Does Wilkes-Barre General Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Wilkes-Barre General Hospital. In a medical emergency, call 911.

Where is Wilkes-Barre General Hospital?

575 North River Street, Wilkes-Barre, PA 18764, in Luzerne County, Pennsylvania.

What is the phone number of Wilkes-Barre General Hospital?

(570) 829-8111, as listed by Medicare (CMS).

What is the Medicare star rating of Wilkes-Barre General Hospital?

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

Wilkes-Barre General Hospital

Quick answers

Does Wilkes-Barre General Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Wilkes-Barre General Hospital. In a medical emergency, call 911.
Where is Wilkes-Barre General Hospital?: 575 North River Street, Wilkes-Barre, PA 18764, in Luzerne County, Pennsylvania.
What is the phone number of Wilkes-Barre General Hospital?: (570) 829-8111, as listed by Medicare (CMS).
What is the Medicare star rating of Wilkes-Barre General Hospital?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][6]

Treatments^[5][6]

Procedures^[4][5][6]

Robotic surgery
Electrophysiology
Left atrial appendage closure device
Endoscopy
Advanced endoscopy
Robotic-assisted surgery
Open-heart surgery
Cardiac MRI
Digital breast tomosynthesis (3D mammography)
Arthroscopic surgery
Capsule pH testing
Colonoscopy
Gastroscopy
Esophageal motility testing
Enteroscopy
Stent placement
Colon decompression
Bronchoscopy
ERCP
Flexible sigmoidoscopy
Interventional endoscopic procedures
Polypectomy

Programs and centers^[4][5]

Heart and Vascular Institute
Chest Pain Center
Joint Center
Heart valve clinic
Stroke center
Robotics program
Breast Imaging Center of Excellence
Center for Advanced Endoscopy

Emergency care (hospital website)^[4][5][7][8]

Emergency room	Yes
Stroke designation	Accredited stroke center (level not stated)

Visiting and practical information

Patient portal	Patient portal

Recognition^[4]

ACR Breast Imaging Center of Excellence
Chest Pain Center, fully accredited by the Society of Chest Pain Centers

Doctors and clinicians (574)

574 doctors and other clinicians list Wilkes-Barre General 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

Doctors with a page on this site (574)

Aalpen A. Patel, MDDiagnostic Radiology
Abdellaziz Dahou, MDInternal Medicine
Abigail E. Lukasik, DOObstetrics/Gynecology
Abike O. Durojaye, MDDiagnostic Radiology
Adel Abdalla, MDDiagnostic Radiology
Adharsh Sahadevan, MDPsychiatry
Adil Sattar, MDInterventional Cardiology
Adrienne Tounsel, MDFamily Practice
Ahamed R. Shamsedeen, MDFamily Practice
Ahmad Raja, DOInternal Medicine
Akram Zalatimo, MDObstetrics/Gynecology
Akshaykumar Vachhani, MDHospitalist
Alfonso I. Rodriguez, MDHospitalist
Alia A. Yesalavage, NPNurse Practitioner
Aliasgar Chittalia, MDInternal Medicine
Aliya A. Lazinsky, CNACertified Registered Nurse Anesthetist (CRNA)
Allen J. Orehek, MDInternal Medicine
Allison M. Zamerowski, NPNurse Practitioner
Aman Ali, MDGastroenterology
Amanda L. Craven, NPNurse Practitioner
Amanda Perrone, PAPhysician Assistant
Amatus A. Legbedion, MDFamily Practice
Amber Sobuto, DOHematology/Oncology
Amy Campbell, CNACertified Registered Nurse Anesthetist (CRNA)

And 550 more: the button below opens the full list.

Other emergency rooms nearby

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

Wilkes Barre VA Medical Center1.8 mi · Wilkes-Barre, PA · Federal/VA Acute Care Hospital
Geisinger Wyoming Valley Medical Center2.9 mi · Wilkes-Barre, PA · Acute Care Hospital
Geisinger-Community Medical Center15 mi · Scranton, PA · Acute Care Hospital
Regional Hospital of Scranton15 mi · Scranton, PA · Acute Care Hospital
Lehigh Valley Hospital - Dickson City18 mi · Dickson City, PA · Acute Care Hospital

Other hospitals nearby

PAM Specialty Hospital of Wilkes-Barre0.0 mi · Wilkes-Barre, PA · Long-Term Acute Care Hospital
John Heinz Institute of Rehabilitation Medicine1.2 mi · Wilkes Barre Townshi, PA · Inpatient Rehabilitation Hospital
Geisinger Behavioral Health Center Northeast12 mi · Moosic, 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

Riverstreet Manor0.3 mi · Wilkes-Barre, PA · 2 of 5 stars
Third Avenue Health & Rehab Center0.6 mi · Kingston, PA · 3 of 5 stars
Edenbrook on Second Ave0.9 mi · Kingston, PA · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Commonwealth Hospice of Berwick1.9 mi · Forty Fort, PA · 5 of 5 stars
Pathways Healthcare1.9 mi · Kingston, PA
Hospice of the Sacred Heart12 mi · Moosic, PA · 5 of 5 stars

All hospice providers in the state →

Home health agencies

Aveanna Healthcare1.6 mi · Wilkes Barre, PA
Compass Home Health and Rehab LLC1.6 mi · Plains, PA · 2 of 5 stars
Maxim Healthcare Services Inc1.6 mi · Plains, PA

All home health agencies in the state →

Dialysis facilities

FKC Freedom Center of Wyoming Valley6.1 mi · Wilkes Barre, PA · 4 of 5 stars
FKC Wilkes Barre6.1 mi · Wilkes Barre, PA · 2 of 5 stars
FKC Pittston7.2 mi · Pittston, PA · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Northeast Regional Surgery Center LLC1.6 mi · Plains, PA
Gateway Surgery Center, LLC1.9 mi · Edwardsville, PA
Surgical Specialty Center of Northeastern PA LLC1.9 mi · Forty Fort, 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

McKinney Clinic0.8 mi · Wilkes Barre, PA · Community health center
The Wright Center for Community Health Wilkes-Barre Practice0.9 mi · Wilkes Barre, PA · Community health center
The Wright Center for Community Health Wilkes-Barre Practice0.9 mi · Wilkes Barre, PA · Community health center

Clinics and urgent care

Medexpress Urgent Care, Pc-Pennsylvania1.9 mi · Edwardsville, PA · Urgent care center
Ultra Care Urgent and Family Care1.9 mi · Kingston, PA · Urgent care center
Medexpress Urgent Care, Pc-Pennsylvania6.1 mi · Wilkes Barre, PA · Urgent care center

Pharmacies

The Wright Center Medical Group1.3 mi · Wilkes Barre, PA · Community/retail pharmacy
Wilkes Barre Behavioral Hospital Company LLC1.3 mi · Wilkes Barre, PA · Community/retail pharmacy
Eckerd Corporation1.6 mi · Plains, PA · Pharmacy

Assisted living nearby

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

Northeast Counseling Services1.3 mi · Wilkes-Barre, PA
Serenity Care Kingston1.9 mi · Kingston, PA
Tiffany Court at Kingston1.9 mi · Kingston, PA
Viva Senior Living at Plymouth4.8 mi · Plymouth, 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 Wilkes-Barre General 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)	2 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	2 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	1 of 5 stars
Information about recovery at home	2 of 5 stars
Room and bathroom kept clean	2 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	59%National average: 72%
Would definitely recommend the hospital	53%National average: 71%
Nurses “always” communicated well	76%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	53%National average: 62%
Were given information about recovery at home	83%National average: 86%
Room and bathroom “always” clean	64%National average: 74%
Area around the room “always” quiet at night	50%National average: 60%
Completed surveys	704Response rate: 30%

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)	0Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0Better than the national benchmark
Surgical site infections after colon surgery	1.343No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.322No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.426Better than the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients	14.5%
Deaths within 30 days: heart failure patients	16%
Deaths within 30 days: pneumonia patients	17.1%
Deaths within 30 days: COPD patients	9.3%
Deaths within 30 days: stroke patients	16.2%
Deaths within 30 days: coronary bypass surgery (CABG)	4%
Serious complications (patient safety indicator PSI-90)	1.11No different from the national rate
Complications after hip or knee replacement	3.1%

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	15.5%
Readmitted within 30 days: heart failure	22.6%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	19.6%
Readmitted within 30 days: coronary bypass surgery	10.3%
Readmitted within 30 days: hip or knee replacement	5.4%

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)	209 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)	73%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 Wilkes-Barre Best hospitals in Wilkes-Barre

