▸ Hospital · NY · CCN 330084
Alice Hyde Medical Center
133 PARK STREET, MALONE, NY, 12953
36 beds2
Compliance grade
A
100/100
Procedures tracked
133
of 209 target codes
Payers
12
with negotiated rates
Rates published
35,219
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 12 | $398 | $398 | $7.77 | $21.55 | $2,544.98 |
| ED visit level 2 | CPT | 99282 | 12 | $544 | $544 | $28.62 | $63.82 | $2,544.98 |
| ED visit level 3 | CPT | 99283 | 12 | $694 | $694 | $48.39 | $109.01 | $2,544.98 |
| ED visit level 4 | CPT | 99284 | 12 | $940 | $940 | $82.48 | $183.93 | $2,544.98 |
| ED visit level 5 | CPT | 99285 | 12 | $1,190 | $1,190 | $119.59 | $267.08 | $2,544.98 |
| Critical care, first hour | CPT | 99291 | 12 | $1,890 | $1,890 | $169.63 | $365.14 | $2,726.6 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $2,195 | $2,195 | $25.81 | $58.49 | $2,162.07 |
| CT head with contrast | CPT | 70460 | 12 | $2,821 | $2,821 | $34.22 | $80.89 | $2,778.68 |
| CT head with and without contrast | CPT | 70470 | 12 | $3,648 | $3,648 | $38.5 | $91.03 | $3,593.28 |
| CT neck with contrast | CPT | 70491 | 12 | $2,724 | $2,724 | $41.76 | $95.86 | $2,683.14 |
| MRI brain without contrast | CPT | 70551 | 12 | $4,113 | $4,113 | $32.96 | $107.11 | $4,051.3 |
| MRI brain with contrast | CPT | 70552 | 12 | $4,256 | $4,256 | $39.93 | $173.47 | $4,192.16 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $5,596 | $5,596 | $52.69 | $300.72 | $5,512.06 |
| Chest X-ray single view | CPT | 71045 | 12 | $184 | $184 | $5.58 | $13.09 | $284.92 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $458 | $458 | $6.67 | $15.78 | $451.13 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $458 | $458 | $8.4 | $19.86 | $451.13 |
| CT chest without contrast | CPT | 71250 | 12 | $2,072 | $2,072 | $32.7 | $76.59 | $2,040.92 |
| CT chest with contrast | CPT | 71260 | 12 | $2,708 | $2,708 | $35.3 | $83.67 | $2,667.38 |
| CT chest with and without contrast | CPT | 71270 | 12 | $2,914 | $2,914 | $37.86 | $91 | $2,870.29 |
| MRI chest without contrast | CPT | 71550 | 12 | $4,836 | $4,836 | $32.35 | $143.34 | $4,763.46 |
| MRI chest with contrast | CPT | 71551 | 12 | $5,298 | $5,298 | $38.41 | $183.09 | $5,218.53 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $6,272 | $6,272 | $50.43 | $194.53 | $6,177.92 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $314 | $314 | $6.46 | $16.28 | $344.11 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $2,307 | $2,307 | $30.15 | $68.79 | $2,272.39 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $2,357 | $2,357 | $30.15 | $68.79 | $2,321.64 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $2,254 | $2,254 | $30.15 | $68.79 | $2,220.19 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $3,666 | $3,666 | $35.83 | $122.3 | $3,611.01 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $3,666 | $3,666 | $35.83 | $122.51 | $3,611.01 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $3,913 | $3,913 | $33.24 | $122.72 | $3,854.3 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $3,928 | $3,928 | $39.93 | $173.17 | $3,869.08 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $5,298 | $5,298 | $57.54 | $196.13 | $5,218.53 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $5,298 | $5,298 | $52.97 | $196.13 | $5,218.53 |
| CT pelvis without contrast | CPT | 72192 | 12 | $2,058 | $2,058 | $32.92 | $75.11 | $2,027.13 |
| CT pelvis with contrast | CPT | 72193 | 12 | $2,368 | $2,368 | $35.09 | $82.94 | $2,332.48 |
| Shoulder X-ray | CPT | 73030 | 12 | $118 | $118 | $5.53 | $13.7 | $284.92 |
| Humerus X-ray | CPT | 73060 | 12 | $295 | $295 | $4.82 | $11.81 | $290.57 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $373 | $373 | $4.63 | $12.68 | $367.4 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $3,835 | $3,835 | $30.66 | $191.92 | $3,777.47 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $3,928 | $3,928 | $47.83 | $361.65 | $3,869.08 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $339 | $339 | $5.14 | $12.16 | $333.92 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $373 | $373 | $4.63 | $12.68 | $367.4 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $3,795 | $3,795 | $30.5 | $191.61 | $3,738.07 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $4,053 | $4,053 | $47.83 | $360.73 | $3,992.2 |
| CT abdomen without contrast | CPT | 74150 | 12 | $2,368 | $2,368 | $35.96 | $82.04 | $2,332.48 |
