Blood clotting time test (prothrombin time, PT): 10 of 16 insurance plan rates AETNA — AETNA: $314.25 Ambetter — AMBETTER: $4.55 BLUE CROSS — BLUE CROSS: $167.60 CIGNA — CIGNA: $293.30 GEISINGER — GEISINGER: $289.11 HUMANA — HUMANA: $4.33 KeyStone First — KEYSTONE FIRST: $167.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $4.29 MultiPlan — MULTIPLAN: $335.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $4.55
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT	$36	$25.20	$6.01 – $28.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates AETNA — AETNA: $27 Ambetter — AMBETTER: $6.37 BLUE CROSS — BLUE CROSS: $14.40 CIGNA — CIGNA: $25.20 GEISINGER — GEISINGER: $24.84 HUMANA — HUMANA: $6.07 KeyStone First — KEYSTONE FIRST: $14.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $6.01 MultiPlan — MULTIPLAN: $28.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $6.37
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT, PLASMA	$36	$25.20	$6.01 – $28.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates AETNA — AETNA: $27 Ambetter — AMBETTER: $6.37 BLUE CROSS — BLUE CROSS: $14.40 CIGNA — CIGNA: $25.20 GEISINGER — GEISINGER: $24.84 HUMANA — HUMANA: $6.07 KeyStone First — KEYSTONE FIRST: $14.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $6.01 MultiPlan — MULTIPLAN: $28.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $6.37
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUPUS COMP APTT	$41	$28.70	$6.01 – $32.80
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates AETNA — AETNA: $30.75 Ambetter — AMBETTER: $6.37 BLUE CROSS — BLUE CROSS: $16.40 CIGNA — CIGNA: $28.70 GEISINGER — GEISINGER: $28.29 HUMANA — HUMANA: $6.07 KeyStone First — KEYSTONE FIRST: $16.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $6.01 MultiPlan — MULTIPLAN: $32.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $6.37

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD W/O CONTRAST	$4,044	$2,830.80	$1,617.60 – $3,235.20
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates AETNA — AETNA: $3,033 Ambetter — AMBETTER: $117.83 BLUE CROSS — BLUE CROSS: $1,617.60 CIGNA — CIGNA: $2,830.80 GEISINGER — GEISINGER: $2,790.36 HUMANA — HUMANA: $112.27 KeyStone First — KEYSTONE FIRST: $1,617.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $111.16 MultiPlan — MULTIPLAN: $3,235.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $117.83
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT HEAD W/O CONTRAST	$4,044	$2,830.80	$1,617.60 – $3,235.20
CT scan of the head or brain, without contrast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,617.60 MultiPlan — MULTIPLAN: $3,235.20 PHCS — PHCS: $2,830.80 SELF-PAY — SELF-PAY: $2,830.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN COMBINED	$5,495	$3,846.50	$2,198 – $4,396
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates AETNA — AETNA: $4,121.25 Ambetter — AMBETTER: $393.19 BLUE CROSS — BLUE CROSS: $2,198 CIGNA — CIGNA: $3,846.50 GEISINGER — GEISINGER: $3,791.55 HUMANA — HUMANA: $374.64 KeyStone First — KEYSTONE FIRST: $2,198 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $370.93 MultiPlan — MULTIPLAN: $4,396 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $393.19
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI BRAIN COMBINED	$5,495	$3,846.50	$2,198 – $4,396
MRI of the brain, before and after contrast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $2,198 MultiPlan — MULTIPLAN: $4,396 PHCS — PHCS: $3,846.50 SELF-PAY — SELF-PAY: $3,846.50
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CHEST AP & LATERAL X-RAY	$453	$317.10	$181.20 – $362.40
Chest X-ray, 2 views: 10 of 17 insurance plan rates AETNA — AETNA: $339.75 Ambetter — AMBETTER: $98.08 BLUE CROSS — BLUE CROSS: $181.20 CIGNA — CIGNA: $317.10 GEISINGER — GEISINGER: $312.57 HUMANA — HUMANA: $93.46 KeyStone First — KEYSTONE FIRST: $181.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $92.53 MultiPlan — MULTIPLAN: $362.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $98.08
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CHEST AP & LATERAL X-RAY	$453	$317.10	$181.20 – $362.40
Chest X-ray, 2 views: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $181.20 MultiPlan — MULTIPLAN: $362.40 PHCS — PHCS: $317.10 SELF-PAY — SELF-PAY: $317.10
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPINE LUMBAR COMPLETE	$940	$658	$376 – $752
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates AETNA — AETNA: $705 Ambetter — AMBETTER: $117.83 BLUE CROSS — BLUE CROSS: $376 CIGNA — CIGNA: $658 GEISINGER — GEISINGER: $648.60 HUMANA — HUMANA: $112.27 KeyStone First — KEYSTONE FIRST: $376 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $111.16 MultiPlan — MULTIPLAN: $752 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $117.83
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINE LUMBAR COMPLETE	$940	$658	$376 – $752
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $376 MultiPlan — MULTIPLAN: $752 PHCS — PHCS: $658 SELF-PAY — SELF-PAY: $658
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI L-SPINE W/O CONTRAST	$4,339	$3,037.30	$1,735.60 – $3,471.20
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates AETNA — AETNA: $3,254.25 Ambetter — AMBETTER: $268.91 BLUE CROSS — BLUE CROSS: $1,735.60 CIGNA — CIGNA: $3,037.30 GEISINGER — GEISINGER: $2,993.91 HUMANA — HUMANA: $256.23 KeyStone First — KEYSTONE FIRST: $1,735.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $253.69 MultiPlan — MULTIPLAN: $3,471.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $268.91
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI L-SPINE W/O CONTRAST	$4,339	$3,037.30	$1,735.60 – $3,471.20