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 64 common services exactly as Wilkes-Barre General 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: INTERMEDIATE ED VIST	$1,403	$336.72	$56.65 – $1,705
Emergency room visit (moderate): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $65.15 Aetna — Aetna: $378.81 Aetna — Aetna HPN: $301.64 Aetna — Aetna NAB FH: $1,084.52 Aetna — Aetna NAB Work Comp: $1,297.78 Aetna — NODE Aetna MCR ADV: $254.84 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $294.63 Cigna — Cigna: $663.62 Community Bluee — NODE Community Blue Medicare Advantage: $112.38
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · Hospital (facility) fee In the file: INTERMEDIATE ED VIST	$1,403	$505.08	$294.63 – $1,297.78
Emergency room visit (moderate): rates for 10 insurance plans Aetna — Aetna: $638.37 Aetna — Aetna HPN: $513.50 Aetna — Aetna NAB FH: $1,084.52 Aetna — Aetna NAB Work Comp: $1,297.78 BCNEPA HM — BCNEPA HM ASO CHS Employee: $294.63 Health America — Health America: $680.45 Independence Blue Cross — IBC CHS Employee: $350.75 InterGroup — InterGroup: $1,234.64 Multiplan — Multiplan Primary: $1,052.25 Self Pay — Self Pay: $505.08
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EXTENDED ED VISIT	$2,476	$594.24	$75 – $2,290.30
Emergency room visit (moderately high): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $109.63 Aetna — Aetna: $668.52 Aetna — Aetna HPN: $532.34 Aetna — Aetna NAB FH: $1,913.95 Aetna — Aetna NAB Work Comp: $2,290.30 Aetna — NODE Aetna MCR ADV: $395.59 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $519.96 Cigna — Cigna: $1,171.15 Community Bluee — NODE Community Blue Medicare Advantage: $198.33
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EXTENDED ED VISIT	$2,476	$891.36	$519.96 – $2,290.30
Emergency room visit (moderately high): rates for 10 insurance plans Aetna — Aetna: $1,126.58 Aetna — Aetna HPN: $906.22 Aetna — Aetna NAB FH: $1,913.95 Aetna — Aetna NAB Work Comp: $2,290.30 BCNEPA HM — BCNEPA HM ASO CHS Employee: $519.96 Health America — Health America: $1,200.86 Independence Blue Cross — IBC CHS Employee: $619 InterGroup — InterGroup: $2,178.88 Multiplan — Multiplan Primary: $1,857 Self Pay — Self Pay: $891.36
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE ED VST	$3,843	$922.32	$75 – $3,554.78
Emergency room visit (high): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $159.55 Aetna — Aetna: $1,037.61 Aetna — Aetna HPN: $826.25 Aetna — Aetna NAB FH: $2,970.64 Aetna — Aetna NAB Work Comp: $3,554.78 Aetna — NODE Aetna MCR ADV: $573.69 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $807.03 Cigna — Cigna: $1,817.74 Community Bluee — NODE Community Blue Medicare Advantage: $307.82
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POST AR TRA EM LV 5F	$4,355	$1,045.20	$75 – $4,028.38
Emergency room visit (high): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $159.55 Aetna — Aetna: $1,175.85 Aetna — Aetna HPN: $936.33 Aetna — Aetna NAB FH: $3,366.41 Aetna — Aetna NAB Work Comp: $4,028.38 Aetna — NODE Aetna MCR ADV: $573.69 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $914.55 Cigna — Cigna: $2,059.91 Community Bluee — NODE Community Blue Medicare Advantage: $348.84
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMPREHENSIVE ED VST	$3,843	$1,383.48	$807.03 – $3,554.78
Emergency room visit (high): rates for 10 insurance plans Aetna — Aetna: $1,748.57 Aetna — Aetna HPN: $1,406.54 Aetna — Aetna NAB FH: $2,970.64 Aetna — Aetna NAB Work Comp: $3,554.78 BCNEPA HM — BCNEPA HM ASO CHS Employee: $807.03 Health America — Health America: $1,863.86 Independence Blue Cross — IBC CHS Employee: $960.75 InterGroup — InterGroup: $3,381.84 Multiplan — Multiplan Primary: $2,882.25 Self Pay — Self Pay: $1,383.48

