Rochester General Hospital
Rochester General Hospital in Rochester, NY publishes cash prices for 61 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
1425 Portland Avenue, Rochester, NY 14621 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST | $1,266.07 | $1,947.80 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST | $1,266.07 | $1,947.80 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD_BRAIN WO CONTRAST | $520.31 | $800.48 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD_BRAIN WO CONTRAST | $520.31 | $800.48 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $845.92 | $1,301.42 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $845.92 | $1,301.42 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $311.47 | $479.18 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $311.47 | $479.18 | 35% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $248.64 | $382.53 | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $248.64 | $382.53 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST | $1,006.36 | $1,548.25 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST | $1,006.36 | $1,548.25 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY ANY JOINT WO _ W CONTRAST | $1,648.98 | $2,536.89 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY ANY JOINT WO _ W CONTRAST | $1,648.98 | $2,536.89 | 35% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN INCLUDING BRAIN STEM WO CONTRAST | $1,006.36 | $1,548.25 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN INCLUDING BRAIN STEM WO CONTRAST | $1,006.36 | $1,548.25 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WO _ W CONTRAST | $1,648.98 | $2,536.89 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN WO _ W CONTRAST | $1,648.98 | $2,536.89 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $1,006.36 | $1,548.25 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $1,006.36 | $1,548.25 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION | $425.45 | $654.54 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION | $425.45 | $654.54 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $284.38 | $437.51 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $284.38 | $437.51 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED | $3,243.02 | $4,989.26 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED | $3,243.02 | $4,989.26 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 HC US ECHOGRAPHY_TRANSVAGINAL | $425.45 | $654.54 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US ECHOGRAPHY_TRANSVAGINAL | $425.45 | $654.54 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE | $425.45 | $654.54 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE | $425.45 | $654.54 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $275.16 | $423.33 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $275.16 | $423.33 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL _8_ | $30.61 | $47.09 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL _8_ | $30.61 | $47.09 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE | $48.45 | $74.54 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE | $48.45 | $74.54 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC WITH AUTO DIFFERENTIAL | $28.12 | $43.26 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH AUTO DIFFERENTIAL | $28.12 | $43.26 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC _HEMOGRAM _ PLT_ | $23.40 | $36.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC _HEMOGRAM _ PLT_ | $23.40 | $36.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL _14_ | $38.23 | $58.81 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL _14_ | $38.23 | $58.81 | 35% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $31.42 | $48.34 | 35% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $31.42 | $48.34 | 35% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL _7_ | $29.58 | $45.50 | 35% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL _7_ | $29.58 | $45.50 | 35% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL | $105.99 | $163.06 | 35% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL | $105.99 | $163.06 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA_ FREE | $66.59 | $102.44 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA_ FREE | $66.59 | $102.44 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA_ TOTAL | $66.59 | $102.44 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA_ TOTAL | $66.59 | $102.44 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT | $21.75 | $33.46 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT | $21.75 | $33.46 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $14.21 | $21.86 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $14.21 | $21.86 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE _TSH_ | $60.82 | $93.57 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE _TSH_ | $60.82 | $93.57 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS _ ROUTINE | $11.50 | $17.69 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS _ ROUTINE | $11.50 | $17.69 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS_ NON_AUTOMATED | $11.78 | $18.13 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS_ NON_AUTOMATED | $11.78 | $18.13 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS WO MICROSCOPY | $8.13 | $12.51 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS WO MICROSCOPY | $8.13 | $12.51 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIPSTICK_ NON_AUTOMATED | $10.20 | $15.70 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIPSTICK_ NON_AUTOMATED | $10.20 | $15.70 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 HC EXTRACAPSULAR CATARACT EXTRACTION W IOL_1ST SAGE_ MANUAL OR MECHANICAL_ W_O ECP | $4,946.91 | $7,610.63 | 35% |