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,735.60 MultiPlan — MULTIPLAN: $3,471.20 PHCS — PHCS: $3,037.30 SELF-PAY — SELF-PAY: $3,037.30
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST	$5,714	$3,999.80	$2,285.60 – $4,571.20
CT scan of the pelvis, with contrast: 10 of 17 insurance plan rates AETNA — AETNA: $4,285.50 Ambetter — AMBETTER: $197.68 BLUE CROSS — BLUE CROSS: $2,285.60 CIGNA — CIGNA: $3,999.80 GEISINGER — GEISINGER: $3,942.66 HUMANA — HUMANA: $188.35 KeyStone First — KEYSTONE FIRST: $2,285.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $186.49 MultiPlan — MULTIPLAN: $4,571.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $197.68
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT PELVIS W/CONTRAST	$5,714	$3,999.80	$2,285.60 – $4,571.20
CT scan of the pelvis, with contrast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $2,285.60 MultiPlan — MULTIPLAN: $4,571.20 PHCS — PHCS: $3,999.80 SELF-PAY — SELF-PAY: $3,999.80
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LOWER EXTREMITY JOINT W/O	$4,339	$3,037.30	$1,735.60 – $3,471.20
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates AETNA — AETNA: $3,254.25 Ambetter — AMBETTER: $268.91 BLUE CROSS — BLUE CROSS: $1,735.60 CIGNA — CIGNA: $3,037.30 GEISINGER — GEISINGER: $2,993.91 HUMANA — HUMANA: $256.23 KeyStone First — KEYSTONE FIRST: $1,735.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $253.69 MultiPlan — MULTIPLAN: $3,471.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $268.91
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MRI LOWER EXTREMITY JOINT W/O	$4,339	$3,037.30	$1,735.60 – $3,471.20
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,735.60 MultiPlan — MULTIPLAN: $3,471.20 PHCS — PHCS: $3,037.30 SELF-PAY — SELF-PAY: $3,037.30
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD/PELVIS W/CONTRAST	$8,159	$5,711.30	$3,263.60 – $6,527.20
CT scan of the abdomen and pelvis, with contrast: 10 of 17 insurance plan rates AETNA — AETNA: $6,119.25 Ambetter — AMBETTER: $393.19 BLUE CROSS — BLUE CROSS: $3,263.60 CIGNA — CIGNA: $5,711.30 GEISINGER — GEISINGER: $5,629.71 HUMANA — HUMANA: $374.64 KeyStone First — KEYSTONE FIRST: $3,263.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $370.93 MultiPlan — MULTIPLAN: $6,527.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $393.19
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT ABD/PELVIS W/CONTRAST	$8,159	$5,711.30	$3,263.60 – $6,527.20
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $3,263.60 MultiPlan — MULTIPLAN: $6,527.20 PHCS — PHCS: $5,711.30 SELF-PAY — SELF-PAY: $5,711.30
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN	$1,706	$1,194.20	$682.40 – $1,364.80
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates AETNA — AETNA: $1,279.50 Ambetter — AMBETTER: $117.83 BLUE CROSS — BLUE CROSS: $682.40 CIGNA — CIGNA: $1,194.20 GEISINGER — GEISINGER: $1,177.14 HUMANA — HUMANA: $112.27 KeyStone First — KEYSTONE FIRST: $682.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $111.16 MultiPlan — MULTIPLAN: $1,364.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $117.83
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US ABDOMEN	$1,706	$1,194.20	$682.40 – $1,364.80
Ultrasound of the abdomen, complete: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $682.40 MultiPlan — MULTIPLAN: $1,364.80 PHCS — PHCS: $1,194.20 SELF-PAY — SELF-PAY: $1,194.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PELVIC PREGNANCY	$1,800	$1,260	$720 – $1,440
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates AETNA — AETNA: $1,350 Ambetter — AMBETTER: $117.83 BLUE CROSS — BLUE CROSS: $720 CIGNA — CIGNA: $1,260 GEISINGER — GEISINGER: $1,242 HUMANA — HUMANA: $112.27 KeyStone First — KEYSTONE FIRST: $720 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $111.16 MultiPlan — MULTIPLAN: $1,440 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $117.83
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG >=14 WKS TRANSABD SGL	$455	$318.50	$182 – $364
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates AETNA — AETNA: $341.25 Ambetter — AMBETTER: $117.83 BLUE CROSS — BLUE CROSS: $182 CIGNA — CIGNA: $318.50 GEISINGER — GEISINGER: $313.95 HUMANA — HUMANA: $112.27 KeyStone First — KEYSTONE FIRST: $182 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $111.16 MultiPlan — MULTIPLAN: $364 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $117.83
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PELVIC PREGNANCY	$1,800	$1,260	$720 – $1,440
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $720 MultiPlan — MULTIPLAN: $1,440 PHCS — PHCS: $1,260 SELF-PAY — SELF-PAY: $1,260
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL ULTRASOUND NON-OB	$1,500	$1,050	$600 – $1,200
Transvaginal ultrasound: 10 of 17 insurance plan rates AETNA — AETNA: $1,125 Ambetter — AMBETTER: $117.83 BLUE CROSS — BLUE CROSS: $600 CIGNA — CIGNA: $1,050 GEISINGER — GEISINGER: $1,035 HUMANA — HUMANA: $112.27 KeyStone First — KEYSTONE FIRST: $600 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $111.16 MultiPlan — MULTIPLAN: $1,200 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $117.83
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: TRANSVAGINAL ULTRASOUND NON-OB	$1,500	$1,050	$600 – $1,200
Transvaginal ultrasound: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $600 MultiPlan — MULTIPLAN: $1,200 PHCS — PHCS: $1,050 SELF-PAY — SELF-PAY: $1,050
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIAG UNILAT INC CAD	$493	$345.10	$79.12 – $394.40