| CT abdomen with contrast | CPT | 74160 | 12 | $2,914 | $2,914 | $38.5 | $91.03 | $2,870.29 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $4,360 | $4,360 | $42.19 | $230.75 | $4,294.6 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $4,419 | $4,419 | $52.71 | $173.76 | $4,352.72 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $5,273 | $5,273 | $55.42 | $130.42 | $5,193.9 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $7,267 | $7,267 | $60.85 | $143.46 | $7,157.99 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $5,359 | $5,359 | $32.5 | $125.41 | $5,278.61 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $6,927 | $6,927 | $50.12 | $191.73 | $6,823.1 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $973 | $973 | $21.84 | $56.55 | $958.4 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $695 | $695 | $15.92 | $72.45 | $684.58 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $695 | $695 | $19.98 | $99.95 | $684.58 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $787 | $787 | $30.14 | $108.41 | $775.2 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $506 | $506 | $30.35 | $124.61 | $498.41 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $414 | $414 | $57.67 | $120.03 | $782.18 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $985 | $985 | $18.71 | $49.64 | $970.23 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $908 | $908 | $18.71 | $84.62 | $894.38 |
| Scrotal ultrasound | CPT | 76870 | 12 | $712 | $712 | $17.57 | $84.2 | $701.32 |
| Diagnostic mammography unilateral | CPT | 77065 | 12 | $551 | $551 | $24.51 | $57.99 | $542.74 |
| Diagnostic mammography bilateral | CPT | 77066 | 12 | $675 | $675 | $30.15 | $71.28 | $664.88 |
| Screening mammography bilateral | CPT | 77067 | 12 | $592 | $592 | $23.21 | $54.65 | $583.12 |
| EKG complete | CPT | 93000 | 12 | $78 | $78 | $9.07 | $14.01 | $76.44 |
| EKG tracing only | CPT | 93005 | 12 | $204 | $204 | $3.92 | $10.38 | $199.92 |
| EKG interpretation only | CPT | 93010 | 12 | $39 | $39 | $5.15 | $7.96 | $38.22 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $1,529 | $1,529 | $43.62 | $180.27 | $1,774.24 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $306 | $306 | $85.33 | $97.92 | $782.18 |
| inpatient | ||||||||
| Initial hospital care, low complexity | CPT | 99221 | 12 | $263 | $263 | $34.9 | $83.07 | $257.74 |
| Initial hospital care, moderate complexity | CPT | 99222 | 12 | $359 | $359 | $48.07 | $127.41 | $351.82 |
| Initial hospital care, high complexity | CPT | 99223 | 12 | $527 | $527 | $70.62 | $169.99 | $516.46 |
| Hospital discharge, <30 min | CPT | 99238 | 12 | $190 | $190 | $26.74 | $77.34 | $186.2 |
| Hospital discharge, >30 min | CPT | 99239 | 12 | $281 | $281 | $38.33 | $109.53 | $275.38 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 12 | $151 | $151 | $5.92 | $48.32 | $148.74 |
| General health panel | CPT | 80050 | 12 | $647 | $647 | $25.26 | $207.04 | $637.29 |
| Electrolyte panel | CPT | 80051 | 12 | $168 | $168 | $4.91 | $53.76 | $165.48 |
| Comprehensive metabolic panel | CPT | 80053 | 12 | $238 | $238 | $7.39 | $76.16 | $234.43 |
| Lipid panel | CPT | 80061 | 12 | $282 | $282 | $7.79 | $88 | $277.77 |
| Renal function panel | CPT | 80069 | 12 | $167 | $167 | $6.08 | $53.44 | $164.5 |
| Hepatic function panel | CPT | 80076 | 12 | $221 | $221 | $5.72 | $70.72 | $217.69 |
| Urinalysis non-automated | CPT | 81002 | 12 | $32 | $32 | $2.44 | $3.48 | $31.36 |
| Urinalysis automated | CPT | 81003 | 12 | $65 | $65 | $1.58 | $2.59 | $64.03 |
| Glucose quantitative | CPT | 82947 | 12 | $101 | $101 | $2.75 | $4.62 | $99.48 |
| Hemoglobin A1c | CPT | 83036 | 12 | $168 | $168 | $6.8 | $53.76 | $165.48 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 12 | $291 | $291 | $11.76 | $93.12 | $286.63 |
| Complete blood count with automated differential | CPT | 85025 | 12 | $120 | $120 | $4.09 | $9.14 | $118.2 |
| Complete blood count without differential | CPT | 85027 | 12 | $91 | $91 | $4.53 | $29.12 | $89.64 |
| Urine culture bacterial | CPT | 87086 | 12 | $134 | $134 | $4.84 | $9.75 | $131.99 |
| Urine culture identification | CPT | 87088 | 12 | $120 | $120 | $5.66 | $38.4 | $118.2 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $392 | $392 | $16.96 | $85.12 | $386.12 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 12 | $396 | $396 | $31.73 | $70.2 | $650.97 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 12 | $7,135 | $7,135 | $1,720.75 | $2,322.79 | $6,992.3 |
| Vaginal delivery only | CPT | 59409 | 12 | $4,037 | $4,037 | $623.08 | $1,059.04 | $10,289 |
