▸ Hospital · NY · CCN 330393
Stony Brook University Hospital
NICOLLS ROAD, STONY BROOK, NY, 11794-9112
725 bedsAcute Care Hospitals10
Compliance grade
F
55/100
Procedures tracked
104
of 209 target codes
Payers
25
with negotiated rates
Rates published
—
last crawl never
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $3,558.81 | $3,558.81 | $86.95 | $1,026.79 | $2,550 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 20 | $2,269.64 | $2,269.64 | $218.3 | $456.64 | $2,503.48 |
| CT head with contrast | CPT | 70460 | 4 | $3,312 | $3,312 | $157.15 | $339.43 | $500.04 |
| CT head with and without contrast | CPT | 70470 | 6 | $3,768.54 | $3,768.54 | $205.2 | $344.85 | $3,383.74 |
| CT neck with contrast | CPT | 70491 | 16 | $3,854.07 | $3,854.07 | $163.9 | $405.02 | $4,975.83 |
| MRI brain without contrast | CPT | 70551 | 21 | $6,207.95 | $6,207.95 | $270.64 | $723.22 | $5,753.46 |
| MRI brain with contrast | CPT | 70552 | 2 | $7,141 | $7,141 | $481.68 | $481.68 | $481.68 |
| MRI brain with and without contrast | CPT | 70553 | 20 | $8,902.1 | $8,902.1 | $423.03 | $1,905.97 | $9,455 |
| Chest X-ray single view | CPT | 71045 | 19 | $991.4 | $991.4 | $10.23 | $133.7 | $1,077.27 |
| Chest X-ray 2 views | CPT | 71046 | 20 | $600.57 | $600.57 | $15 | $99.66 | $1,611.5 |
| CT chest without contrast | CPT | 71250 | 18 | $2,749.95 | $2,749.95 | $126.75 | $514.89 | $2,906 |
| CT chest with contrast | CPT | 71260 | 20 | $9,540.9 | $9,540.9 | $172.61 | $1,042.95 | $4,937.7 |
| CT chest with and without contrast | CPT | 71270 | 4 | $17,525 | $17,525 | $188.59 | $347.15 | $514.89 |
| MRI chest without contrast | CPT | 71550 | 2 | $4,234.02 | $4,234.02 | $2,451.5 | $2,451.5 | $2,451.5 |
| MRI chest with and without contrast | CPT | 71552 | 7 | $6,320.75 | $6,320.75 | $500 | $3,889.02 | $6,543.5 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $698.26 | $698.26 | $12.82 | $452.75 | $778 |
| CT cervical spine without contrast | CPT | 72125 | 17 | $4,283.92 | $4,283.92 | $126.75 | $395.48 | $2,533 |
| CT thoracic spine without contrast | CPT | 72128 | 7 | $1,787.21 | $1,787.21 | $99.88 | $293.54 | $1,604 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $1,955.42 | $1,955.42 | $99.5 | $382.76 | $2,075 |
| MRI cervical spine without contrast | CPT | 72141 | 17 | $5,182.76 | $5,182.76 | $186.23 | $2,267.26 | $5,811 |
| MRI thoracic spine without contrast | CPT | 72146 | 14 | $4,379.24 | $4,379.24 | $177.09 | $1,188.59 | $4,876 |
| MRI lumbar spine without contrast | CPT | 72148 | 18 | $5,384.89 | $5,384.89 | $182.98 | $2,327.53 | $5,862.4 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 2 | $7,249 | $7,249 | $3,923 | $3,923 | $3,923 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $6,581.65 | $6,581.65 | $318.11 | $903.41 | $6,406.83 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $6,337.04 | $6,337.04 | $301.05 | $2,916.97 | $6,142.79 |
| CT pelvis without contrast | CPT | 72192 | 13 | $2,379.16 | $2,379.16 | $99.12 | $270.42 | $2,352 |
| CT pelvis with contrast | CPT | 72193 | 2 | $3,995.29 | $3,995.29 | $275.03 | $275.03 | $275.03 |
| Shoulder X-ray | CPT | 73030 | 19 | $566.85 | $566.85 | $15 | $293.26 | $1,040 |
| Humerus X-ray | CPT | 73060 | 15 | $511.04 | $511.04 | $9.73 | $264.45 | $556.32 |
| Hand X-ray 3 views | CPT | 73130 | 16 | $1,018.28 | $1,018.28 | $12.5 | $516.36 | $1,147 |
| MRI upper extremity joint without contrast | CPT | 73221 | 14 | $4,060.11 | $4,060.11 | $201.99 | $2,261.5 | $4,381 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 5 | $5,187.6 | $5,187.6 | $423.03 | $2,315.63 | $3,990.48 |
| Knee X-ray 1-2 views | CPT | 73560 | 18 | $499.36 | $499.36 | $10 | $265 | $687.25 |
| Ankle X-ray 3 views | CPT | 73610 | 20 | $662.34 | $662.34 | $12.5 | $369.28 | $783 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $4,700.16 | $4,700.16 | $168.53 | $2,412 | $4,550.25 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 9 | $6,753 | $6,753 | $355.33 | $2,373.93 | $5,810.39 |