Diagnostic mammogram, one breast: 10 of 17 insurance plan rates AETNA — AETNA: $369.75 Ambetter — AMBETTER: $83.87 BLUE CROSS — BLUE CROSS: $197.20 CIGNA — CIGNA: $345.10 GEISINGER — GEISINGER: $340.17 HUMANA — HUMANA: $79.91 KeyStone First — KEYSTONE FIRST: $197.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $79.12 MultiPlan — MULTIPLAN: $394.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $83.87
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIAG UNILAT INC CAD	$493	$345.10	$197.20 – $394.40
Diagnostic mammogram, one breast: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $197.20 MultiPlan — MULTIPLAN: $394.40 PHCS — PHCS: $345.10 SELF-PAY — SELF-PAY: $345.10
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO DIAGNOSTIC BILAT INC CAD	$493	$345.10	$101.51 – $394.40
Diagnostic mammogram, both breasts: 10 of 17 insurance plan rates AETNA — AETNA: $369.75 Ambetter — AMBETTER: $107.60 BLUE CROSS — BLUE CROSS: $197.20 CIGNA — CIGNA: $345.10 GEISINGER — GEISINGER: $340.17 HUMANA — HUMANA: $102.53 KeyStone First — KEYSTONE FIRST: $197.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $101.51 MultiPlan — MULTIPLAN: $394.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $107.60
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO DIAGNOSTIC BILAT INC CAD	$493	$345.10	$197.20 – $394.40
Diagnostic mammogram, both breasts: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $197.20 MultiPlan — MULTIPLAN: $394.40 PHCS — PHCS: $345.10 SELF-PAY — SELF-PAY: $345.10
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO SCREENING BILAT INC CAD	$493	$345.10	$83.72 – $394.40
Screening mammogram, both breasts: 10 of 17 insurance plan rates AETNA — AETNA: $369.75 Ambetter — AMBETTER: $88.74 BLUE CROSS — BLUE CROSS: $197.20 CIGNA — CIGNA: $345.10 GEISINGER — GEISINGER: $340.17 HUMANA — HUMANA: $84.56 KeyStone First — KEYSTONE FIRST: $197.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $83.72 MultiPlan — MULTIPLAN: $394.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $88.74
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MAMMO SCREENING UNILAT INC CAD	$493	$345.10	$83.72 – $394.40
Screening mammogram, both breasts: 10 of 17 insurance plan rates AETNA — AETNA: $369.75 Ambetter — AMBETTER: $88.74 BLUE CROSS — BLUE CROSS: $197.20 CIGNA — CIGNA: $345.10 GEISINGER — GEISINGER: $340.17 HUMANA — HUMANA: $84.56 KeyStone First — KEYSTONE FIRST: $197.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $83.72 MultiPlan — MULTIPLAN: $394.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $88.74
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAMMO SCREENING BILAT INC CAD	$493	$345.10	$197.20 – $394.40
Screening mammogram, both breasts: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $197.20 MultiPlan — MULTIPLAN: $394.40 PHCS — PHCS: $345.10 SELF-PAY — SELF-PAY: $345.10

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LV GRAM ONLY	$26,228	$18,359.60	$10,491.20 – $20,982.40
Left heart catheterization (diagnostic): 10 of 17 insurance plan rates AETNA — AETNA: $19,671 Ambetter — AMBETTER: $3,653.72 BLUE CROSS — BLUE CROSS: $10,491.20 CIGNA — CIGNA: $18,359.60 GEISINGER — GEISINGER: $18,097.32 HUMANA — HUMANA: $3,481.38 KeyStone First — KEYSTONE FIRST: $10,491.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3,446.91 MultiPlan — MULTIPLAN: $20,982.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3,653.72
Left heart catheterization (diagnostic) CPT 93452 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LV GRAM ONLY	$26,228	$18,359.60	$10,491.20 – $20,982.40
Left heart catheterization (diagnostic): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $10,491.20 MultiPlan — MULTIPLAN: $20,982.40 PHCS — PHCS: $18,359.60 SELF-PAY — SELF-PAY: $18,359.60
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP POLYSOMNOGRAPHY 4 OR MOR	$3,654	$2,557.80	$1,461.60 – $2,923.20
Sleep study (overnight, in a sleep lab): 10 of 17 insurance plan rates AETNA — AETNA: $2,740.50 Ambetter — AMBETTER: $967.82 BLUE CROSS — BLUE CROSS: $1,461.60 CIGNA — CIGNA: $2,557.80 GEISINGER — GEISINGER: $2,521.26 HUMANA — HUMANA: $922.17 KeyStone First — KEYSTONE FIRST: $1,461.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $913.04 MultiPlan — MULTIPLAN: $2,923.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $967.82
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SLEEP POLYSOMNOGRAPHY 4 OR MOR	$3,654	$2,557.80	$1,461.60 – $2,923.20
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,461.60 MultiPlan — MULTIPLAN: $2,923.20 PHCS — PHCS: $2,557.80 SELF-PAY — SELF-PAY: $2,557.80

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPEUTIC EXERCISES	$122	$85.40	$27.92 – $97.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates AETNA — AETNA: $91.50 Ambetter — AMBETTER: $29.60 BLUE CROSS — BLUE CROSS: $48.80 CIGNA — CIGNA: $85.40 GEISINGER — GEISINGER: $84.18 HUMANA — HUMANA: $28.20 KeyStone First — KEYSTONE FIRST: $48.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $27.92 MultiPlan — MULTIPLAN: $97.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $29.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: RANGE OF MOTION	$122	$85.40	$27.92 – $97.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 17 insurance plan rates AETNA — AETNA: $91.50 Ambetter — AMBETTER: $29.60 BLUE CROSS — BLUE CROSS: $48.80 CIGNA — CIGNA: $85.40 GEISINGER — GEISINGER: $84.18 HUMANA — HUMANA: $28.20 KeyStone First — KEYSTONE FIRST: $48.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $27.92 MultiPlan — MULTIPLAN: $97.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $29.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: RANGE OF MOTION	$122	$85.40	$27.92 – $97.60
