▸ Hospital · · CCN 399807

Milton S Hershey Medical Center Transplant Center

Compliance grade

86/100

Rates published

1,784

last crawl 2026-05-24

Procedures tracked

180

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals JSON

Source MRF: https://www.pennstatehealth.org/sites/default/files/Finance/Apr-2026/251854772_the-milton-s.-hershey-medical-center_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	0	—	—	—	—	—
Psychiatric diagnostic evaluation	CPT	90791	0	$1,044	$345.88	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$1,044	$345.88	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$1,044	$345.88	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$1,044	$345.88	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$1,044	$345.88	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$1,044	$345.88	—	—	—
emergency
ED visit level 1	CPT	99281	0	$572	$189.5	—	—	—
ED visit level 2	CPT	99282	0	$1,029	$340.91	—	—	—
ED visit level 3	CPT	99283	0	$1,800	$596.34	—	—	—
ED visit level 4	CPT	99284	0	$2,768	$917.04	—	—	—
ED visit level 5	CPT	99285	0	$3,985	$1,320.23	—	—	—
Critical care, first hour	CPT	99291	0	$5,477	$1,814.53	—	—	—
imaging
CT head without contrast	CPT	70450	0	$532	$176.25	—	—	—
CT head with contrast	CPT	70460	0	$890	$294.86	—	—	—
CT head with and without contrast	CPT	70470	0	$890	$294.86	—	—	—
CT neck with contrast	CPT	70491	0	$890	$294.86	—	—	—
MRI brain without contrast	CPT	70551	0	$1,209	$400.54	—	—	—
MRI brain with contrast	CPT	70552	0	$1,786	$591.7	—	—	—
MRI brain with and without contrast	CPT	70553	0	$1,786	$591.7	—	—	—
Chest X-ray single view	CPT	71045	0	$440	$145.77	—	—	—
Chest X-ray 2 views	CPT	71046	0	$440	$145.77	—	—	—
Chest X-ray 3 views	CPT	71047	0	$440	$145.77	—	—	—
CT chest without contrast	CPT	71250	0	$532	$176.25	—	—	—
CT chest with contrast	CPT	71260	0	$890	$294.86	—	—	—
CT chest with and without contrast	CPT	71270	0	$890	$294.86	—	—	—
MRI chest without contrast	CPT	71550	0	$1,209	$400.54	—	—	—
MRI chest with contrast	CPT	71551	0	$3,950	$1,308.64	—	—	—
MRI chest with and without contrast	CPT	71552	0	$1,786	$591.7	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$532	$176.25	—	—	—
CT cervical spine without contrast	CPT	72125	0	$532	$176.25	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$532	$176.25	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$532	$176.25	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$1,209	$400.54	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$1,209	$400.54	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$1,209	$400.54	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$1,786	$591.7	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$1,786	$591.7	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$1,786	$591.7	—	—	—
CT pelvis without contrast	CPT	72192	0	$532	$176.25	—	—	—
CT pelvis with contrast	CPT	72193	0	$890	$294.86	—	—	—
Shoulder X-ray	CPT	73030	0	$440	$145.77	—	—	—
Humerus X-ray	CPT	73060	0	$440	$145.77	—	—	—
Hand X-ray 3 views	CPT	73130	0	$440	$145.77	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$1,209	$400.54	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$1,786	$591.7	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$440	$145.77	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$440	$145.77	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$1,209	$400.54	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$1,786	$591.7	—	—	—
CT abdomen without contrast	CPT	74150	0	$532	$176.25	—	—	—
CT abdomen with contrast	CPT	74160	0	$890	$294.86	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$890	$294.86	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$1,209	$400.54	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$1,786	$591.7	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$1,786	$591.7	—	—	—
