Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PORT FILM 1
Teaneck, NJ
See all hospitals reporting CPT 77417 →Price type
Holy Name’s median price of $265 is 142% above the median hospital's median price ($109), higher than 74% of the 1,716 hospitals reporting CPT 77417. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 18 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna whole health facility · fee schedule · outpatient | $38 | $38 | — | — | — | $38 – $38 |
| 2 | UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges | $65 | $65 | — | — | — | $65 – $65 |
| 3 | Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 4 | Aetna medicare prime facility · percent of total billed charges · outpatientfrom % of charges | $74 | $74 | — | — | — | $74 – $74 |
| 5 | Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 6 | Aetna golden medicare facility · percent of total billed charges · outpatientfrom % of charges | $90 | $90 | — | — | — | $90 – $90 |
| 7 | Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges | $102 | $102 | — | — | — | $102 – $102 |
| 8 | Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges | $137 | $137 | — | — | — | $137 – $137 |
| 9 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $195 | $195 | — | — | — | $195 – $195 |
| 10 | Cigna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges | $204 | $204 | — | — | — | $204 – $204 |
| 11 | Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $248 | $248 | — | — | — | $248 – $248 |
| 12 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $265 | $265 | — | — | — | $265 – $265 |
| 13 | MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $346 | $346 | — | — | — | $346 – $346 |
| 14 | MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges | $366 | $366 | — | — | — | $366 – $366 |
| 15 | Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges | $377 | $377 | — | — | — | $377 – $377 |
| 16 | Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges | $377 | $377 | — | — | — | $377 – $377 |
| 17 | Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges | $377 | $377 | — | — | — | $377 – $377 |
| 18 | UnitedHealthcare uhc facility · other · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
Last updated: Nov 10, 2025
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