| Vaginal delivery with postpartum | CPT | 59410 | 12 | $3,533 | $3,533 | $843.5 | $1,025.45 | $3,462.34 |
| Routine obstetric care with C-section | CPT | 59510 | 12 | $7,930 | $7,930 | $1,948.09 | $2,561.36 | $7,771.4 |
| C-section delivery only | CPT | 59514 | 12 | $4,578 | $4,578 | $704.25 | $1,193.27 | $4,509.33 |
| C-section with postpartum | CPT | 59515 | 12 | $4,274 | $4,274 | $1,042.67 | $1,258.92 | $4,188.52 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 12 | $378 | $378 | $37.42 | $85.6 | $370.44 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 12 | $463 | $463 | $65.21 | $107.2 | $453.74 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 12 | $613 | $613 | $106.32 | $164.8 | $600.74 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 12 | $719 | $719 | $144.56 | $178.57 | $704.62 |
| Office visit, established patient, 5 min | CPT | 99211 | 12 | $183 | $183 | $6.98 | $22.1 | $179.34 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 12 | $299 | $299 | $28.08 | $52.99 | $293.02 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 12 | $373 | $373 | $52.63 | $72.64 | $365.54 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 12 | $465 | $465 | $75 | $107.52 | $455.7 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 12 | $558 | $558 | $102 | $143.68 | $546.84 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $2,205 | $2,205 | $96.56 | $429.26 | $9,020.04 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $3,723 | $3,723 | $108.6 | $496.34 | $9,020.04 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | $3,049 | $3,049 | $45.02 | $249.78 | $9,020.04 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | $1,770 | $1,770 | $57.26 | $163.21 | $1,734.6 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | $3,049 | $3,049 | $144.99 | $482.66 | $9,020.04 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | $3,723 | $3,723 | $157.7 | $624.2 | $9,020.04 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | $3,867 | $3,867 | $199.02 | $624.2 | $9,020.04 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 12 | $4,310 | $4,310 | $917.13 | $1,407.52 | $4,223.8 |
| Hip hemiarthroplasty | CPT | 27125 | 12 | $4,322 | $4,322 | $720.8 | $1,103.46 | $4,235.56 |
| Total hip replacement | CPT | 27130 | 12 | $5,515 | $5,515 | $815.56 | $1,258.87 | $41,636 |
| Total knee replacement | CPT | 27447 | 12 | $5,897 | $5,897 | $814.57 | $1,257.78 | $41,636 |
| Knee revision arthroplasty single component | CPT | 27486 | 12 | $4,203 | $4,203 | $892.39 | $1,367.02 | $4,118.94 |
| Knee revision arthroplasty all components | CPT | 27487 | 12 | $5,281 | $5,281 | $1,110.38 | $1,703.46 | $5,175.38 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 12 | $1,400 | $1,400 | $108.05 | $166.84 | $9,020.04 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | $3,114 | $3,114 | $680.8 | $1,044.33 | $3,051.72 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | $2,458 | $2,458 | $348.6 | $538.27 | $10,499 |
| ACL reconstruction | CPT | 29888 | 12 | $3,781 | $3,781 | $620.87 | $952.99 | $3,705.38 |
| Open appendectomy | CPT | 44950 | 12 | $2,401 | $2,401 | $404.99 | $622.09 | $2,352.98 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | $6,163 | $6,163 | $381.36 | $585.28 | $6,039.74 |
| Laparoscopic cholecystectomy | CPT | 47562 | 12 | $6,163 | $6,163 | $417.97 | $645.39 | $18,879 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | $5,950 | $5,950 | $454.33 | $697.48 | $5,831 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | $1,221 | $1,221 | $275.5 | $422.02 | $1,196.58 |
| Total abdominal hysterectomy | CPT | 58150 | 12 | $3,858 | $3,858 | $646.4 | $992.68 | $3,780.84 |
| Vaginal hysterectomy | CPT | 58260 | 12 | $3,128 | $3,128 | $531.98 | $820.46 | $3,065.44 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | $2,881 | $2,881 | $560.25 | $865.1 | $18,879 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | $2,353 | $2,353 | $622.85 | $959.26 | $2,305.94 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | $2,090 | $2,090 | $413.79 | $638.94 | $18,879 |
Payer mix (top 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 133 | $162.22 |
| Blue Cross Blue Shield | 133 | $163.97 |
| capital district physicians' health plan | 133 | $111.99 |
| choicecare | 133 | $167.55 |
| fidelis care | 133 | $102.85 |
| Humana | 133 | $103.63 |
| magnacare | 133 | $358.8 |
| martins point | 133 | $119.36 |
| mvp | 133 | $132.77 |
| st. regis | 133 | $194.8 |
| UnitedHealthcare | 133 | $134.44 |
| VA Health | 133 | $108.45 |