MRI abdomen without contrast	CPT	74181	0	$1,209	$400.54	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$1,786	$591.7	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$532	$176.25	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$532	$176.25	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$532	$176.25	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$532	$176.25	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$532	$176.25	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$1,209	$400.54	—	—	—
Transvaginal ultrasound	CPT	76830	0	$532	$176.25	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$532	$176.25	—	—	—
Scrotal ultrasound	CPT	76870	0	$532	$176.25	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$513	$169.96	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$653	$216.34	—	—	—
Screening mammography bilateral	CPT	77067	0	$540	$178.9	—	—	—
EKG tracing only	CPT	93005	0	$386	$127.88	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$5,135	$1,701.23	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$1,571	$520.47	—	—	—
Stress echocardiogram	CPT	93350	0	$5,135	$1,701.23	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	—	—	—	—	—
COPD w MCC	MS-DRG	190	0	—	—	—	—	—
COPD w CC	MS-DRG	191	0	—	—	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	—	—	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	—	—	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	—	—	—	—	—
AMI discharged alive w MCC	MS-DRG	280	0	—	—	—	—	—
AMI discharged alive w CC	MS-DRG	281	0	—	—	—	—	—
AMI discharged alive w/o CC/MCC	MS-DRG	282	0	—	—	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	—	—	—	—	—
Heart failure & shock w CC	MS-DRG	292	0	—	—	—	—	—
Heart failure & shock w/o CC/MCC	MS-DRG	293	0	—	—	—	—	—
Cardiac arrhythmia w MCC	MS-DRG	308	0	—	—	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	—	—	—	—	—
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	0	—	—	—	—	—
GI hemorrhage w CC	MS-DRG	378	0	—	—	—	—	—
GI hemorrhage w/o CC/MCC	MS-DRG	379	0	—	—	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	—	—	—	—	—
Fractures of femur w/o MCC	MS-DRG	533	0	—	—	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	—	—	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	—	—	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	—	—	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	—	—	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$55	$18.22	—	—	—
General health panel	CPT	80050	0	$513	$169.96	—	—	—
Electrolyte panel	CPT	80051	0	$46	$15.24	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$69	$22.86	—	—	—
Lipid panel	CPT	80061	0	$87	$28.82	—	—	—
Renal function panel	CPT	80069	0	$56	$18.55	—	—	—
Hepatic function panel	CPT	80076	0	$53	$17.56	—	—	—
Urinalysis non-automated	CPT	81002	0	$23	$7.62	—	—	—
Urinalysis automated	CPT	81003	0	$15	$4.97	—	—	—
Glucose quantitative	CPT	82947	0	$26	$8.61	—	—	—
Hemoglobin A1c	CPT	83036	0	$63	$20.87	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$109	$36.11	—	—	—
Complete blood count with automated differential	CPT	85025	0	$51	$16.9	—	—	—
Complete blood count without differential	CPT	85027	0	$42	$13.91	—	—	—
Urine culture bacterial	CPT	87086	0	$52	$17.23	—	—	—
Urine culture identification	CPT	87088	0	$53	$17.56	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$347	$114.96	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$1,308	$433.34	—	—	—
Routine obstetric care including vaginal delivery	CPT	59400	0	$20,667	$6,846.98	—	—	—
Vaginal delivery only	CPT	59409	0	$20,667	$6,846.98	—	—	—
Vaginal delivery with postpartum	CPT	59410	0	$20,667	$6,846.98	—	—	—
Routine obstetric care with C-section	CPT	59510	0	$20,667	$6,846.98	—	—	—
C-section delivery only	CPT	59514	0	$20,667	$6,846.98	—	—	—
C-section with postpartum	CPT	59515	0	$20,667	$6,846.98	—	—	—