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 METABO CA TOTA	$70	$16.80	$5.61 – $64.75
Basic metabolic panel (blood test): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $10.76 Aetna — Aetna: $19.04 Aetna — Aetna HPN: $15.05 Aetna — Aetna NAB FH: $54.11 Aetna — Aetna NAB Work Comp: $64.75 Aetna — NODE Aetna MCR ADV: $8.29 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $9.36 BCNEPA HM — BCNEPA HM ASO CHS Employee: $14.70 Cigna — Cigna: $8.30 Community Bluee — NODE Community Blue Medicare Advantage: $5.61
Basic metabolic panel (blood test) CPT 80048 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BASIC METABO CA TOTA	$70	$25.20	$14.70 – $64.75
Basic metabolic panel (blood test): rates for 10 insurance plans Aetna — Aetna: $31.85 Aetna — Aetna HPN: $25.62 Aetna — Aetna NAB FH: $54.11 Aetna — Aetna NAB Work Comp: $64.75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $14.70 Health America — Health America: $33.95 Independence Blue Cross — IBC CHS Employee: $17.50 InterGroup — InterGroup: $61.60 Multiplan — Multiplan Primary: $52.50 Self Pay — Self Pay: $25.20
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMP METAB PANEL	$88	$21.12	$7.05 – $81.40
Comprehensive metabolic panel (blood test): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $13.44 Aetna — Aetna: $23.77 Aetna — Aetna HPN: $18.92 Aetna — Aetna NAB FH: $68.02 Aetna — Aetna NAB Work Comp: $81.40 Aetna — NODE Aetna MCR ADV: $10.35 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $11.69 BCNEPA HM — BCNEPA HM ASO CHS Employee: $18.48 Cigna — Cigna: $10.29 Community Bluee — NODE Community Blue Medicare Advantage: $7.05
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient (hospital stay) · Hospital (facility) fee In the file: COMP METAB PANEL	$88	$31.68	$18.48 – $81.40
Comprehensive metabolic panel (blood test): rates for 10 insurance plans Aetna — Aetna: $40.04 Aetna — Aetna HPN: $32.21 Aetna — Aetna NAB FH: $68.02 Aetna — Aetna NAB Work Comp: $81.40 BCNEPA HM — BCNEPA HM ASO CHS Employee: $18.48 Health America — Health America: $42.68 Independence Blue Cross — IBC CHS Employee: $22 InterGroup — InterGroup: $77.44 Multiplan — Multiplan Primary: $66 Self Pay — Self Pay: $31.68
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$572	$137.28	$12 – $529.10
Obstetric blood test panel: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $13.80 Aetna — Aetna: $107.67 Aetna — Aetna HPN: $122.98 Aetna — Aetna NAB FH: $442.16 Aetna — Aetna NAB Work Comp: $529.10 Aetna — NODE Aetna MCR ADV: $46.85 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $12 BCNEPA HM — BCNEPA HM ASO CHS Employee: $120.12 Cigna — Cigna: $46.81 Community Bluee — NODE Community Blue Medicare Advantage: $45.82
Obstetric blood test panel CPT 80055 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	$572	$205.92	$120.12 – $529.10
Obstetric blood test panel: rates for 10 insurance plans Aetna — Aetna: $260.26 Aetna — Aetna HPN: $209.35 Aetna — Aetna NAB FH: $442.16 Aetna — Aetna NAB Work Comp: $529.10 BCNEPA HM — BCNEPA HM ASO CHS Employee: $120.12 Health America — Health America: $277.42 Independence Blue Cross — IBC CHS Employee: $143 InterGroup — InterGroup: $503.36 Multiplan — Multiplan Primary: $429 Self Pay — Self Pay: $205.92
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$87	$20.88	$6.97 – $80.47
Cholesterol panel (lipid panel): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $16.10 Aetna — Aetna: $30.16 Aetna — Aetna HPN: $18.70 Aetna — Aetna NAB FH: $67.25 Aetna — Aetna NAB Work Comp: $80.47 Aetna — NODE Aetna MCR ADV: $13.12 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $14 BCNEPA HM — BCNEPA HM ASO CHS Employee: $18.27 Cigna — Cigna: $13.28 Community Bluee — NODE Community Blue Medicare Advantage: $6.97
Cholesterol panel (lipid panel) CPT 80061 · Inpatient (hospital stay) · Hospital (facility) fee In the file: LIPID PANEL	$87	$31.32	$18.27 – $80.48
Cholesterol panel (lipid panel): rates for 10 insurance plans Aetna — Aetna: $39.59 Aetna — Aetna HPN: $31.84 Aetna — Aetna NAB FH: $67.25 Aetna — Aetna NAB Work Comp: $80.48 BCNEPA HM — BCNEPA HM ASO CHS Employee: $18.27 Health America — Health America: $42.20 Independence Blue Cross — IBC CHS Employee: $21.75 InterGroup — InterGroup: $76.56 Multiplan — Multiplan Primary: $65.25 Self Pay — Self Pay: $31.32
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$100	$24	$6.08 – $92.50
Kidney function panel: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $11.04 Aetna — Aetna: $19.54 Aetna — Aetna HPN: $21.50 Aetna — Aetna NAB FH: $77.30 Aetna — Aetna NAB Work Comp: $92.50 Aetna — NODE Aetna MCR ADV: $8.51 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $9.60 BCNEPA HM — BCNEPA HM ASO CHS Employee: $21 Cigna — Cigna: $8.63 Community Bluee — NODE Community Blue Medicare Advantage: $8.01
Kidney function panel CPT 80069 · Inpatient (hospital stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$100	$36	$21 – $92.50
Kidney function panel: rates for 10 insurance plans Aetna — Aetna: $45.50 Aetna — Aetna HPN: $36.60 Aetna — Aetna NAB FH: $77.30 Aetna — Aetna NAB Work Comp: $92.50 BCNEPA HM — BCNEPA HM ASO CHS Employee: $21 Health America — Health America: $48.50 Independence Blue Cross — IBC CHS Employee: $25 InterGroup — InterGroup: $88 Multiplan — Multiplan Primary: $75 Self Pay — Self Pay: $36
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PAN	$95	$22.80	$5.72 – $87.88
Liver function panel: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $10.38 Aetna — Aetna: $18.40 Aetna — Aetna HPN: $20.43 Aetna — Aetna NAB FH: $73.44 Aetna — Aetna NAB Work Comp: $87.88 Aetna — NODE Aetna MCR ADV: $8.01 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $9.03 BCNEPA HM — BCNEPA HM ASO CHS Employee: $19.95 Cigna — Cigna: $7.97 Community Bluee — NODE Community Blue Medicare Advantage: $7.61
Liver function panel CPT 80076 · Inpatient (hospital stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PAN	$95	$34.20	$19.95 – $87.88
Liver function panel: rates for 10 insurance plans Aetna — Aetna: $43.23 Aetna — Aetna HPN: $34.77 Aetna — Aetna NAB FH: $73.44 Aetna — Aetna NAB Work Comp: $87.88 BCNEPA HM — BCNEPA HM ASO CHS Employee: $19.95 Health America — Health America: $46.07 Independence Blue Cross — IBC CHS Employee: $23.75 InterGroup — InterGroup: $83.60 Multiplan — Multiplan Primary: $71.25 Self Pay — Self Pay: $34.20
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA, AUTO W-SCOPE	$38	$9.12	$2.22 – $35.15
Urine test (automated, with microscope): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $3.45 Aetna — Aetna: $7.14 Aetna — Aetna HPN: $8.17 Aetna — Aetna NAB FH: $29.37 Aetna — Aetna NAB Work Comp: $35.15 Aetna — NODE Aetna MCR ADV: $3.11 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $3 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7.98 Cigna — Cigna: $2.99 Community Bluee — NODE Community Blue Medicare Advantage: $3.04
Urine test (automated, with microscope) CPT 81001 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UA, AUTO W-SCOPE	$38	$13.68	$7.98 – $35.15
Urine test (automated, with microscope): rates for 10 insurance plans Aetna — Aetna: $17.29 Aetna — Aetna HPN: $13.91 Aetna — Aetna NAB FH: $29.37 Aetna — Aetna NAB Work Comp: $35.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7.98 Health America — Health America: $18.43 Independence Blue Cross — IBC CHS Employee: $9.50 InterGroup — InterGroup: $33.44 Multiplan — Multiplan Primary: $28.50 Self Pay — Self Pay: $13.68
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA, AUTO, W-O SCOPE	$38	$9.12	$1.58 – $35.15
Urine test (automated, without microscope): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $3.56 Aetna — Aetna: $5.06 Aetna — Aetna HPN: $8.17 Aetna — Aetna NAB FH: $29.37 Aetna — Aetna NAB Work Comp: $35.15 Aetna — NODE Aetna MCR ADV: $2.20 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $3.10 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7.98 Cigna — Cigna: $2.32 Community Bluee — NODE Community Blue Medicare Advantage: $3.04
Urine test (automated, without microscope) CPT 81003 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UA, AUTO, W-O SCOPE	$38	$13.68	$7.98 – $35.15
Urine test (automated, without microscope): rates for 10 insurance plans Aetna — Aetna: $17.29 Aetna — Aetna HPN: $13.91 Aetna — Aetna NAB FH: $29.37 Aetna — Aetna NAB Work Comp: $35.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7.98 Health America — Health America: $18.43 Independence Blue Cross — IBC CHS Employee: $9.50 InterGroup — InterGroup: $33.44 Multiplan — Multiplan Primary: $28.50 Self Pay — Self Pay: $13.68
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA, TOTAL	$125	$30	$10.01 – $115.63
PSA (prostate specific antigen) blood test: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $28.01 Aetna — Aetna: $41.42 Aetna — Aetna HPN: $26.88 Aetna — Aetna NAB FH: $96.63 Aetna — Aetna NAB Work Comp: $115.63 Aetna — NODE Aetna MCR ADV: $18.02 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $24.36 BCNEPA HM — BCNEPA HM ASO CHS Employee: $26.25 Cigna — Cigna: $17.93 Community Bluee — NODE Community Blue Medicare Advantage: $10.01
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PSA, TOTAL	$125	$45	$26.25 – $115.63
PSA (prostate specific antigen) blood test: rates for 10 insurance plans Aetna — Aetna: $56.88 Aetna — Aetna HPN: $45.75 Aetna — Aetna NAB FH: $96.63 Aetna — Aetna NAB Work Comp: $115.63 BCNEPA HM — BCNEPA HM ASO CHS Employee: $26.25 Health America — Health America: $60.63 Independence Blue Cross — IBC CHS Employee: $31.25 InterGroup — InterGroup: $110 Multiplan — Multiplan Primary: $93.75 Self Pay — Self Pay: $45
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THYROID STIM TSH	$125	$30	$10.01 – $115.63
Thyroid stimulating hormone (TSH) test: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $26.69 Aetna — Aetna: $37.84 Aetna — Aetna HPN: $26.88 Aetna — Aetna NAB FH: $96.63 Aetna — Aetna NAB Work Comp: $115.63 Aetna — NODE Aetna MCR ADV: $16.46 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $23.21 BCNEPA HM — BCNEPA HM ASO CHS Employee: $26.25 Cigna — Cigna: $16.60 Community Bluee — NODE Community Blue Medicare Advantage: $10.01
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THYROID STIM TSH	$125	$45	$26.25 – $115.63
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans Aetna — Aetna: $56.88 Aetna — Aetna HPN: $45.75 Aetna — Aetna NAB FH: $96.63 Aetna — Aetna NAB Work Comp: $115.63 BCNEPA HM — BCNEPA HM ASO CHS Employee: $26.25 Health America — Health America: $60.63 Independence Blue Cross — IBC CHS Employee: $31.25 InterGroup — InterGroup: $110 Multiplan — Multiplan Primary: $93.75 Self Pay — Self Pay: $45
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W-PLT AUTO COMPD	$57	$13.68	$4.57 – $52.73
Complete blood count (CBC) with differential: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $6.90 Aetna — Aetna: $17.49 Aetna — Aetna HPN: $12.26 Aetna — Aetna NAB FH: $44.06 Aetna — Aetna NAB Work Comp: $52.73 Aetna — NODE Aetna MCR ADV: $7.61 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $6 BCNEPA HM — BCNEPA HM ASO CHS Employee: $11.97 Cigna — Cigna: $7.64 Community Bluee — NODE Community Blue Medicare Advantage: $4.57
Complete blood count (CBC) with differential CPT 85025 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W-PLT AUTO COMPD	$57	$20.52	$11.97 – $52.73
Complete blood count (CBC) with differential: rates for 10 insurance plans Aetna — Aetna: $25.94 Aetna — Aetna HPN: $20.86 Aetna — Aetna NAB FH: $44.06 Aetna — Aetna NAB Work Comp: $52.73 BCNEPA HM — BCNEPA HM ASO CHS Employee: $11.97 Health America — Health America: $27.64 Independence Blue Cross — IBC CHS Employee: $14.25 InterGroup — InterGroup: $50.16 Multiplan — Multiplan Primary: $42.75 Self Pay — Self Pay: $20.52
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W-PLT	$51	$12.24	$4.09 – $47.17
Complete blood count (CBC), automated: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $8.65 Aetna — Aetna: $14.57 Aetna — Aetna HPN: $10.96 Aetna — Aetna NAB FH: $39.42 Aetna — Aetna NAB Work Comp: $47.17 Aetna — NODE Aetna MCR ADV: $6.34 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $7.52 BCNEPA HM — BCNEPA HM ASO CHS Employee: $10.71 Cigna — Cigna: $6.31 Community Bluee — NODE Community Blue Medicare Advantage: $4.09
Complete blood count (CBC), automated CPT 85027 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CBC W-PLT	$51	$18.36	$10.71 – $47.18
Complete blood count (CBC), automated: rates for 10 insurance plans Aetna — Aetna: $23.21 Aetna — Aetna HPN: $18.67 Aetna — Aetna NAB FH: $39.42 Aetna — Aetna NAB Work Comp: $47.18 BCNEPA HM — BCNEPA HM ASO CHS Employee: $10.71 Health America — Health America: $24.73 Independence Blue Cross — IBC CHS Employee: $12.75 InterGroup — InterGroup: $44.88 Multiplan — Multiplan Primary: $38.25 Self Pay — Self Pay: $18.36
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$48	$11.52	$3 – $44.40
Blood clotting time test (prothrombin time, PT): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $4.60 Aetna — Aetna: $9.65 Aetna — Aetna HPN: $10.32 Aetna — Aetna NAB FH: $37.10 Aetna — Aetna NAB Work Comp: $44.40 Aetna — NODE Aetna MCR ADV: $4.20 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $4 BCNEPA HM — BCNEPA HM ASO CHS Employee: $10.08 Cigna — Cigna: $4.32 Community Bluee — NODE Community Blue Medicare Advantage: $3.84
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient (hospital stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$48	$17.28	$10.08 – $44.40
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans Aetna — Aetna: $21.84 Aetna — Aetna HPN: $17.57 Aetna — Aetna NAB FH: $37.10 Aetna — Aetna NAB Work Comp: $44.40 BCNEPA HM — BCNEPA HM ASO CHS Employee: $10.08 Health America — Health America: $23.28 Independence Blue Cross — IBC CHS Employee: $12 InterGroup — InterGroup: $42.24 Multiplan — Multiplan Primary: $36 Self Pay — Self Pay: $17.28
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLAST TIMEPTT	$70	$16.80	$4.21 – $64.75
Blood clotting test (partial thromboplastin time, PTT): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $8.63 Aetna — Aetna: $13.54 Aetna — Aetna HPN: $15.05 Aetna — Aetna NAB FH: $54.11 Aetna — Aetna NAB Work Comp: $64.75 Aetna — NODE Aetna MCR ADV: $5.89 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $7.50 BCNEPA HM — BCNEPA HM ASO CHS Employee: $14.70 Cigna — Cigna: $5.98 Community Bluee — NODE Community Blue Medicare Advantage: $5.61
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient (hospital stay) · Hospital (facility) fee In the file: THROMBOPLAST TIMEPTT	$70	$25.20	$14.70 – $64.75
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans Aetna — Aetna: $31.85 Aetna — Aetna HPN: $25.62 Aetna — Aetna NAB FH: $54.11 Aetna — Aetna NAB Work Comp: $64.75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $14.70 Health America — Health America: $33.95 Independence Blue Cross — IBC CHS Employee: $17.50 InterGroup — InterGroup: $61.60 Multiplan — Multiplan Primary: $52.50 Self Pay — Self Pay: $25.20