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates AETNA — AETNA: $91.50 Ambetter — AMBETTER: $29.60 BLUE CROSS — BLUE CROSS: $48.80 CIGNA — CIGNA: $85.40 GEISINGER — GEISINGER: $84.18 HUMANA — HUMANA: $28.20 KeyStone First — KEYSTONE FIRST: $48.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $27.92 MultiPlan — MULTIPLAN: $97.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $29.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEXITY	$493	$345.10	$94.07 – $394.40
Physical therapy evaluation (low complexity): 10 of 17 insurance plan rates AETNA — AETNA: $369.75 Ambetter — AMBETTER: $99.71 BLUE CROSS — BLUE CROSS: $197.20 CIGNA — CIGNA: $345.10 GEISINGER — GEISINGER: $340.17 HUMANA — HUMANA: $95.01 KeyStone First — KEYSTONE FIRST: $197.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $94.07 MultiPlan — MULTIPLAN: $394.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $99.71
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEXITY	$493	$345.10	$197.20 – $394.40
Physical therapy evaluation (low complexity): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $197.20 MultiPlan — MULTIPLAN: $394.40 PHCS — PHCS: $345.10 SELF-PAY — SELF-PAY: $345.10
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MODERATE COMPLEXITY	$573	$401.10	$94.07 – $458.40
Physical therapy evaluation (moderate complexity): 10 of 17 insurance plan rates AETNA — AETNA: $429.75 Ambetter — AMBETTER: $99.71 BLUE CROSS — BLUE CROSS: $229.20 CIGNA — CIGNA: $401.10 GEISINGER — GEISINGER: $395.37 HUMANA — HUMANA: $95.01 KeyStone First — KEYSTONE FIRST: $229.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $94.07 MultiPlan — MULTIPLAN: $458.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $99.71
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MODERATE COMPLEXITY	$573	$401.10	$229.20 – $458.40
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $229.20 MultiPlan — MULTIPLAN: $458.40 PHCS — PHCS: $401.10 SELF-PAY — SELF-PAY: $401.10
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEXITY	$655	$458.50	$94.07 – $524
Physical therapy evaluation (high complexity): 10 of 17 insurance plan rates AETNA — AETNA: $491.25 Ambetter — AMBETTER: $99.71 BLUE CROSS — BLUE CROSS: $262 CIGNA — CIGNA: $458.50 GEISINGER — GEISINGER: $451.95 HUMANA — HUMANA: $95.01 KeyStone First — KEYSTONE FIRST: $262 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $94.07 MultiPlan — MULTIPLAN: $524 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $99.71
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEXITY	$655	$458.50	$262 – $524
Physical therapy evaluation (high complexity): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $262 MultiPlan — MULTIPLAN: $524 PHCS — PHCS: $458.50 SELF-PAY — SELF-PAY: $458.50

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR EXC CYST/LESN BREAST	$9,902	$6,931.40	$3,960.80 – $7,921.60
Removal of breast growth (open surgery): 10 of 17 insurance plan rates AETNA — AETNA: $7,426.50 Ambetter — AMBETTER: $4,412.77 BLUE CROSS — BLUE CROSS: $3,960.80 CIGNA — CIGNA: $6,931.40 GEISINGER — GEISINGER: $6,832.38 HUMANA — HUMANA: $4,204.62 KeyStone First — KEYSTONE FIRST: $3,960.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $4,162.99 MultiPlan — MULTIPLAN: $7,921.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $4,412.77
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR EXC CYST/LESN BREAST	$9,902	$6,931.40	$3,960.80 – $7,921.60
Removal of breast growth (open surgery): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $3,960.80 MultiPlan — MULTIPLAN: $7,921.60 PHCS — PHCS: $6,931.40 SELF-PAY — SELF-PAY: $6,931.40
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR TOTAL HIP ARTHROPLASTY	$33,275	$23,292.50	$13,310 – $26,620
Total hip replacement: 10 of 17 insurance plan rates AETNA — AETNA: $24,956.25 Ambetter — AMBETTER: $14,469.45 BLUE CROSS — BLUE CROSS: $13,310 CIGNA — CIGNA: $23,292.50 GEISINGER — GEISINGER: $22,959.75 HUMANA — HUMANA: $13,786.92 KeyStone First — KEYSTONE FIRST: $13,310 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $13,650.42 MultiPlan — MULTIPLAN: $26,620 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $14,469.45
Total hip replacement CPT 27130 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR TOTAL HIP ARTHROPLASTY	$33,275	$23,292.50	$13,310 – $26,620
Total hip replacement: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $13,310 MultiPlan — MULTIPLAN: $26,620 PHCS — PHCS: $23,292.50 SELF-PAY — SELF-PAY: $23,292.50
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR TOTAL KNEE ARTHROPLASTY	$33,275	$23,292.50	$13,310 – $26,620
Total knee replacement: 10 of 17 insurance plan rates AETNA — AETNA: $24,956.25 Ambetter — AMBETTER: $14,469.45 BLUE CROSS — BLUE CROSS: $13,310 CIGNA — CIGNA: $23,292.50 GEISINGER — GEISINGER: $22,959.75 HUMANA — HUMANA: $13,786.92 KeyStone First — KEYSTONE FIRST: $13,310 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $13,650.42 MultiPlan — MULTIPLAN: $26,620 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $14,469.45
Total knee replacement CPT 27447 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR TOTAL KNEE ARTHROPLASTY	$33,275	$23,292.50	$13,310 – $26,620
Total knee replacement: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $13,310 MultiPlan — MULTIPLAN: $26,620 PHCS — PHCS: $23,292.50 SELF-PAY — SELF-PAY: $23,292.50
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR ARTHROSC SHLDR DECOMP SUBAC	$6,426	$4,498.20	$2,570.40 – $5,140.80
Shoulder arthroscopy: shaving of shoulder bone: rates for 10 insurance plans AETNA — AETNA: $4,819.50 BLUE CROSS — BLUE CROSS: $2,570.40 CIGNA — CIGNA: $4,498.20 GEISINGER — GEISINGER: $4,433.94 KeyStone First — KEYSTONE FIRST: $2,570.40 MultiPlan — MULTIPLAN: $5,140.80 PHCS — PHCS: $4,498.20 SELF-PAY — SELF-PAY: $4,498.20 UHC — UHC: $4,498.20 UPMC — UPMC: $3,470.04