office
Office visit, established patient, 5 min	CPT	99211	0	$115	$38.1	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$115	$38.1	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$6,094	$2,018.94	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$6,094	$2,018.94	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$5,926	$1,963.28	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$5,926	$1,963.28	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$5,926	$1,963.28	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$7,664	$2,539.08	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$7,664	$2,539.08	—	—	—
surgery
Total shoulder arthroplasty	CPT	23472	0	$119,535	$39,602	—	—	—
Hip hemiarthroplasty	CPT	27125	0	$36,060	$11,947	—	—	—
Total hip replacement	CPT	27130	0	$83,634	$27,708	—	—	—
Total knee replacement	CPT	27447	0	$83,634	$27,708	—	—	—
Knee revision arthroplasty single component	CPT	27486	0	$36,060	$11,947	—	—	—
Knee revision arthroplasty all components	CPT	27487	0	$36,060	$11,947	—	—	—
Shoulder arthroscopy with decompression	CPT	29826	0	$3,863	$1,279.81	—	—	—
Shoulder arthroscopy with rotator cuff repair	CPT	29827	0	$46,434	$15,384	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	$21,090	$6,987.12	—	—	—
ACL reconstruction	CPT	29888	0	$46,434	$15,384	—	—	—
Major small/large bowel procedures w MCC	MS-DRG	329	0	—	—	—	—	—
Major small/large bowel procedures w CC	MS-DRG	330	0	—	—	—	—	—
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	0	—	—	—	—	—
CABG single arterial graft	CPT	33533	0	$33,477	$11,091	—	—	—
CABG 2 arterial grafts	CPT	33534	0	$20,553	$6,809.21	—	—	—
CABG 3 arterial grafts	CPT	33535	0	$22,844	$7,568.22	—	—	—
CABG 4+ arterial grafts	CPT	33536	0	$36,948	$12,241	—	—	—
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	0	—	—	—	—	—
Open appendectomy	CPT	44950	0	$40,558	$13,437	—	—	—
Laparoscopic appendectomy	CPT	44970	0	$37,923	$12,564	—	—	—
Major joint replacement w MCC	MS-DRG	469	0	—	—	—	—	—
Major joint replacement w/o MCC	MS-DRG	470	0	—	—	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	$37,923	$12,564	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	$37,923	$12,564	—	—	—
Hip & femur procedures except major joint w MCC	MS-DRG	480	0	—	—	—	—	—
Hip & femur procedures except major joint w CC	MS-DRG	481	0	—	—	—	—	—
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	0	—	—	—	—	—
Lap inguinal hernia repair	CPT	49650	0	$37,923	$12,564	—	—	—
Total abdominal hysterectomy	CPT	58150	0	$9,709	$3,216.59	—	—	—
Vaginal hysterectomy	CPT	58260	0	$32,087	$10,630	—	—	—
Lap-assisted vaginal hysterectomy	CPT	58550	0	$37,923	$12,564	—	—	—
Lap-assisted vaginal hysterectomy >250g	CPT	58552	0	$67,673	$22,420	—	—	—
Lap salpingo-oophorectomy	CPT	58661	0	$37,923	$12,564	—	—	—
OR procedure for obesity w MCC	MS-DRG	619	0	—	—	—	—	—
OR procedure for obesity w CC	MS-DRG	620	0	—	—	—	—	—
OR procedure for obesity w/o CC/MCC	MS-DRG	621	0	—	—	—	—	—
Complex cataract surgery	CPT	66982	0	$14,825	$4,911.52	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$14,825	$4,911.52	—	—	—
Intravitreal injection	CPT	67028	0	$2,156	$714.28	—	—	—
Vitrectomy mechanical	CPT	67042	0	$26,149	$8,663.16	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	—	—	—	—	—
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	0	—	—	—	—	—
PCI single major coronary artery	CPT	92920	0	$37,060	$12,278	—	—	—
PCI with drug-eluting stent	CPT	92928	0	$73,714	$24,421	—	—	—
PCI bypass graft	CPT	92937	0	$73,714	$24,421	—	—	—
Left heart catheterization	CPT	93452	0	$20,907	$6,926.49	—	—	—
Coronary angiography with cath	CPT	93455	0	$20,907	$6,926.49	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	$20,907	$6,926.49	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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