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT-HEAD WO	$2,919	$700.56	$77.50 – $3,494
CT scan of the head or brain, without contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $89.13 Aetna — Aetna: $788.13 Aetna — Aetna HPN: $627.59 Aetna — Aetna NAB FH: $2,256.39 Aetna — Aetna NAB Work Comp: $2,700.08 Aetna — NODE Aetna MCR ADV: $98.19 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $85.25 BCNEPA HM — BCNEPA HM ASO CHS Employee: $612.99 Cigna — Cigna: $1,380.69 Community Bluee — NODE Community Blue Medicare Advantage: $233.81
CT scan of the head or brain, without contrast CPT 70450 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT-HEAD WO	$2,919	$1,050.84	$612.99 – $2,700.08
CT scan of the head or brain, without contrast: rates for 10 insurance plans Aetna — Aetna: $1,328.14 Aetna — Aetna HPN: $1,068.35 Aetna — Aetna NAB FH: $2,256.39 Aetna — Aetna NAB Work Comp: $2,700.08 BCNEPA HM — BCNEPA HM ASO CHS Employee: $612.99 Health America — Health America: $1,415.71 Independence Blue Cross — IBC CHS Employee: $729.75 InterGroup — InterGroup: $2,568.72 Multiplan — Multiplan Primary: $2,189.25 Self Pay — Self Pay: $1,050.84
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR-BRAIN WWO	$9,702	$2,328.48	$269 – $8,974.35
MRI of the brain, before and after contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $309.35 Aetna — Aetna: $2,619.54 Aetna — Aetna HPN: $2,085.93 Aetna — Aetna NAB FH: $7,499.65 Aetna — Aetna NAB Work Comp: $8,974.35 Aetna — NODE Aetna MCR ADV: $343.48 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $295.90 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,037.42 Cigna — Cigna: $4,589.05 Community Bluee — NODE Community Blue Medicare Advantage: $777.13
MRI of the brain, before and after contrast CPT 70553 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR-BRAIN WWO	$9,702	$3,492.72	$2,037.42 – $8,974.35
MRI of the brain, before and after contrast: rates for 10 insurance plans Aetna — Aetna: $4,414.41 Aetna — Aetna HPN: $3,550.93 Aetna — Aetna NAB FH: $7,499.65 Aetna — Aetna NAB Work Comp: $8,974.35 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,037.42 Health America — Health America: $4,705.47 Independence Blue Cross — IBC CHS Employee: $2,425.50 InterGroup — InterGroup: $8,537.76 Multiplan — Multiplan Primary: $7,276.50 Self Pay — Self Pay: $3,492.72
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CH-CHEST 2V DR	$615	$147.60	$14.85 – $648
Chest X-ray, 2 views: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $17.08 Aetna — Aetna: $166.05 Aetna — Aetna HPN: $132.22 Aetna — Aetna NAB FH: $475.39 Aetna — Aetna NAB Work Comp: $568.88 Aetna — NODE Aetna MCR ADV: $81.16 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $16.34 BCNEPA HM — BCNEPA HM ASO CHS Employee: $129.15 Cigna — Cigna: $290.89 Community Bluee — NODE Community Blue Medicare Advantage: $49.26
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CH-CHEST 2V DR	$615	$221.40	$129.15 – $568.88
Chest X-ray, 2 views: rates for 10 insurance plans Aetna — Aetna: $279.82 Aetna — Aetna HPN: $225.09 Aetna — Aetna NAB FH: $475.40 Aetna — Aetna NAB Work Comp: $568.88 BCNEPA HM — BCNEPA HM ASO CHS Employee: $129.15 Health America — Health America: $298.27 Independence Blue Cross — IBC CHS Employee: $153.75 InterGroup — InterGroup: $541.20 Multiplan — Multiplan Primary: $461.25 Self Pay — Self Pay: $221.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: CH-CHEST 2V DR	$615	$147.60	$14.85 – $648
Chest X-ray, 2 views: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $17.08 Aetna — Aetna: $166.05 Aetna — Aetna HPN: $132.22 Aetna — Aetna NAB FH: $475.39 Aetna — Aetna NAB Work Comp: $568.88 Aetna — NODE Aetna MCR ADV: $32.46 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $16.34 BCNEPA HM — BCNEPA HM ASO CHS Employee: $129.15 Cigna — Cigna: $290.89 Community Bluee — NODE Community Blue Medicare Advantage: $49.26
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SP-LS SPNE 4VPLUS DR	$1,189	$285.36	$22.50 – $1,099.83
X-ray of the lower spine, at least 4 views: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $25.88 Aetna — Aetna: $321.03 Aetna — Aetna HPN: $255.63 Aetna — Aetna NAB FH: $919.10 Aetna — Aetna NAB Work Comp: $1,099.83 Aetna — NODE Aetna MCR ADV: $98.19 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $24.75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $249.69 Cigna — Cigna: $562.40 Community Bluee — NODE Community Blue Medicare Advantage: $95.24
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SP-LS SPNE 4VPLUS DR	$1,189	$428.04	$249.69 – $1,099.83
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Aetna — Aetna: $541 Aetna — Aetna HPN: $435.17 Aetna — Aetna NAB FH: $919.10 Aetna — Aetna NAB Work Comp: $1,099.83 BCNEPA HM — BCNEPA HM ASO CHS Employee: $249.69 Health America — Health America: $576.66 Independence Blue Cross — IBC CHS Employee: $297.25 InterGroup — InterGroup: $1,046.32 Multiplan — Multiplan Primary: $891.75 Self Pay — Self Pay: $428.04
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: SP-LS SPNE 4VPLUS DR	$1,189	$285.36	$22.50 – $1,099.83
X-ray of the lower spine, at least 4 views: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $25.88 Aetna — Aetna: $321.03 Aetna — Aetna HPN: $255.63 Aetna — Aetna NAB FH: $919.10 Aetna — Aetna NAB Work Comp: $1,099.83 Aetna — NODE Aetna MCR ADV: $39.28 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $24.75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $249.69 Cigna — Cigna: $562.40 Community Bluee — NODE Community Blue Medicare Advantage: $95.24
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR-LUMB SPINE WO	$6,053	$1,452.72	$187.20 – $5,599.03
MRI of the lower back (lumbar spine), without contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $215.28 Aetna — Aetna: $1,634.31 Aetna — Aetna HPN: $1,301.40 Aetna — Aetna NAB FH: $4,678.97 Aetna — Aetna NAB Work Comp: $5,599.03 Aetna — NODE Aetna MCR ADV: $218.86 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $205.92 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,271.13 Cigna — Cigna: $2,863.07 Community Bluee — NODE Community Blue Medicare Advantage: $484.85
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR-LUMB SPINE WO	$6,053	$2,179.08	$1,271.13 – $5,599.03
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans Aetna — Aetna: $2,754.12 Aetna — Aetna HPN: $2,215.40 Aetna — Aetna NAB FH: $4,678.97 Aetna — Aetna NAB Work Comp: $5,599.03 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,271.13 Health America — Health America: $2,935.70 Independence Blue Cross — IBC CHS Employee: $1,513.25 InterGroup — InterGroup: $5,326.64 Multiplan — Multiplan Primary: $4,539.75 Self Pay — Self Pay: $2,179.08
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT-PELVIS W	$5,024	$1,205.76	$86.50 – $4,647.20
CT scan of the pelvis, with contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $99.47 Aetna — Aetna: $1,356.48 Aetna — Aetna HPN: $1,080.16 Aetna — Aetna NAB FH: $3,883.55 Aetna — Aetna NAB Work Comp: $4,647.20 Aetna — NODE Aetna MCR ADV: $164.10 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $95.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,055.04 Cigna — Cigna: $2,376.35 Community Bluee — NODE Community Blue Medicare Advantage: $402.42
CT scan of the pelvis, with contrast CPT 72193 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT-PELVIS W	$5,024	$1,808.64	$1,055.04 – $4,647.20
CT scan of the pelvis, with contrast: rates for 10 insurance plans Aetna — Aetna: $2,285.92 Aetna — Aetna HPN: $1,838.78 Aetna — Aetna NAB FH: $3,883.55 Aetna — Aetna NAB Work Comp: $4,647.20 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,055.04 Health America — Health America: $2,436.64 Independence Blue Cross — IBC CHS Employee: $1,256 InterGroup — InterGroup: $4,421.12 Multiplan — Multiplan Primary: $3,768 Self Pay — Self Pay: $1,808.64
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MR-LW JOINT WO	$6,561	$1,574.64	$211.30 – $6,068.94
MRI of a leg joint (such as the knee), without contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $309.35 Aetna — Aetna: $1,771.47 Aetna — Aetna HPN: $1,410.62 Aetna — Aetna NAB FH: $5,071.65 Aetna — Aetna NAB Work Comp: $6,068.94 Aetna — NODE Aetna MCR ADV: $218.86 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $295.90 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,377.81 Cigna — Cigna: $3,103.35 Community Bluee — NODE Community Blue Medicare Advantage: $525.54
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MR-LW JOINT WO	$6,561	$2,361.96	$1,377.81 – $6,068.93
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans Aetna — Aetna: $2,985.26 Aetna — Aetna HPN: $2,401.33 Aetna — Aetna NAB FH: $5,071.65 Aetna — Aetna NAB Work Comp: $6,068.93 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,377.81 Health America — Health America: $3,182.09 Independence Blue Cross — IBC CHS Employee: $1,640.25 InterGroup — InterGroup: $5,773.68 Multiplan — Multiplan Primary: $4,920.75 Self Pay — Self Pay: $2,361.96
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: MR-LW JOINT WO BI	$9,842	$2,362.08	$347.96 – $9,103.85
MRI of a leg joint (such as the knee), without contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $762.20 Aetna — Aetna: $2,657.34 Aetna — Aetna HPN: $2,116.03 Aetna — Aetna NAB FH: $7,607.87 Aetna — Aetna NAB Work Comp: $9,103.85 Aetna — NODE Aetna MCR ADV: $489.99 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $729.06 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,066.82 Cigna — Cigna: $4,655.27 Community Bluee — NODE Community Blue Medicare Advantage: $788.34
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	$9,968	$2,392.32	$192.73 – $9,220.40
CT scan of the abdomen and pelvis, with contrast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $221.64 Aetna — Aetna: $2,691.36 Aetna — Aetna HPN: $2,143.12 Aetna — Aetna NAB FH: $7,705.26 Aetna — Aetna NAB Work Comp: $9,220.40 Aetna — NODE Aetna MCR ADV: $343.48 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $212 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,093.28 Cigna — Cigna: $4,714.86 Community Bluee — NODE Community Blue Medicare Advantage: $798.44
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CT-ABD PELVIS W	$9,968	$3,588.48	$2,093.28 – $9,220.40
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Aetna — Aetna: $4,535.44 Aetna — Aetna HPN: $3,648.29 Aetna — Aetna NAB FH: $7,705.26 Aetna — Aetna NAB Work Comp: $9,220.40 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,093.28 Health America — Health America: $4,834.48 Independence Blue Cross — IBC CHS Employee: $2,492 InterGroup — InterGroup: $8,771.84 Multiplan — Multiplan Primary: $7,476 Self Pay — Self Pay: $3,588.48
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US-ABDOMEN COMP WO	$2,057	$493.68	$57.50 – $1,902.73
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $66.13 Aetna — Aetna: $555.39 Aetna — Aetna HPN: $442.26 Aetna — Aetna NAB FH: $1,590.06 Aetna — Aetna NAB Work Comp: $1,902.73 Aetna — NODE Aetna MCR ADV: $98.19 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $63.25 BCNEPA HM — BCNEPA HM ASO CHS Employee: $431.97 Cigna — Cigna: $972.96 Community Bluee — NODE Community Blue Medicare Advantage: $164.77
Ultrasound of the abdomen, complete CPT 76700 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US-ABDOMEN COMP WO	$2,057	$740.52	$431.97 – $1,902.73
Ultrasound of the abdomen, complete: rates for 10 insurance plans Aetna — Aetna: $935.94 Aetna — Aetna HPN: $752.86 Aetna — Aetna NAB FH: $1,590.06 Aetna — Aetna NAB Work Comp: $1,902.73 BCNEPA HM — BCNEPA HM ASO CHS Employee: $431.97 Health America — Health America: $997.64 Independence Blue Cross — IBC CHS Employee: $514.25 InterGroup — InterGroup: $1,810.16 Multiplan — Multiplan Primary: $1,542.75 Self Pay — Self Pay: $740.52
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: US-ABDOMEN COMP WO	$2,057	$493.68	$57.50 – $1,902.73
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $66.13 Aetna — Aetna: $555.39 Aetna — Aetna HPN: $442.26 Aetna — Aetna NAB FH: $1,590.06 Aetna — Aetna NAB Work Comp: $1,902.73 Aetna — NODE Aetna MCR ADV: $39.28 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $63.25 BCNEPA HM — BCNEPA HM ASO CHS Employee: $431.97 Cigna — Cigna: $972.96 Community Bluee — NODE Community Blue Medicare Advantage: $164.77
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US-PELVIS PREG	$1,864	$447.36	$46.50 – $1,724.20
Pregnancy ultrasound (after the first trimester): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $53.48 Aetna — Aetna: $503.28 Aetna — Aetna HPN: $400.76 Aetna — Aetna NAB FH: $1,440.87 Aetna — Aetna NAB Work Comp: $1,724.20 Aetna — NODE Aetna MCR ADV: $98.19 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $51.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $391.44 Cigna — Cigna: $881.67 Community Bluee — NODE Community Blue Medicare Advantage: $149.31
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US-PELVIS PREG	$1,864	$671.04	$391.44 – $1,724.20
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans Aetna — Aetna: $848.12 Aetna — Aetna HPN: $682.22 Aetna — Aetna NAB FH: $1,440.87 Aetna — Aetna NAB Work Comp: $1,724.20 BCNEPA HM — BCNEPA HM ASO CHS Employee: $391.44 Health America — Health America: $904.04 Independence Blue Cross — IBC CHS Employee: $466 InterGroup — InterGroup: $1,640.32 Multiplan — Multiplan Primary: $1,398 Self Pay — Self Pay: $671.04
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: US-PELVIS PREG	$1,864	$447.36	$46.50 – $1,724.20
Pregnancy ultrasound (after the first trimester): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $53.48 Aetna — Aetna: $503.28 Aetna — Aetna HPN: $400.76 Aetna — Aetna NAB FH: $1,440.87 Aetna — Aetna NAB Work Comp: $1,724.20 Aetna — NODE Aetna MCR ADV: $39.28 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $51.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $391.44 Cigna — Cigna: $881.67 Community Bluee — NODE Community Blue Medicare Advantage: $149.31
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US-TRANSVAGINAL	$1,864	$447.36	$46.50 – $1,724.20
Transvaginal ultrasound: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $53.48 Aetna — Aetna: $503.28 Aetna — Aetna HPN: $400.76 Aetna — Aetna NAB FH: $1,440.87 Aetna — Aetna NAB Work Comp: $1,724.20 Aetna — NODE Aetna MCR ADV: $98.19 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $51.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $391.44 Cigna — Cigna: $881.67 Community Bluee — NODE Community Blue Medicare Advantage: $149.31
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · Hospital (facility) fee In the file: US-TRANSVAGINAL	$1,864	$671.04	$391.44 – $1,724.20
Transvaginal ultrasound: rates for 10 insurance plans Aetna — Aetna: $848.12 Aetna — Aetna HPN: $682.22 Aetna — Aetna NAB FH: $1,440.87 Aetna — Aetna NAB Work Comp: $1,724.20 BCNEPA HM — BCNEPA HM ASO CHS Employee: $391.44 Health America — Health America: $904.04 Independence Blue Cross — IBC CHS Employee: $466 InterGroup — InterGroup: $1,640.32 Multiplan — Multiplan Primary: $1,398 Self Pay — Self Pay: $671.04
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: US-TRANSVAGINAL	$1,864	$447.36	$46.50 – $1,724.20
Transvaginal ultrasound: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $53.48 Aetna — Aetna: $503.28 Aetna — Aetna HPN: $400.76 Aetna — Aetna NAB FH: $1,440.87 Aetna — Aetna NAB Work Comp: $1,724.20 Aetna — NODE Aetna MCR ADV: $39.28 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $51.15 BCNEPA HM — BCNEPA HM ASO CHS Employee: $391.44 Cigna — Cigna: $881.67 Community Bluee — NODE Community Blue Medicare Advantage: $149.31
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BR-DIG MAMMO UNILAT	$950	$228	$71.01 – $878.75
Diagnostic mammogram, one breast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $81.66 Aetna — Aetna: $256.50 Aetna — Aetna HPN: $204.25 Aetna — Aetna NAB FH: $734.35 Aetna — Aetna NAB Work Comp: $878.75 Aetna — NODE Aetna MCR ADV: $79.56 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $78.11 BCNEPA HM — BCNEPA HM ASO CHS Employee: $199.50 Cigna — Cigna: $449.35 Community Bluee — NODE Community Blue Medicare Advantage: $76.10
Diagnostic mammogram, one breast CPT 77065 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BR-DIG MAMMO UNILAT	$950	$342	$199.50 – $878.75
Diagnostic mammogram, one breast: rates for 10 insurance plans Aetna — Aetna: $432.25 Aetna — Aetna HPN: $347.70 Aetna — Aetna NAB FH: $734.35 Aetna — Aetna NAB Work Comp: $878.75 BCNEPA HM — BCNEPA HM ASO CHS Employee: $199.50 Health America — Health America: $460.75 Independence Blue Cross — IBC CHS Employee: $237.50 InterGroup — InterGroup: $836 Multiplan — Multiplan Primary: $712.50 Self Pay — Self Pay: $342
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BR-DIG MAMMO UNILAT	$950	$228	$71.01 – $878.75
Diagnostic mammogram, one breast: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $81.66 Aetna — Aetna: $256.50 Aetna — Aetna HPN: $204.25 Aetna — Aetna NAB FH: $734.35 Aetna — Aetna NAB Work Comp: $878.75 Aetna — NODE Aetna MCR ADV: $79.56 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $78.11 BCNEPA HM — BCNEPA HM ASO CHS Employee: $199.50 Cigna — Cigna: $449.35 Community Bluee — NODE Community Blue Medicare Advantage: $76.10
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BR-DIG MAMMO BILAT	$1,155	$277.20	$90.83 – $1,068.38
Diagnostic mammogram, both breasts: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $104.45 Aetna — Aetna: $311.85 Aetna — Aetna HPN: $248.32 Aetna — Aetna NAB FH: $892.82 Aetna — Aetna NAB Work Comp: $1,068.38 Aetna — NODE Aetna MCR ADV: $102.02 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $99.91 BCNEPA HM — BCNEPA HM ASO CHS Employee: $242.55 Cigna — Cigna: $546.32 Community Bluee — NODE Community Blue Medicare Advantage: $92.52
Diagnostic mammogram, both breasts CPT 77066 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BR-DIG MAMMO BILAT	$1,155	$415.80	$242.55 – $1,068.38
Diagnostic mammogram, both breasts: rates for 10 insurance plans Aetna — Aetna: $525.52 Aetna — Aetna HPN: $422.73 Aetna — Aetna NAB FH: $892.82 Aetna — Aetna NAB Work Comp: $1,068.38 BCNEPA HM — BCNEPA HM ASO CHS Employee: $242.55 Health America — Health America: $560.17 Independence Blue Cross — IBC CHS Employee: $288.75 InterGroup — InterGroup: $1,016.40 Multiplan — Multiplan Primary: $866.25 Self Pay — Self Pay: $415.80
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BR-DIG MAMMO BILAT	$1,155	$277.20	$90.83 – $1,068.38
Diagnostic mammogram, both breasts: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $104.45 Aetna — Aetna: $311.85 Aetna — Aetna HPN: $248.32 Aetna — Aetna NAB FH: $892.82 Aetna — Aetna NAB Work Comp: $1,068.38 Aetna — NODE Aetna MCR ADV: $102.02 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $99.91 BCNEPA HM — BCNEPA HM ASO CHS Employee: $242.55 Cigna — Cigna: $546.32 Community Bluee — NODE Community Blue Medicare Advantage: $92.52
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BR-DIG MAMMO SCRN BI	$992	$238.08	$75.02 – $917.60
Screening mammogram, both breasts: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $86.27 Aetna — Aetna: $267.84 Aetna — Aetna HPN: $213.28 Aetna — Aetna NAB FH: $766.82 Aetna — Aetna NAB Work Comp: $917.60 Aetna — NODE Aetna MCR ADV: $83.76 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $82.52 BCNEPA HM — BCNEPA HM ASO CHS Employee: $208.32 Cigna — Cigna: $469.22 Community Bluee — NODE Community Blue Medicare Advantage: $79.46
Screening mammogram, both breasts CPT 77067 · Inpatient (hospital stay) · Hospital (facility) fee In the file: BR-DIG MAMMO SCRN BI	$992	$357.12	$208.32 – $917.60
Screening mammogram, both breasts: rates for 10 insurance plans Aetna — Aetna: $451.36 Aetna — Aetna HPN: $363.07 Aetna — Aetna NAB FH: $766.82 Aetna — Aetna NAB Work Comp: $917.60 BCNEPA HM — BCNEPA HM ASO CHS Employee: $208.32 Health America — Health America: $481.12 Independence Blue Cross — IBC CHS Employee: $248 InterGroup — InterGroup: $872.96 Multiplan — Multiplan Primary: $744 Self Pay — Self Pay: $357.12
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: BR-DIG MAMMO SCRN BI	$992	$238.08	$75.02 – $917.60
Screening mammogram, both breasts: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $86.27 Aetna — Aetna: $267.84 Aetna — Aetna HPN: $213.28 Aetna — Aetna NAB FH: $766.82 Aetna — Aetna NAB Work Comp: $917.60 Aetna — NODE Aetna MCR ADV: $83.76 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $82.52 BCNEPA HM — BCNEPA HM ASO CHS Employee: $208.32 Cigna — Cigna: $469.22 Community Bluee — NODE Community Blue Medicare Advantage: $79.46