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR ARTHROSC SHLDR DECOMP SUBAC	$6,426	$4,498.20	$2,570.40 – $5,140.80
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $2,570.40 MultiPlan — MULTIPLAN: $5,140.80 PHCS — PHCS: $4,498.20 SELF-PAY — SELF-PAY: $4,498.20
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR KNEE ARTHROSCOPY/SURGERY	$8,390	$5,873	$3,356 – $6,712
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 17 insurance plan rates AETNA — AETNA: $6,292.50 Ambetter — AMBETTER: $3,687.61 BLUE CROSS — BLUE CROSS: $3,356 CIGNA — CIGNA: $5,873 GEISINGER — GEISINGER: $5,789.10 HUMANA — HUMANA: $3,513.67 KeyStone First — KEYSTONE FIRST: $3,356 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3,478.88 MultiPlan — MULTIPLAN: $6,712 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3,687.61
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR KNEE ARTHROSCOPY/SURGERY	$8,390	$5,873	$3,356 – $6,712
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $3,356 MultiPlan — MULTIPLAN: $6,712 PHCS — PHCS: $5,873 SELF-PAY — SELF-PAY: $5,873
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR REMOVE TONSILS AND ADENO<12	$15,299	$10,709.30	$6,119.60 – $12,239.20
Removal of tonsils and adenoids (under age 12): 10 of 17 insurance plan rates AETNA — AETNA: $11,474.25 Ambetter — AMBETTER: $6,671.77 BLUE CROSS — BLUE CROSS: $6,119.60 CIGNA — CIGNA: $10,709.30 GEISINGER — GEISINGER: $10,556.31 HUMANA — HUMANA: $6,357.06 KeyStone First — KEYSTONE FIRST: $6,119.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $6,294.12 MultiPlan — MULTIPLAN: $12,239.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $6,671.77
Removal of tonsils and adenoids (under age 12) CPT 42820 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR REMOVE TONSILS AND ADENO<12	$15,299	$10,709.30	$6,119.60 – $12,239.20
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $6,119.60 MultiPlan — MULTIPLAN: $12,239.20 PHCS — PHCS: $10,709.30 SELF-PAY — SELF-PAY: $10,709.30
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR EGD DIAGNOSTIC BRUSH WASH	$2,426	$1,698.20	$970.40 – $1,940.80
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates AETNA — AETNA: $1,819.50 Ambetter — AMBETTER: $1,022.19 BLUE CROSS — BLUE CROSS: $970.40 CIGNA — CIGNA: $1,698.20 GEISINGER — GEISINGER: $1,673.94 HUMANA — HUMANA: $973.97 KeyStone First — KEYSTONE FIRST: $970.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $964.33 MultiPlan — MULTIPLAN: $1,940.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,022.19
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DX W/BRUSHING/WASHING	$1,902	$1,331.40	$760.80 – $1,521.60
Upper GI endoscopy (diagnostic): 10 of 17 insurance plan rates AETNA — AETNA: $1,426.50 Ambetter — AMBETTER: $1,022.19 BLUE CROSS — BLUE CROSS: $760.80 CIGNA — CIGNA: $1,331.40 GEISINGER — GEISINGER: $1,312.38 HUMANA — HUMANA: $973.97 KeyStone First — KEYSTONE FIRST: $760.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $964.33 MultiPlan — MULTIPLAN: $1,521.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,022.19
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR EGD DIAGNOSTIC BRUSH WASH	$2,426	$1,698.20	$970.40 – $1,940.80
Upper GI endoscopy (diagnostic): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $970.40 MultiPlan — MULTIPLAN: $1,940.80 PHCS — PHCS: $1,698.20 SELF-PAY — SELF-PAY: $1,698.20
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR EGD BIOPSY SINGLE/MULTIPLE	$2,426	$1,698.20	$970.40 – $1,940.80
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates AETNA — AETNA: $1,819.50 Ambetter — AMBETTER: $1,022.19 BLUE CROSS — BLUE CROSS: $970.40 CIGNA — CIGNA: $1,698.20 GEISINGER — GEISINGER: $1,673.94 HUMANA — HUMANA: $973.97 KeyStone First — KEYSTONE FIRST: $970.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $964.33 MultiPlan — MULTIPLAN: $1,940.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,022.19
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD FLEX W/BIOPSY	$2,067	$1,446.90	$826.80 – $1,653.60
Upper GI endoscopy with biopsy: 10 of 17 insurance plan rates AETNA — AETNA: $1,550.25 Ambetter — AMBETTER: $1,022.19 BLUE CROSS — BLUE CROSS: $826.80 CIGNA — CIGNA: $1,446.90 GEISINGER — GEISINGER: $1,426.23 HUMANA — HUMANA: $973.97 KeyStone First — KEYSTONE FIRST: $826.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $964.33 MultiPlan — MULTIPLAN: $1,653.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,022.19
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR EGD BIOPSY SINGLE/MULTIPLE	$2,426	$1,698.20	$970.40 – $1,940.80
Upper GI endoscopy with biopsy: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $970.40 MultiPlan — MULTIPLAN: $1,940.80 PHCS — PHCS: $1,698.20 SELF-PAY — SELF-PAY: $1,698.20
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR COLO FLX DX W/COLLJ SPEC WH	$2,436	$1,705.20	$974.40 – $1,948.80
Colonoscopy (diagnostic): 10 of 17 insurance plan rates AETNA — AETNA: $1,827 Ambetter — AMBETTER: $1,048.09 BLUE CROSS — BLUE CROSS: $974.40 CIGNA — CIGNA: $1,705.20 GEISINGER — GEISINGER: $1,680.84 HUMANA — HUMANA: $998.65 KeyStone First — KEYSTONE FIRST: $974.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $988.76 MultiPlan — MULTIPLAN: $1,948.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,048.09
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY FLX DX WHEN PFRMD	$2,436	$1,705.20	$974.40 – $1,948.80
Colonoscopy (diagnostic): 10 of 17 insurance plan rates AETNA — AETNA: $1,827 Ambetter — AMBETTER: $1,048.09 BLUE CROSS — BLUE CROSS: $974.40 CIGNA — CIGNA: $1,705.20 GEISINGER — GEISINGER: $1,680.84 HUMANA — HUMANA: $998.65 KeyStone First — KEYSTONE FIRST: $974.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $988.76 MultiPlan — MULTIPLAN: $1,948.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,048.09