| Cataract surgery with lens implant inpatient CPT 66984 HC EXTRACAPSULAR CATARACT EXTRACTION W IOL_1ST SAGE_ MANUAL OR MECHANICAL_ W_O ECP | $4,946.91 | $7,610.63 | 35% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY_ FLEXIBLE_ PROXIMAL TO SPLENIC FLEXURE_ DIAGNOSTIC | $2,393.41 | $3,682.17 | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY_ FLEXIBLE_ PROXIMAL TO SPLENIC FLEXURE_ DIAGNOSTIC | $2,393.41 | $3,682.17 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC DISCISSION SECONDARY MEMBRANOUS CATARACT_ LASER SURGERY | $1,639.22 | $2,521.88 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC DISCISSION SECONDARY MEMBRANOUS CATARACT_ LASER SURGERY | $1,639.22 | $2,521.88 | 35% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W_VENTRCLGRPHY | $8,273.02 | $12,727.73 | 35% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W_VENTRCLGRPHY | $8,273.02 | $12,727.73 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING | $852.20 | $1,311.08 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING | $852.20 | $1,311.08 | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX_THER SBST INTRLMNR LMBR_SAC W_O IMG GDN | $1,129.76 | $1,738.10 | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX_THER SBST INTRLMNR LMBR_SAC W_O IMG GDN | $1,129.76 | $1,738.10 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL | $2,188.39 | $3,366.76 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC NJX AA__STRD TFRML EPI LUMBAR_SACRAL 1 LEVEL | $2,188.39 | $3,366.76 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC NJX AA__STRD TFRML EPI LUMBAR_SACRAL 1 LEVEL | $2,188.39 | $3,366.76 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL | $2,188.39 | $3,366.76 | 35% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH | $5,191.40 | $7,986.77 | 35% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH | $5,191.40 | $7,986.77 | 35% |
| Removal of a breast lump, open surgery CPT 19120 HC EXC CYST_ABERRANT BREAST TISSUE OPEN 1__ LESION | $7,392.41 | $11,372.94 | 35% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISION OF CYST_FIBROADENOMA_BENIGH OR MALIGNANT TUMOR_ BREAST TISSUE_ MALE_FEMALE_ 1 OR MORE | $9,100.68 | $14,001.05 | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXC CYST_ABERRANT BREAST TISSUE OPEN 1__ LESION | $7,392.41 | $11,372.94 | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXCISION OF CYST_FIBROADENOMA_BENIGH OR MALIGNANT TUMOR_ BREAST TISSUE_ MALE_FEMALE_ 1 OR MORE | $9,100.68 | $14,001.05 | 35% |
| Total knee replacement CPT 27447 HC ARTHRP KHC NE CONDYLE_PLATU MEDIAL_LAT COMPARTMENTS | $13,931.12 | $21,432.50 | 35% |
| Total knee replacement inpatient CPT 27447 HC ARTHRP KHC NE CONDYLE_PLATU MEDIAL_LAT COMPARTMENTS | $13,931.12 | $21,432.50 | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE_MULTIPLE | $1,574.62 | $2,422.49 | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE_MULTIPLE | $1,574.62 | $2,422.49 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,706.99 | $2,626.14 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,706.99 | $2,626.14 | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 HC OASAS FAMILY PSYCHOTHERAPY W_PATIENT PRESENT 50 MINS | $321.46 | $494.55 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC BHN FAMILY PSYCHOTHERAPY W PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY THERAPY W_PATIENT PRESENT | $415.97 | $639.96 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OASAS FAMILY PSYCHOTHERAPY W_PATIENT PRESENT 50 MINS | $321.46 | $494.55 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC BHN FAMILY PSYCHOTHERAPY W PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY THERAPY W_PATIENT PRESENT | $415.97 | $639.96 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $337.53 | $519.27 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC BHN FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OMH FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY THERAPY W_OUT PATIENT PRESENT | $415.97 | $639.96 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $337.53 | $519.27 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OMH FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC BHN FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY THERAPY W_OUT PATIENT PRESENT | $415.97 | $639.96 | 35% |
| Group psychotherapy session CPT 90853 HC BHN GROUP PSYCHOTHERAPY | $225.39 | $346.75 | 35% |
| Group psychotherapy session CPT 90853 HC OASAS GROUP PSYCHOTHERAPY | $225.39 | $346.75 | 35% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ | $225.39 | $346.75 | 35% |