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP-COMP EP W-O ARRY	$39,076	$9,378.24	$1,197 – $39,076
Heart rhythm study (electrophysiology evaluation): 10 of 47 insurance plan rates Aetna — Aetna: $10,550.52 Aetna — Aetna HPN: $8,401.34 Aetna — Aetna NAB FH: $30,205.75 Aetna — Aetna NAB Work Comp: $36,145.30 Aetna — NODE Aetna MCR ADV: $6,670.31 BCNEPA HM — BCNEPA HM ASO CHS Employee: $8,205.96 Cigna — Cigna: $18,482.95 Community Bluee — NODE Community Blue Medicare Advantage: $3,129.99 Geisinger Indemnity — Geisinger HP: $18,195.57 Health America — Health America: $11,175.74
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP-COMP EP W-O ARRY	$39,076	$14,067.36	$8,205.96 – $36,145.30
Heart rhythm study (electrophysiology evaluation): rates for 10 insurance plans Aetna — Aetna: $17,779.58 Aetna — Aetna HPN: $14,301.82 Aetna — Aetna NAB FH: $30,205.75 Aetna — Aetna NAB Work Comp: $36,145.30 BCNEPA HM — BCNEPA HM ASO CHS Employee: $8,205.96 Health America — Health America: $18,951.86 Independence Blue Cross — IBC CHS Employee: $9,769 InterGroup — InterGroup: $34,386.88 Multiplan — Multiplan Primary: $29,307 Self Pay — Self Pay: $14,067.36
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EP-ATR FIB PULM VN I	$99,999	$23,999.76	$895.50 – $99,999
Heart rhythm study with ablation for atrial fibrillation: 10 of 48 insurance plan rates Aetna — Aetna: $26,999.73 Aetna — Aetna HPN: $21,499.78 Aetna — Aetna NAB FH: $77,299.23 Aetna — Aetna NAB Work Comp: $92,499.07 Aetna — NODE Aetna MCR ADV: $21,159.40 BCNEPA HM — BCNEPA HM ASO CHS Employee: $20,999.79 Cigna — Cigna: $47,299.53 Community Bluee — NODE Community Blue Medicare Advantage: $8,009.92 Geisinger Indemnity — Geisinger HP: $57,865.77 Health America — Health America: $28,599.71
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient (hospital stay) · Hospital (facility) fee In the file: EP-ATR FIB PULM VN I	$99,999	$35,999.64	$20,999.79 – $92,499.08
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans Aetna — Aetna: $45,499.54 Aetna — Aetna HPN: $36,599.63 Aetna — Aetna NAB FH: $77,299.23 Aetna — Aetna NAB Work Comp: $92,499.08 BCNEPA HM — BCNEPA HM ASO CHS Employee: $20,999.79 Health America — Health America: $48,499.51 Independence Blue Cross — IBC CHS Employee: $24,999.75 InterGroup — InterGroup: $87,999.12 Multiplan — Multiplan Primary: $74,999.25 Self Pay — Self Pay: $35,999.64
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOMNO GT4 GE6YO	$7,271	$1,745.04	$270.32 – $6,725.68
Sleep study (overnight, in a sleep lab): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $310.87 Aetna — Aetna: $1,963.17 Aetna — Aetna HPN: $1,563.27 Aetna — Aetna NAB FH: $5,620.48 Aetna — Aetna NAB Work Comp: $6,725.68 Aetna — NODE Aetna MCR ADV: $933.84 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $297.35 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,526.91 Cigna — Cigna: $3,439.18 Community Bluee — NODE Community Blue Medicare Advantage: $582.41
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient (hospital stay) · Hospital (facility) fee In the file: POLYSOMNO GT4 GE6YO	$7,271	$2,617.56	$1,526.91 – $6,725.68
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans Aetna — Aetna: $3,308.31 Aetna — Aetna HPN: $2,661.19 Aetna — Aetna NAB FH: $5,620.48 Aetna — Aetna NAB Work Comp: $6,725.68 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,526.91 Health America — Health America: $3,526.43 Independence Blue Cross — IBC CHS Employee: $1,817.75 InterGroup — InterGroup: $6,398.48 Multiplan — Multiplan Primary: $5,453.25 Self Pay — Self Pay: $2,617.56