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR COLO FLX DX W/COLLJ SPEC WH	$2,436	$1,705.20	$974.40 – $1,948.80
Colonoscopy (diagnostic): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $974.40 MultiPlan — MULTIPLAN: $1,948.80 PHCS — PHCS: $1,705.20 SELF-PAY — SELF-PAY: $1,705.20
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR COLONOSCOPY W/BIOPSY SIN/MU	$3,056	$2,139.20	$1,222.40 – $2,444.80
Colonoscopy with biopsy: 10 of 17 insurance plan rates AETNA — AETNA: $2,292 Ambetter — AMBETTER: $1,348.64 BLUE CROSS — BLUE CROSS: $1,222.40 CIGNA — CIGNA: $2,139.20 GEISINGER — GEISINGER: $2,108.64 HUMANA — HUMANA: $1,285.02 KeyStone First — KEYSTONE FIRST: $1,222.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $1,272.30 MultiPlan — MULTIPLAN: $2,444.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,348.64
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	$2,153	$1,507.10	$861.20 – $1,722.40
Colonoscopy with biopsy: 10 of 17 insurance plan rates AETNA — AETNA: $1,614.75 Ambetter — AMBETTER: $1,348.64 BLUE CROSS — BLUE CROSS: $861.20 CIGNA — CIGNA: $1,507.10 GEISINGER — GEISINGER: $1,485.57 HUMANA — HUMANA: $1,285.02 KeyStone First — KEYSTONE FIRST: $861.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $1,272.30 MultiPlan — MULTIPLAN: $1,722.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,348.64
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR COLONOSCOPY W/BIOPSY SIN/MU	$3,056	$2,139.20	$1,222.40 – $2,444.80
Colonoscopy with biopsy: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,222.40 MultiPlan — MULTIPLAN: $2,444.80 PHCS — PHCS: $2,139.20 SELF-PAY — SELF-PAY: $2,139.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR COLSC FLX W/RMVL LESION SNA	$3,056	$2,139.20	$1,222.40 – $2,444.80
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates AETNA — AETNA: $2,292 Ambetter — AMBETTER: $1,348.64 BLUE CROSS — BLUE CROSS: $1,222.40 CIGNA — CIGNA: $2,139.20 GEISINGER — GEISINGER: $2,108.64 HUMANA — HUMANA: $1,285.02 KeyStone First — KEYSTONE FIRST: $1,222.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $1,272.30 MultiPlan — MULTIPLAN: $2,444.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,348.64
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	$1,958	$1,370.60	$783.20 – $1,566.40
Colonoscopy with removal of polyps (snare): 10 of 17 insurance plan rates AETNA — AETNA: $1,468.50 Ambetter — AMBETTER: $1,348.64 BLUE CROSS — BLUE CROSS: $783.20 CIGNA — CIGNA: $1,370.60 GEISINGER — GEISINGER: $1,351.02 HUMANA — HUMANA: $1,285.02 KeyStone First — KEYSTONE FIRST: $783.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $1,272.30 MultiPlan — MULTIPLAN: $1,566.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,348.64
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR COLSC FLX W/RMVL LESION SNA	$3,056	$2,139.20	$1,222.40 – $2,444.80
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,222.40 MultiPlan — MULTIPLAN: $2,444.80 PHCS — PHCS: $2,139.20 SELF-PAY — SELF-PAY: $2,139.20
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR COLON CA SCREENING	$2,514	$1,759.80	$1,005.60 – $2,011.20
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates AETNA — AETNA: $1,885.50 Ambetter — AMBETTER: $1,048.09 BLUE CROSS — BLUE CROSS: $1,005.60 CIGNA — CIGNA: $1,759.80 GEISINGER — GEISINGER: $1,734.66 HUMANA — HUMANA: $998.65 KeyStone First — KEYSTONE FIRST: $1,005.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $988.76 MultiPlan — MULTIPLAN: $2,011.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,048.09
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLON CA SCREENING	$2,514	$1,759.80	$1,005.60 – $2,011.20
Screening colonoscopy (not high risk): 10 of 17 insurance plan rates AETNA — AETNA: $1,885.50 Ambetter — AMBETTER: $1,048.09 BLUE CROSS — BLUE CROSS: $1,005.60 CIGNA — CIGNA: $1,759.80 GEISINGER — GEISINGER: $1,734.66 HUMANA — HUMANA: $998.65 KeyStone First — KEYSTONE FIRST: $1,005.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $988.76 MultiPlan — MULTIPLAN: $2,011.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $1,048.09
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR COLON CA SCREENING	$2,514	$1,759.80	$1,005.60 – $2,011.20
Screening colonoscopy (not high risk): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $1,005.60 MultiPlan — MULTIPLAN: $2,011.20 PHCS — PHCS: $1,759.80 SELF-PAY — SELF-PAY: $1,759.80
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR LAPAROSCOPIC CHOLECYSTECTOM	$15,089	$10,562.30	$6,035.60 – $12,071.20
Gallbladder removal by laparoscope: 10 of 17 insurance plan rates AETNA — AETNA: $11,316.75 Ambetter — AMBETTER: $6,813.43 BLUE CROSS — BLUE CROSS: $6,035.60 CIGNA — CIGNA: $10,562.30 GEISINGER — GEISINGER: $10,411.41 HUMANA — HUMANA: $6,492.04 KeyStone First — KEYSTONE FIRST: $6,035.60 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $6,427.76 MultiPlan — MULTIPLAN: $12,071.20 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $6,813.43
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR LAPAROSCOPIC CHOLECYSTECTOM	$15,089	$10,562.30	$6,035.60 – $12,071.20
Gallbladder removal by laparoscope: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $6,035.60 MultiPlan — MULTIPLAN: $12,071.20 PHCS — PHCS: $10,562.30 SELF-PAY — SELF-PAY: $10,562.30
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR PRP I/HERN INIT REDUC >5 YR	$9,130	$6,391	$3,652 – $7,304