| Group psychotherapy session CPT 90853 HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP | $225.39 | $346.75 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC BHN GROUP PSYCHOTHERAPY | $225.39 | $346.75 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP | $225.39 | $346.75 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC OASAS GROUP PSYCHOTHERAPY | $225.39 | $346.75 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ | $225.39 | $346.75 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES | $182.57 | $280.87 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OMH E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 3 | $277.97 | $427.64 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC BHN E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES | $182.57 | $280.87 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OMH E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC BHN E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 3 | $277.97 | $427.64 | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES | $224.39 | $345.22 | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 4 | $291.87 | $449.03 | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC BHN E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OMH E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OASAS ALCOHOL_ MED MANAGEMENT NEW PATIENT LEVEL 4 | $313.76 | $482.70 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES | $224.39 | $345.22 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OMH E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 4 | $291.87 | $449.03 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC BHN E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OASAS ALCOHOL_ MED MANAGEMENT NEW PATIENT LEVEL 4 | $313.76 | $482.70 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES | $281.00 | $432.31 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 5 | $306.46 | $471.48 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OMH E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC BHN E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES | $281.00 | $432.31 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OMH E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 5 | $306.46 | $471.48 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC BHN E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PULMONARY REHABILITATION THERAPEUTIC EXCERCISES EA 15 MINUTES | $44.55 | $68.54 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PULMONARY REHABILITATION THERAPEUTIC EXCERCISES EA 15 MINUTES | $44.55 | $68.54 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS | $323.10 | $497.07 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS | $323.10 | $497.07 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS | $374.22 | $575.73 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS | $374.22 | $575.73 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC OMH PSYCHOTHERAPY_ 30 MINS_ W PATIENT AND_OR FAMILY MEMBER | $239.82 | $368.96 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC BHN PSYCHOTHERAPY 30 MINS | $239.82 | $368.96 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS | $269.31 | $414.32 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OMH PSYCHOTHERAPY_ 30 MINS_ W PATIENT AND_OR FAMILY MEMBER | $239.82 | $368.96 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC BHN PSYCHOTHERAPY 30 MINS | $239.82 | $368.96 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS | $269.31 | $414.32 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC BHN PSYCHOTHERAPY 45MINS | $312.24 | $480.37 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC OMH PSYCHOTHERAPY_ 45 MINS_ W PATIENT AND_OR FAMILY MEMBER | $312.24 | $480.37 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ 45_ MINS | $346.84 | $533.60 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC OMH PSYCHOTHERAPY_ 45 MINS_ W PATIENT AND_OR FAMILY MEMBER | $312.24 | $480.37 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC BHN PSYCHOTHERAPY 45MINS | $312.24 | $480.37 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ 45_ MINS | $346.84 | $533.60 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC OASAS PSYCHOTHERAPY 60 MINS W PATIENT AND_OR FAMILY MEMBER | $300.20 | $461.85 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC BHN PSYCHOTHERAPY 60 MINS | $386.94 | $595.30 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY 60 MINUTES W PATIENT | $386.94 | $595.30 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC OASAS PSYCHOTHERAPY 60 MINS W PATIENT AND_OR FAMILY MEMBER | $300.20 | $461.85 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY 60 MINUTES W PATIENT | $386.94 | $595.30 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC BHN PSYCHOTHERAPY 60 MINS | $386.94 | $595.30 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE | $116.27 | $178.88 | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE | $116.27 | $178.88 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE | $168.98 | $259.97 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE | $168.98 | $259.97 | 35% |
Dental
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Dental implant, surgical placement CDT D6010 HC SURGICAL PLACEMENT OF IMPLANT BODY_ ENDOSTEAL IMPLANT | $520.00 | $800.00 | 35% |
| Dental implant, surgical placement inpatient CDT D6010 HC SURGICAL PLACEMENT OF IMPLANT BODY_ ENDOSTEAL IMPLANT | $520.00 | $800.00 | 35% |
| Porcelain crown CDT D2740 HC CROWN_PORCELAIN_CERAMIC SUBSTRATE | $781.30 | $1,202.00 | 35% |
| Porcelain crown inpatient CDT D2740 HC CROWN_PORCELAIN_CERAMIC SUBSTRATE | $781.30 | $1,202.00 | 35% |