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: THER EXRCS-15MIN PT	$281	$67.44	$8.80 – $324
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 51 insurance plan rates Aetna — Aetna: $75.87 Aetna — Aetna HPN: $60.41 Aetna — Aetna NAB FH: $217.21 Aetna — Aetna NAB Work Comp: $259.93 Aetna — NODE Aetna MCR ADV: $27.80 BCNEPA HM — BCNEPA HM ASO CHS Employee: $59.01 Cigna — Cigna: $132.91 Community Bluee — NODE Community Blue Medicare Advantage: $22.51 Geisinger Indemnity — Geisinger HP: $75.83 Geisinger Indemnity — Geisinger Medicaid PA: $8.80
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THER EXRCS-15MIN PTA	$281	$67.44	$8.80 – $324
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 51 insurance plan rates Aetna — Aetna: $75.87 Aetna — Aetna HPN: $60.41 Aetna — Aetna NAB FH: $217.21 Aetna — Aetna NAB Work Comp: $259.93 Aetna — NODE Aetna MCR ADV: $27.80 BCNEPA HM — BCNEPA HM ASO CHS Employee: $59.01 Cigna — Cigna: $132.91 Community Bluee — NODE Community Blue Medicare Advantage: $22.51 Geisinger Indemnity — Geisinger HP: $75.83 Geisinger Indemnity — Geisinger Medicaid PA: $8.80
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THER EXRCS-15MIN OT	$281	$67.44	$8.80 – $324
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 51 insurance plan rates Aetna — Aetna: $75.87 Aetna — Aetna HPN: $60.41 Aetna — Aetna NAB FH: $217.21 Aetna — Aetna NAB Work Comp: $259.93 Aetna — NODE Aetna MCR ADV: $27.80 BCNEPA HM — BCNEPA HM ASO CHS Employee: $59.01 Cigna — Cigna: $132.91 Community Bluee — NODE Community Blue Medicare Advantage: $22.51 Geisinger Indemnity — Geisinger HP: $75.83 Geisinger Indemnity — Geisinger Medicaid PA: $8.80
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- LOW CMP PT	$665	$159.60	$53.27 – $615.13
Physical therapy evaluation (low complexity): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $73.15 Aetna — Aetna: $179.55 Aetna — Aetna HPN: $142.97 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 Aetna — NODE Aetna MCR ADV: $95.07 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $69.97 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Cigna — Cigna: $314.54 Community Bluee — NODE Community Blue Medicare Advantage: $53.27
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- LOW CMP PTA	$665	$159.60	$53.27 – $615.13
Physical therapy evaluation (low complexity): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $73.15 Aetna — Aetna: $179.55 Aetna — Aetna HPN: $142.97 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 Aetna — NODE Aetna MCR ADV: $95.07 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $69.97 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Cigna — Cigna: $314.54 Community Bluee — NODE Community Blue Medicare Advantage: $53.27
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- LOW CMP PT	$665	$239.40	$139.65 – $615.13
Physical therapy evaluation (low complexity): rates for 10 insurance plans Aetna — Aetna: $302.57 Aetna — Aetna HPN: $243.39 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Health America — Health America: $322.52 Independence Blue Cross — IBC CHS Employee: $166.25 InterGroup — InterGroup: $585.20 Multiplan — Multiplan Primary: $498.75 Self Pay — Self Pay: $239.40
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- MOD CMP PT	$665	$159.60	$53.27 – $615.13
Physical therapy evaluation (moderate complexity): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $73.15 Aetna — Aetna: $179.55 Aetna — Aetna HPN: $142.97 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 Aetna — NODE Aetna MCR ADV: $95.07 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $69.97 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Cigna — Cigna: $314.54 Community Bluee — NODE Community Blue Medicare Advantage: $53.27
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- MOD CMP PTA	$665	$159.60	$53.27 – $615.13
Physical therapy evaluation (moderate complexity): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $73.15 Aetna — Aetna: $179.55 Aetna — Aetna HPN: $142.97 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 Aetna — NODE Aetna MCR ADV: $95.07 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $69.97 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Cigna — Cigna: $314.54 Community Bluee — NODE Community Blue Medicare Advantage: $53.27
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- MOD CMP PT	$665	$239.40	$139.65 – $615.13
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans Aetna — Aetna: $302.57 Aetna — Aetna HPN: $243.39 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Health America — Health America: $322.52 Independence Blue Cross — IBC CHS Employee: $166.25 InterGroup — InterGroup: $585.20 Multiplan — Multiplan Primary: $498.75 Self Pay — Self Pay: $239.40
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- HGH CMP PT	$665	$159.60	$53.27 – $615.13
Physical therapy evaluation (high complexity): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $73.15 Aetna — Aetna: $179.55 Aetna — Aetna HPN: $142.97 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 Aetna — NODE Aetna MCR ADV: $95.07 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $69.97 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Cigna — Cigna: $314.54 Community Bluee — NODE Community Blue Medicare Advantage: $53.27
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- HGH CMP PTA	$665	$159.60	$53.27 – $615.13
Physical therapy evaluation (high complexity): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $73.15 Aetna — Aetna: $179.55 Aetna — Aetna HPN: $142.97 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 Aetna — NODE Aetna MCR ADV: $95.07 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $69.97 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Cigna — Cigna: $314.54 Community Bluee — NODE Community Blue Medicare Advantage: $53.27
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL- HGH CMP PT	$665	$239.40	$139.65 – $615.13
Physical therapy evaluation (high complexity): rates for 10 insurance plans Aetna — Aetna: $302.57 Aetna — Aetna HPN: $243.39 Aetna — Aetna NAB FH: $514.04 Aetna — Aetna NAB Work Comp: $615.13 BCNEPA HM — BCNEPA HM ASO CHS Employee: $139.65 Health America — Health America: $322.52 Independence Blue Cross — IBC CHS Employee: $166.25 InterGroup — InterGroup: $585.20 Multiplan — Multiplan Primary: $498.75 Self Pay — Self Pay: $239.40