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates AETNA — AETNA: $6,847.50 Ambetter — AMBETTER: $4,035.19 BLUE CROSS — BLUE CROSS: $3,652 CIGNA — CIGNA: $6,391 GEISINGER — GEISINGER: $6,299.70 HUMANA — HUMANA: $3,844.85 KeyStone First — KEYSTONE FIRST: $3,652 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3,806.78 MultiPlan — MULTIPLAN: $7,304 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $4,035.19
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	$9,130	$6,391	$3,652 – $7,304
Groin (inguinal) hernia repair, age 5 or older: 10 of 17 insurance plan rates AETNA — AETNA: $6,847.50 Ambetter — AMBETTER: $4,035.19 BLUE CROSS — BLUE CROSS: $3,652 CIGNA — CIGNA: $6,391 GEISINGER — GEISINGER: $6,299.70 HUMANA — HUMANA: $3,844.85 KeyStone First — KEYSTONE FIRST: $3,652 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3,806.78 MultiPlan — MULTIPLAN: $7,304 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $4,035.19
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR PRP I/HERN INIT REDUC >5 YR	$9,130	$6,391	$3,652 – $7,304
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $3,652 MultiPlan — MULTIPLAN: $7,304 PHCS — PHCS: $6,391 SELF-PAY — SELF-PAY: $6,391
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	$5,475	$3,832.50	$1,642.50 – $4,380
Prostate biopsy: rates for 10 insurance plans AETNA — AETNA: $4,106.25 BLUE CROSS — BLUE CROSS: $2,190 GEISINGER — GEISINGER: $3,777.75 KeyStone First — KEYSTONE FIRST: $2,190 MultiPlan — MULTIPLAN: $4,380 PHCS — PHCS: $3,832.50 SELF-PAY — SELF-PAY: $3,832.50 UHC — UHC: $3,832.50 UPMC — UPMC: $2,956.50 WELLPATH (State Prison) — WELLPATH (State Prison): $1,642.50
Prostate biopsy CPT 55700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	$5,475	$3,832.50	$2,190 – $4,380
Prostate biopsy: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $2,190 MultiPlan — MULTIPLAN: $4,380 PHCS — PHCS: $3,832.50 SELF-PAY — SELF-PAY: $3,832.50
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR LAPS SURG PRST8ECT RPBIC	$27,038	$18,926.60	$10,815.20 – $21,630.40
Prostate removal by laparoscope (radical prostatectomy): 10 of 17 insurance plan rates AETNA — AETNA: $20,278.50 Ambetter — AMBETTER: $11,980.04 BLUE CROSS — BLUE CROSS: $10,815.20 CIGNA — CIGNA: $18,926.60 GEISINGER — GEISINGER: $18,656.22 HUMANA — HUMANA: $11,414.94 KeyStone First — KEYSTONE FIRST: $10,815.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $11,301.92 MultiPlan — MULTIPLAN: $21,630.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $11,980.04
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	$27,038	$18,926.60	$10,815.20 – $21,630.40
Prostate removal by laparoscope (radical prostatectomy): 10 of 17 insurance plan rates AETNA — AETNA: $20,278.50 Ambetter — AMBETTER: $11,980.04 BLUE CROSS — BLUE CROSS: $10,815.20 CIGNA — CIGNA: $18,926.60 GEISINGER — GEISINGER: $18,656.22 HUMANA — HUMANA: $11,414.94 KeyStone First — KEYSTONE FIRST: $10,815.20 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $11,301.92 MultiPlan — MULTIPLAN: $21,630.40 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $11,980.04
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR LAPS SURG PRST8ECT RPBIC	$27,038	$18,926.60	$10,815.20 – $21,630.40
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $10,815.20 MultiPlan — MULTIPLAN: $21,630.40 PHCS — PHCS: $18,926.60 SELF-PAY — SELF-PAY: $18,926.60
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSC BX ENDOMETRIAL	$8,222	$5,755.40	$3,288.80 – $6,577.60
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates AETNA — AETNA: $6,166.50 Ambetter — AMBETTER: $3,648.31 BLUE CROSS — BLUE CROSS: $3,288.80 CIGNA — CIGNA: $5,755.40 GEISINGER — GEISINGER: $5,673.18 HUMANA — HUMANA: $3,476.22 KeyStone First — KEYSTONE FIRST: $3,288.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3,441.80 MultiPlan — MULTIPLAN: $6,577.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3,648.31
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR HYSTEROSCOPY BIOPSY	$8,222	$5,755.40	$3,288.80 – $6,577.60
Hysteroscopy with biopsy of the uterus lining: 10 of 17 insurance plan rates AETNA — AETNA: $6,166.50 Ambetter — AMBETTER: $3,648.31 BLUE CROSS — BLUE CROSS: $3,288.80 CIGNA — CIGNA: $5,755.40 GEISINGER — GEISINGER: $5,673.18 HUMANA — HUMANA: $3,476.22 KeyStone First — KEYSTONE FIRST: $3,288.80 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $3,441.80 MultiPlan — MULTIPLAN: $6,577.60 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $3,648.31
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HYSTEROSC BX ENDOMETRIAL	$8,222	$5,755.40	$3,288.80 – $6,577.60
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $3,288.80 MultiPlan — MULTIPLAN: $6,577.60 PHCS — PHCS: $5,755.40 SELF-PAY — SELF-PAY: $5,755.40
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR CARPAL TUNNEL SURGERY	$5,051	$3,535.70	$2,020.40 – $4,040.80
Carpal tunnel release: 10 of 17 insurance plan rates AETNA — AETNA: $3,788.25 Ambetter — AMBETTER: $2,200.76 BLUE CROSS — BLUE CROSS: $2,020.40 CIGNA — CIGNA: $3,535.70 GEISINGER — GEISINGER: $3,485.19 HUMANA — HUMANA: $2,096.95 KeyStone First — KEYSTONE FIRST: $2,020.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $2,076.19 MultiPlan — MULTIPLAN: $4,040.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $2,200.76
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEUROPLASTY CARPAL TUNNEL	$5,051	$3,535.70	$2,020.40 – $4,040.80
Carpal tunnel release: 10 of 17 insurance plan rates AETNA — AETNA: $3,788.25 Ambetter — AMBETTER: $2,200.76 BLUE CROSS — BLUE CROSS: $2,020.40 CIGNA — CIGNA: $3,535.70 GEISINGER — GEISINGER: $3,485.19 HUMANA — HUMANA: $2,096.95 KeyStone First — KEYSTONE FIRST: $2,020.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $2,076.19 MultiPlan — MULTIPLAN: $4,040.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $2,200.76