| CT abdomen without contrast | CPT | 74150 | 2 | $2,764.2 | $2,764.2 | $1,363 | $1,410.75 | $1,458.5 |
| CT abdomen with contrast | CPT | 74160 | 4 | $4,270.17 | $4,270.17 | $170 | $1,178.25 | $2,208.83 |
| CT abdomen with and without contrast | CPT | 74170 | 3 | $4,774.38 | $4,774.38 | $2,366.5 | $3,031.49 | $3,696.47 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 20 | $4,961.73 | $4,961.73 | $237.95 | $401.52 | $4,214.08 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 21 | $6,417.37 | $6,417.37 | $323.73 | $1,027.77 | $10,444 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $7,204.57 | $7,204.57 | $157.15 | $430.74 | $6,179.62 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $2,293.29 | $2,293.29 | $184.05 | $1,138 | $3,923 |
| MRI abdomen with and without contrast | CPT | 74183 | 16 | $8,004.14 | $8,004.14 | $331.19 | $3,923 | $7,594.16 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $1,306.84 | $1,306.84 | $113.76 | $653.29 | $1,252.88 |
| Abdominal ultrasound limited | CPT | 76705 | 17 | $1,532.49 | $1,532.49 | $40 | $301.83 | $1,172.5 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 19 | $1,337.1 | $1,337.1 | $94.63 | $718.86 | $1,318 |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $1,053.36 | $1,053.36 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 3 | $1,114.76 | $1,114.76 | $138.67 | $246.81 | $787.5 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 2 | $827.88 | $827.88 | $179.02 | $179.02 | $179.02 |
| Transvaginal ultrasound | CPT | 76830 | 17 | $3,647.2 | $3,647.2 | $60 | $375.21 | $2,656.5 |
| Pelvic ultrasound complete | CPT | 76856 | 21 | $1,875.72 | $1,875.72 | $91.66 | $727.72 | $1,796.99 |
| Scrotal ultrasound | CPT | 76870 | 10 | $3,965.74 | $3,965.74 | $30.9 | $946.07 | $1,961.5 |
| Diagnostic mammography unilateral | CPT | 77065 | 17 | $809.07 | $809.07 | $99.46 | $418 | $871 |
| Diagnostic mammography bilateral | CPT | 77066 | 20 | $1,013.17 | $1,013.17 | $82.45 | $352.39 | $2,039 |
| Screening mammography bilateral | CPT | 77067 | 20 | $1,014.49 | $1,014.49 | $57.07 | $412.24 | $1,068 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 21 | $244.58 | $244.58 | $8.46 | $117.7 | $670 |
| Electrolyte panel | CPT | 80051 | 6 | $144.88 | $144.88 | $5.96 | $55.63 | $134.19 |
| Comprehensive metabolic panel | CPT | 80053 | 19 | $521.73 | $521.73 | $8.88 | $131.69 | $478.63 |
| Lipid panel | CPT | 80061 | 22 | $250.27 | $250.27 | $8.6 | $45.32 | $530.5 |
| Renal function panel | CPT | 80069 | 8 | $281.17 | $281.17 | $8.68 | $25.82 | $276 |
| Hepatic function panel | CPT | 80076 | 21 | $320.07 | $320.07 | $8.17 | $128.56 | $547.5 |
| Urinalysis automated | CPT | 81003 | 12 | $82.92 | $82.92 | $2 | $38.5 | $77 |
| Glucose quantitative | CPT | 82947 | 20 | $65.84 | $65.84 | $3.25 | $15.86 | $66 |
| Hemoglobin A1c | CPT | 83036 | 21 | $227.12 | $227.12 | $8.25 | $87.47 | $243 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 22 | $293.53 | $293.53 | $9.09 | $150.85 | $299 |
| Complete blood count with automated differential | CPT | 85025 | 22 | $146.23 | $146.23 | $4 | $70.62 | $162.84 |
| Complete blood count without differential | CPT | 85027 | 21 | $104.41 | $104.41 | $3.27 | $29.7 | $228.47 |
| Urine culture bacterial | CPT | 87086 | 22 | $171.22 | $171.22 | $8.07 | $74.44 | $348 |
| Urine culture identification | CPT | 87088 | 16 | $226.55 | $226.55 | $6.88 | $96.66 | $203.1 |
| Tissue exam by pathologist level IV | CPT | 88305 | 20 | $433.51 | $433.51 | $29.73 | $247.4 | $2,185 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 13 | $4,614.64 | $4,614.64 | $12.75 | $273.57 | $615 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 2 | $6,020 | $6,020 | $4,704 | $4,704 | $4,704 |
| Vaginal delivery only | CPT | 59409 | 2 | $6,595.21 | $6,595.21 | $31.67 | $31.67 | $31.67 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 16 | $2,196.99 | $2,196.99 | $467.37 | $2,102.83 | $5,108 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 19 | $3,636.21 | $3,636.21 | $203.27 | $1,896.48 | $4,822 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | $3,945.9 | $3,945.9 | $66.41 | $2,325.31 | $5,241.41 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 5 | $4,552.6 | $4,552.6 | $949.84 | $2,768.92 | $4,822 |