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: REMOVAL OF BREAST LESION	$37,677	$9,042.48	$173 – $37,677
Removal of breast growth (open surgery): 10 of 56 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $198.95 Aetna — Aetna: $10,172.79 Aetna — Aetna HPN: $8,100.56 Aetna — Aetna NAB FH: $29,124.32 Aetna — Aetna NAB Work Comp: $34,851.22 Aetna — NODE Aetna MCR ADV: $3,404.50 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $190.30 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7,912.17 Cigna — Cigna: $17,821.22 Community Bluee — NODE Community Blue Medicare Advantage: $3,017.93
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	$131,973	$31,673.52	$814.80 – $131,973
Total hip replacement: 10 of 50 insurance plan rates Aetna — Aetna: $35,632.71 Aetna — Aetna HPN: $28,374.19 Aetna — Aetna NAB FH: $102,015.13 Aetna — Aetna NAB Work Comp: $122,075.02 Aetna — NODE Aetna MCR ADV: $11,739.90 BCNEPA HM — BCNEPA HM ASO CHS Employee: $27,714.33 Cigna — Cigna: $62,423.23 Community Bluee — NODE Community Blue Medicare Advantage: $10,571.04 Geisinger Indemnity — Geisinger HP: $32,065.94 Geisinger Indemnity — Geisinger Medicaid PA: $814.80
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	$137,590	$33,021.60	$814.80 – $137,590
Total knee replacement: 10 of 56 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $1,150 Aetna — Aetna: $37,149.30 Aetna — Aetna HPN: $29,581.85 Aetna — Aetna NAB FH: $106,357.07 Aetna — Aetna NAB Work Comp: $127,270.75 Aetna — NODE Aetna MCR ADV: $11,739.90 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $1,100 BCNEPA HM — BCNEPA HM ASO CHS Employee: $28,893.90 Cigna — Cigna: $65,080.07 Community Bluee — NODE Community Blue Medicare Advantage: $11,020.96
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	$56,540	$13,569.60	$164.62 – $56,540
Shoulder arthroscopy: shaving of shoulder bone: 10 of 26 insurance plan rates Aetna — Aetna: $15,265.80 Aetna — Aetna HPN: $12,156.10 Aetna — Aetna NAB FH: $43,705.42 Aetna — Aetna NAB Work Comp: $52,299.50 BCNEPA HM — BCNEPA HM ASO CHS Employee: $11,873.40 Cigna — Cigna: $26,743.42 Community Bluee — NODE Community Blue Medicare Advantage: $4,528.85 Geisinger Indemnity — Geisinger Medicaid PA: $814.80 Health America — Health America: $16,170.44 Health Net — Health Net: $29,400.80
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KNEE ARTHROSCOPY/SURGERY	$34,053	$8,172.72	$526.14 – $34,053
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $625.02 Aetna — Aetna: $9,194.31 Aetna — Aetna HPN: $7,321.40 Aetna — Aetna NAB FH: $26,322.97 Aetna — Aetna NAB Work Comp: $31,499.03 Aetna — NODE Aetna MCR ADV: $2,891.02 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $597.85 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7,151.13 Cigna — Cigna: $16,107.07 Community Bluee — NODE Community Blue Medicare Advantage: $2,727.65
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	$32,869	$7,888.56	$283.30 – $32,869
Removal of tonsils and adenoids (under age 12): 10 of 51 insurance plan rates Aetna — Aetna: $8,874.63 Aetna — Aetna HPN: $7,066.84 Aetna — Aetna NAB FH: $25,407.74 Aetna — Aetna NAB Work Comp: $30,403.83 Aetna — NODE Aetna MCR ADV: $5,230.52 BCNEPA HM — BCNEPA HM ASO CHS Employee: $6,902.49 Cigna — Cigna: $15,547.04 Community Bluee — NODE Community Blue Medicare Advantage: $2,632.81 Geisinger Indemnity — Geisinger HP: $14,268.05 Geisinger Indemnity — Geisinger Medicaid PA: $728.70
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	$21,451	$5,148.24	$125.22 – $21,451
Upper GI endoscopy (diagnostic): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $144 Aetna — Aetna: $5,791.77 Aetna — Aetna HPN: $4,611.97 Aetna — Aetna NAB FH: $16,581.62 Aetna — Aetna NAB Work Comp: $19,842.17 Aetna — NODE Aetna MCR ADV: $809.64 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $137.74 BCNEPA HM — BCNEPA HM ASO CHS Employee: $4,504.71 Cigna — Cigna: $10,146.32 Community Bluee — NODE Community Blue Medicare Advantage: $1,718.23
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	$17,441	$4,185.84	$148.58 – $17,441
Upper GI endoscopy with biopsy: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $170.87 Aetna — Aetna: $4,709.07 Aetna — Aetna HPN: $3,749.82 Aetna — Aetna NAB FH: $13,481.89 Aetna — Aetna NAB Work Comp: $16,132.92 Aetna — NODE Aetna MCR ADV: $809.64 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $163.44 BCNEPA HM — BCNEPA HM ASO CHS Employee: $3,662.61 Cigna — Cigna: $8,249.59 Community Bluee — NODE Community Blue Medicare Advantage: $1,397.02
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	$12,843	$3,082.32	$180.50 – $12,843
Colonoscopy (diagnostic): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $207.57 Aetna — Aetna: $3,467.61 Aetna — Aetna HPN: $2,761.24 Aetna — Aetna NAB FH: $9,927.64 Aetna — Aetna NAB Work Comp: $11,879.77 Aetna — NODE Aetna MCR ADV: $816.32 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $198.55 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,697.03 Cigna — Cigna: $6,074.74 Community Bluee — NODE Community Blue Medicare Advantage: $1,028.72
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	$15,684	$3,764.16	$225.42 – $15,684
Colonoscopy with biopsy: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $259.23 Aetna — Aetna: $4,234.68 Aetna — Aetna HPN: $3,372.06 Aetna — Aetna NAB FH: $12,123.73 Aetna — Aetna NAB Work Comp: $14,507.70 Aetna — NODE Aetna MCR ADV: $1,053.99 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $247.96 BCNEPA HM — BCNEPA HM ASO CHS Employee: $3,293.64 Cigna — Cigna: $7,418.53 Community Bluee — NODE Community Blue Medicare Advantage: $1,256.29
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	$15,869	$3,808.56	$268.08 – $15,869
Colonoscopy with removal of polyps (snare): 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $308.29 Aetna — Aetna: $4,284.63 Aetna — Aetna HPN: $3,411.84 Aetna — Aetna NAB FH: $12,266.74 Aetna — Aetna NAB Work Comp: $14,678.83 Aetna — NODE Aetna MCR ADV: $1,053.99 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $294.89 BCNEPA HM — BCNEPA HM ASO CHS Employee: $3,332.49 Cigna — Cigna: $7,506.04 Community Bluee — NODE Community Blue Medicare Advantage: $1,271.11
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	$29,559	$7,094.16	$219.29 – $29,559
Ultrasound of the lower bowel by endoscope: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $252.18 Aetna — Aetna: $7,980.93 Aetna — Aetna HPN: $6,355.19 Aetna — Aetna NAB FH: $22,849.11 Aetna — Aetna NAB Work Comp: $27,342.08 Aetna — NODE Aetna MCR ADV: $1,053.99 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $241.22 BCNEPA HM — BCNEPA HM ASO CHS Employee: $6,207.39 Cigna — Cigna: $13,981.41 Community Bluee — NODE Community Blue Medicare Advantage: $2,367.68
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLON CA SCRN NOT HI RSK IND	$12,885	$3,092.40	$322.64 – $12,885
Screening colonoscopy (not high risk): 10 of 49 insurance plan rates Aetna — Aetna: $3,478.95 Aetna — Aetna HPN: $2,770.28 Aetna — Aetna NAB FH: $9,960.10 Aetna — Aetna NAB Work Comp: $11,918.63 Aetna — NODE Aetna MCR ADV: $813 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,705.85 Cigna — Cigna: $6,094.60 Community Bluee — NODE Community Blue Medicare Advantage: $1,032.09 Geisinger Indemnity — Geisinger HP: $2,226.79 Health America — Health America: $3,685.11
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	$45,573	$10,937.52	$639.95 – $45,573
Gallbladder removal by laparoscope: 10 of 51 insurance plan rates Aetna — Aetna: $12,304.71 Aetna — Aetna HPN: $9,798.19 Aetna — Aetna NAB FH: $35,227.93 Aetna — Aetna NAB Work Comp: $42,155.03 Aetna — NODE Aetna MCR ADV: $5,153.53 BCNEPA HM — BCNEPA HM ASO CHS Employee: $9,570.33 Cigna — Cigna: $21,556.03 Community Bluee — NODE Community Blue Medicare Advantage: $3,650.40 Geisinger Indemnity — Geisinger HP: $14,058.04 Geisinger Indemnity — Geisinger Medicaid PA: $814.80
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	$41,575	$9,978	$317.50 – $41,575
Groin (inguinal) hernia repair, age 5 or older: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $365.13 Aetna — Aetna: $11,225.25 Aetna — Aetna HPN: $8,938.63 Aetna — Aetna NAB FH: $32,137.47 Aetna — Aetna NAB Work Comp: $38,456.88 Aetna — NODE Aetna MCR ADV: $3,090.05 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $349.25 BCNEPA HM — BCNEPA HM ASO CHS Employee: $8,730.75 Cigna — Cigna: $19,664.97 Community Bluee — NODE Community Blue Medicare Advantage: $3,330.16
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	$27,322	$6,557.28	$89.50 – $27,322
Prostate biopsy: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $102.92 Aetna — Aetna: $7,376.94 Aetna — Aetna HPN: $5,874.23 Aetna — Aetna NAB FH: $21,119.91 Aetna — Aetna NAB Work Comp: $25,272.85 Aetna — NODE Aetna MCR ADV: $1,819.21 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $98.45 BCNEPA HM — BCNEPA HM ASO CHS Employee: $5,737.62 Cigna — Cigna: $12,923.31 Community Bluee — NODE Community Blue Medicare Advantage: $2,188.49
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	$95,806	$22,993.44	$1,150.76 – $95,806
Prostate removal by laparoscope (radical prostatectomy): 10 of 49 insurance plan rates Aetna — Aetna: $25,867.62 Aetna — Aetna HPN: $20,598.29 Aetna — Aetna NAB FH: $74,058.04 Aetna — Aetna NAB Work Comp: $88,620.55 Aetna — NODE Aetna MCR ADV: $9,189.23 BCNEPA HM — BCNEPA HM ASO CHS Employee: $20,119.26 Cigna — Cigna: $45,316.24 Community Bluee — NODE Community Blue Medicare Advantage: $7,674.06 Geisinger Indemnity — Geisinger HP: $25,079.72 Health America — Health America: $27,400.52
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	$27,067	$6,496.08	$814.80 – $27,067
Hysteroscopy with biopsy of the uterus lining: 10 of 51 insurance plan rates Aetna — Aetna: $7,308.09 Aetna — Aetna HPN: $5,819.40 Aetna — Aetna NAB FH: $20,922.79 Aetna — Aetna NAB Work Comp: $25,036.97 Aetna — NODE Aetna MCR ADV: $2,792.36 BCNEPA HM — BCNEPA HM ASO CHS Employee: $5,684.07 Cigna — Cigna: $12,802.69 Community Bluee — NODE Community Blue Medicare Advantage: $2,168.07 Geisinger Indemnity — Geisinger HP: $7,617.12 Geisinger Indemnity — Geisinger Medicaid PA: $814.80
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: IR-DI L-S INJ W IM	$5,654	$1,356.96	$81.32 – $5,229.95
Spinal injection, lower back (epidural), with imaging guidance: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $93.52 Aetna — Aetna: $1,526.58 Aetna — Aetna HPN: $1,215.61 Aetna — Aetna NAB FH: $4,370.54 Aetna — Aetna NAB Work Comp: $5,229.95 Aetna — NODE Aetna MCR ADV: $617.67 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $89.45 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,187.34 Cigna — Cigna: $2,674.34 Community Bluee — NODE Community Blue Medicare Advantage: $452.89
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	$24,647	$5,915.28	$81.32 – $24,647
Spinal injection, lower back (epidural), with imaging guidance: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $93.52 Aetna — Aetna: $6,654.69 Aetna — Aetna HPN: $5,299.10 Aetna — Aetna NAB FH: $19,052.13 Aetna — Aetna NAB Work Comp: $22,798.47 Aetna — NODE Aetna MCR ADV: $617.67 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $89.45 BCNEPA HM — BCNEPA HM ASO CHS Employee: $5,175.87 Cigna — Cigna: $11,658.03 Community Bluee — NODE Community Blue Medicare Advantage: $1,974.22
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient (hospital stay) · Hospital (facility) fee In the file: IR-DI L-S INJ W IM	$5,654	$2,035.44	$1,187.34 – $5,229.95
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Aetna — Aetna: $2,572.57 Aetna — Aetna HPN: $2,069.36 Aetna — Aetna NAB FH: $4,370.54 Aetna — Aetna NAB Work Comp: $5,229.95 BCNEPA HM — BCNEPA HM ASO CHS Employee: $1,187.34 Health America — Health America: $2,742.19 Independence Blue Cross — IBC CHS Employee: $1,413.50 InterGroup — InterGroup: $4,975.52 Multiplan — Multiplan Primary: $4,240.50 Self Pay — Self Pay: $2,035.44
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$13,306	$3,193.44	$95.04 – $13,306
Nerve root injection, lower back, with imaging guidance: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $109.30 Aetna — Aetna: $3,592.62 Aetna — Aetna HPN: $2,860.79 Aetna — Aetna NAB FH: $10,285.54 Aetna — Aetna NAB Work Comp: $12,308.05 Aetna — NODE Aetna MCR ADV: $814.10 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $104.54 BCNEPA HM — BCNEPA HM ASO CHS Employee: $2,794.26 Cigna — Cigna: $6,293.74 Community Bluee — NODE Community Blue Medicare Advantage: $1,065.81
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	$21,896	$5,255.04	$300 – $21,896
Carpal tunnel release: 10 of 57 insurance plan rates Aetna — ABH Coventry Cares Medicaid PA: $345 Aetna — Aetna: $5,911.92 Aetna — Aetna HPN: $4,707.64 Aetna — Aetna NAB FH: $16,925.61 Aetna — Aetna NAB Work Comp: $20,253.80 Aetna — NODE Aetna MCR ADV: $1,724.50 Amerihealth Caritas — Amerihealth Caritas Medicaid PA: $330 BCNEPA HM — BCNEPA HM ASO CHS Employee: $4,598.16 Cigna — Cigna: $10,356.81 Community Bluee — NODE Community Blue Medicare Advantage: $1,753.87