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR CARPAL TUNNEL SURGERY	$5,051	$3,535.70	$2,020.40 – $4,040.80
Carpal tunnel release: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $2,020.40 MultiPlan — MULTIPLAN: $4,040.80 PHCS — PHCS: $3,535.70 SELF-PAY — SELF-PAY: $3,535.70
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OR XCAPSL CTRC RMVL W/O ECP	$5,901	$4,130.70	$2,360.40 – $4,720.80
Cataract removal with lens implant: 10 of 17 insurance plan rates AETNA — AETNA: $4,425.75 Ambetter — AMBETTER: $2,600.96 BLUE CROSS — BLUE CROSS: $2,360.40 CIGNA — CIGNA: $4,130.70 GEISINGER — GEISINGER: $4,071.69 HUMANA — HUMANA: $2,478.28 KeyStone First — KEYSTONE FIRST: $2,360.40 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $2,453.74 MultiPlan — MULTIPLAN: $4,720.80 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $2,600.96
Cataract removal with lens implant CPT 66984 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OR XCAPSL CTRC RMVL W/O ECP	$5,901	$4,130.70	$2,360.40 – $4,720.80
Cataract removal with lens implant: rates for 4 insurance plans KeyStone First — KEYSTONE FIRST: $2,360.40 MultiPlan — MULTIPLAN: $4,720.80 PHCS — PHCS: $4,130.70 SELF-PAY — SELF-PAY: $4,130.70

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$1,202 – $170,428.70
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 17 insurance plan rates AETNA — AETNA: $73,371 Ambetter — AMBETTER: $95,240.73 BLUE CROSS — BLUE CROSS: $154,565.40 CIGNA — CIGNA: $139,894.04 GEISINGER — GEISINGER: $1,202 HUMANA — HUMANA: $90,748.25 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $89,849.75 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $95,240.73 UHC — UHC: $63,588.20 UPMC — UPMC: $170,428.70
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$1,202 – $35,611.60
Spinal fusion (not neck), without major complications: rates for 10 insurance plans Ambetter — AMBETTER: $35,611.60 GEISINGER — GEISINGER: $1,202 HUMANA — HUMANA: $33,931.81 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $33,595.85 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $35,611.60 UPMC MEDICARE — UPMC MEDICARE: $34,939.68 KeyStone First — KEYSTONE FIRST: 40% (a percentage in the contract, not a dollar amount) MultiPlan — MULTIPLAN: 80% (a percentage in the contract, not a dollar amount) PHCS — PHCS: 70% (a percentage in the contract, not a dollar amount) SELF-PAY — SELF-PAY: 70% (a percentage in the contract, not a dollar amount)
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	$1,100 – $33,603.87
Hip or knee replacement (major joint of the leg), without major complications: 10 of 17 insurance plan rates AETNA — AETNA: $14,466.75 Ambetter — AMBETTER: $18,778.86 BLUE CROSS — BLUE CROSS: $30,476.06 CIGNA — CIGNA: $27,583.27 GEISINGER — GEISINGER: $1,202 HUMANA — HUMANA: $17,893.07 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $17,715.91 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $18,778.86 PHCS — PHCS: $1,100 UHC — UHC: $12,537.85
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	$1,100 – $42,530.52
Neck (cervical) spinal fusion, without complications: 10 of 17 insurance plan rates AETNA — AETNA: $18,309.75 Ambetter — AMBETTER: $23,767.34 BLUE CROSS — BLUE CROSS: $38,571.83 CIGNA — CIGNA: $34,910.59 GEISINGER — GEISINGER: $1,202 HUMANA — HUMANA: $22,646.24 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $22,422.02 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $23,767.34 PHCS — PHCS: $1,100 UHC — UHC: $15,868.45
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	$1,100 – $21,614.56
Uterus and ovary surgery (not for cancer), without complications: 10 of 17 insurance plan rates AETNA — AETNA: $9,305.25 Ambetter — AMBETTER: $12,078.88 BLUE CROSS — BLUE CROSS: $19,602.70 CIGNA — CIGNA: $17,742.01 GEISINGER — GEISINGER: $1,202 HUMANA — HUMANA: $11,509.12 MEDICARE ADVANTAGE 100Percentage — MEDICARE ADVANTAGE 100Percentage: $11,395.17 PA HEALTH & WELLNESS — PA HEALTH WELLNESS: $12,078.88 PHCS — PHCS: $1,100 UHC — UHC: $8,064.55

Source: Wayne Memorial Hospital’s standard charges file (wmh.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 16, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	601 Park Street, Honesdale, PA 18431
County	Wayne County
State	Pennsylvania
Phone	(570) 253‑8100
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	390125
Name in Medicare records	WAYNE MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Official website	wmh.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Wayne Memorial Hospital — wmh.org
Services - Wayne Memorial Hospital — wmh.org
About WMH — wmh.org
Visitor Information — wmh.org
Outpatient Locations - Wayne Memorial Hospital — wmh.org
Certified Primary Stroke Center | Wayne Memorial Hospital — wmh.org
Emergency Department | Wayne Memorial Hospital — wmh.org
Imaging & Radiology | X-rays | Ultrasound | Wayne Memorial Hospital — wmh.org
Emergency Department | Emergency Care Teams | Wayne Memorial Hospital — wmh.org
Cardiovascular Disease Department | Wayne Memorial Hospital — wmh.org
Oncology, Chemotherapy & Infusion | Wayne Memorial Hospital — wmh.org
Orthopedic Services | Wayne Memorial Hospital — wmh.org
General & Specialized Surgery at Wayne Memorial Hospital — wmh.org
Cardiac Rehabilitation | Wayne Memorial Hospital — wmh.org
Behavioral Health Center | Wayne Memorial Hospital — wmh.org
Chest Pain Center - Wayne Memorial Hospital — wmh.org
Parkinson's Rehabilitation Therapy | Wayne Memorial Hospital — wmh.org
Rehabilitation Services - Wayne Memorial Hospital — wmh.org

Wayne Memorial Hospital

Summary

Profile from official sources

At a glance