| Colonoscopy diagnostic | CPT | 45378 | 18 | $4,741.97 | $4,741.97 | $209.91 | $2,569.3 | $6,696 |
| Colonoscopy with biopsy | CPT | 45380 | 19 | $4,420.54 | $4,420.54 | $425.71 | $1,614.1 | $6,050 |
| Colonoscopy with polyp removal | CPT | 45385 | 19 | $6,445.25 | $6,445.25 | $618.44 | $2,281.75 | $6,050 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 8 | $20,858 | $20,858 | $1,806.76 | $8,426.98 | $14,448 |
| Total hip replacement | CPT | 27130 | 13 | $12,258 | $12,258 | $2,025.07 | $11,855 | $31,107 |
| Total knee replacement | CPT | 27447 | 11 | $15,499 | $15,499 | $1,607.51 | $14,448 | $30,851 |
| Knee revision arthroplasty single component | CPT | 27486 | 2 | $14,497 | $14,497 | $10,285 | $10,285 | $10,285 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 6 | $3,912.85 | $3,912.85 | $1,891 | $3,125.19 | $4,257 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 11 | $8,736.47 | $8,736.47 | $3,851.49 | $6,408.61 | $10,285 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 14 | $5,321 | $5,321 | $1,430.62 | $4,711.63 | $7,564 |
| ACL reconstruction | CPT | 29888 | 11 | $9,866.65 | $9,866.65 | $3,587.44 | $5,036.91 | $10,285 |
| Laparoscopic appendectomy | CPT | 44970 | 18 | $14,123 | $14,123 | $1,460.6 | $6,385.2 | $12,852 |
| Laparoscopic cholecystectomy | CPT | 47562 | 15 | $13,291 | $13,291 | $860.47 | $8,546.87 | $10,609 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 13 | $7,396.7 | $7,396.7 | $2,882.77 | $8,103.34 | $12,905 |
| Open umbilical hernia repair | CPT | 49560 | 5 | $10,597 | $10,597 | $2,438.27 | $3,689.75 | $7,564 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 9 | $7,064.65 | $7,064.65 | $1,123.13 | $4,386.36 | $8,170 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | $11,986 | $11,986 | $2,114.19 | $7,781.43 | $13,396 |
| Lap incisional hernia repair | CPT | 49652 | 5 | $13,752 | $13,752 | $4,282 | $8,978 | $10,609 |
| Total abdominal hysterectomy | CPT | 58150 | 3 | $19,450 | $19,450 | $2,411 | $3,596.5 | $4,782 |
| Vaginal hysterectomy | CPT | 58260 | 2 | $17,773 | $17,773 | $8,346 | $8,346 | $8,346 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 5 | $23,070 | $23,070 | $2,330.1 | $9,199.72 | $10,588 |
| Lap salpingo-oophorectomy | CPT | 58661 | 16 | $8,440.24 | $8,440.24 | $1,135.67 | $6,949.17 | $12,375 |
| Complex cataract surgery | CPT | 66982 | 14 | $5,390.65 | $5,390.65 | $2,301.89 | $4,300.28 | $6,017.59 |
| Cataract surgery with lens implant | CPT | 66984 | 14 | $4,432.32 | $4,432.32 | $2,312.79 | $3,930.29 | $6,050 |
| Intravitreal injection | CPT | 67028 | 3 | $1,658.17 | $1,658.17 | $270.05 | $318.17 | $366.28 |
| Vitrectomy mechanical | CPT | 67042 | 7 | $11,720 | $11,720 | $3,109.63 | $5,127 | $8,774 |
Payer mix (top 25)
| Payer | Codes covered | Median rate |
|---|---|---|
| derived contracted rate | 103 | $1,256.03 |
| Empire BCBS | 89 | $2,039 |
| UnitedHealthcare | 88 | $540.24 |
| Medicaid | 84 | $305.33 |
| Aetna | 81 | $727 |
| emblemhealth-commercial other | 76 | $440.13 |
| Cigna | 73 | $1,820.01 |
| oxford-commercial other | 71 | $2,250 |
| Healthfirst | 71 | $177.09 |
| Medicare Advantage | 67 | $266.62 |
| Blue Cross Blue Shield | 66 | $2,184.97 |
| emblemhealth-commercial hmo/pos | 62 | $2,199.11 |
| fidelis-commercial other | 52 | $239.53 |
| emblemhealth-commercial ppo/open access | 46 | $1,015.88 |
| TRICARE | 46 | $125.63 |
| Molina | 45 | $293.54 |
| 1199-commercial other | 44 | $860.7 |
| Humana | 43 | $236.66 |
| optum-commercial other | 42 | $150.41 |
| Meritain Health | 36 | $453.26 |
| healthplus hp-commercial other | 30 | $229.29 |
| veteran family-commercial other | 6 | $66.94 |
| evernorth-commercial other | 2 | $162.32 |
| carelon health-commercial other | 1 | $1,360.71 |
| beacon health-commercial other | 1 | $86.95 |