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	$51,051 – $227,856.49
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 45 insurance plan rates Aetna — NODE Aetna MCR ADV: $67,572.18 BCNEPA HM — BCNEPA HM ASO CHS Employee: $63,799.82 Cigna — Cigna: $156,453.98 Community Bluee — NODE Community Blue Medicare Advantage: $62,357.44 Geisinger Indemnity — Geisinger HP: $125,812.61 Health Net — Health Net: $51,051 HighMark Blue Cross Blue Shield — BCNEPA HM Affordablue: $91,130.06 HighMark Blue Cross Blue Shield — BCNEPA HM FPH: $115,035.83 HighMark Blue Cross Blue Shield — BCNEPA HM PPO: $116,601.95 HighMark Blue Cross Blue Shield — BCNEPA HM Tiered: $92,880.96
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	$12,321 – $59,796.67
Spinal fusion (not neck), without major complications: 10 of 38 insurance plan rates Aetna — NODE Aetna MCR ADV: $25,734.45 BCNEPA HM — BCNEPA HM ASO CHS Employee: $16,743.07 Community Bluee — NODE Community Blue Medicare Advantage: $23,610.48 Health Net — Health Net: $12,321 HighMark Blue Cross Blue Shield — BCNEPA HM Affordablue: $29,014.87 HighMark Blue Cross Blue Shield — BCNEPA HM FPH: $36,626.21 HighMark Blue Cross Blue Shield — BCNEPA HM PPO: $37,124.85 HighMark Blue Cross Blue Shield — BCNEPA HM Tiered: $29,572.33 HighMark Blue Cross Blue Shield — BCNEPA HM Trad: $34,691.94 Multiplan — Multiplan Primary: $59,796.67
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	$5,796.29 – $31,766.90
Hip or knee replacement (major joint of the leg), without major complications: 10 of 44 insurance plan rates Aetna — NODE Aetna MCR ADV: $13,361.59 BCNEPA HM — BCNEPA HM ASO CHS Employee: $5,796.29 Cigna — Cigna: $30,565.84 Community Bluee — NODE Community Blue Medicare Advantage: $12,230.01 Geisinger Indemnity — Geisinger HP: $24,579.55 Health Net — Health Net: $13,614 HighMark Blue Cross Blue Shield — BCNEPA HM Affordablue: $16,086.52 HighMark Blue Cross Blue Shield — BCNEPA HM FPH: $20,306.43 HighMark Blue Cross Blue Shield — BCNEPA HM PPO: $20,582.88 HighMark Blue Cross Blue Shield — BCNEPA HM Tiered: $16,395.59
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	$7,194.31 – $39,885.96
Neck (cervical) spinal fusion, without complications: 10 of 45 insurance plan rates Aetna — NODE Aetna MCR ADV: $16,725.66 BCNEPA HM — BCNEPA HM ASO CHS Employee: $7,194.31 Cigna — Cigna: $38,377.92 Community Bluee — NODE Community Blue Medicare Advantage: $15,939.14 Geisinger Indemnity — Geisinger HP: $30,861.64 Health Net — Health Net: $12,321 HighMark Blue Cross Blue Shield — BCNEPA HM Affordablue: $20,628.91 HighMark Blue Cross Blue Shield — BCNEPA HM FPH: $26,040.41 HighMark Blue Cross Blue Shield — BCNEPA HM PPO: $26,394.93 HighMark Blue Cross Blue Shield — BCNEPA HM Tiered: $21,025.26
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	$7,618.74 – $38,990.64
Uterus and ovary surgery (not for cancer), without complications: 10 of 43 insurance plan rates Aetna — NODE Aetna MCR ADV: $8,567.12 BCNEPA HM — BCNEPA HM ASO CHS Employee: $10,917.38 Cigna — Cigna: $19,432.13 Community Bluee — NODE Community Blue Medicare Advantage: $7,618.74 Geisinger Indemnity — Geisinger HP: $15,626.36 HighMark Blue Cross Blue Shield — BCNEPA HM Affordablue: $11,544.13 HighMark Blue Cross Blue Shield — BCNEPA HM FPH: $14,572.45 HighMark Blue Cross Blue Shield — BCNEPA HM PPO: $14,770.84 HighMark Blue Cross Blue Shield — BCNEPA HM Tiered: $11,765.93 HighMark Blue Cross Blue Shield — BCNEPA HM Trad: $13,802.86

Source: Wilkes-Barre General Hospital’s standard charges file (commonwealthhealth.net, CSV, CMS template 2.0.0; it can be a very large file), last updated by the hospital on December 1, 2024; 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	575 North River Street, Wilkes-Barre, PA 18764
County	Luzerne County
State	Pennsylvania
Phone	(570) 829‑8111
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	2 of 5 stars
CMS Certification Number	390137
Name in Medicare records	WILKES-BARRE GENERAL HOSPITAL
Profile level	Medicare data + hospital website
Official website	commonwealthhealth.net
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.

Wilkes-Barre General Hospital - CommonwealthHealth — commonwealthhealth.net
Services & Specialties - CommonwealthHealth — commonwealthhealth.net
Services & Specialties - CommonwealthHealth — commonwealthhealth.net
Emergency Services - CommonwealthHealth — commonwealthhealth.net
Emergency Departments - CommonwealthHealth — commonwealthhealth.net