Connecticut General Statutes Compliance

While scheduling your procedure you indicated you wanted to find out more information about the Quality and/or Cost of your procedure.  This information is being provided to you pursuant to Connecticut General Statutes.  Middlesex Hospital is required to provide Quality & Cost information, when requested, for certain scheduled procedures, which are listed in the tables below.  The overall quality information related to Middlesex Hospital is also provided below.  

The Joint Commission Composite Accountability Rating

https://www.jointcommission.org/

Middlesex Hospital

>95% (Top Performer)

Medicare Hospital Compare Star Rating

https://www.medicare.gov/hospitalcompare/

Middlesex Hospital

 Stars


Disclosure:  The average insurance reimbursement provided is based on the information Middlesex Hospital currently has on file for all insurance carriers combined.  Any change to your insurance or services rendered at the time of your appointment may change your financial responsibility.
 

Average Cost Information:

 

Radiology
Procedure
Code
Procedure Description Average
Procedure Price
Average
Insurance Reimbursement*
70450 CT Scan, Head or Brain, with Contrast $2,026 $744
70553 MRI, Brain $6,139 $2,073
73721 MRI, Lower Joint/Extremity, without Contrast $3,480 $1,196
74177 CT Scan, Abdomen and Pelvis, with Contrast $4,388 $1,146
76536 Ultrasound, Head and Neck $1,165 $257
76641 Ultrasound, Breast, Unilateral, Complete $230 $155
76642 Ultrasound, Breast, Unilateral, Limited $230 $119
76700 Ultrasound, Abdominal, Complete $1,534 $298
76830 Ultrasound, Transvaginal $954 $231
76856 Ultrasound, Pelvic (nonobstetric), Complete $1,075 $247
76942 Ultrasonic Guidance for Needle Placement (eg, biopsy) $1,007 $183
G0202 Mammogram, Screening $308 $199
G0206 Mammogram, Diagnostic $537 $204
Outpatient Surgical
26055 Incise finger tendon sheath $5,503 $976
28285 Repair of hammertoe $7,267 $3,258
29827 Arthroscop rotator cuff repr $29,562 $12,676
29881 Knee arthroscopy/surgery.. $7,029 $2,509
36561 Insert tunneled cv cath 36561 $12,344 $3,972
41899 Dental surgery procedure $12,934 $5,390
43235 Uppr gi endoscopy diagnosis 43235 $5,613 $1,548
43239 Upper gi endoscopy biopsy 43239 $6,719 $1,826
45378 Colonoscopy, flexible-45378 $6,646 $2,007
45380 Colonoscopy, flexible-45380 $7,723 $2,130
45385 Colonoscopy, flexible-45385 $8,530 $2,425
47562 Laparoscopic cholecystectomy $19,500 $7,816
58558 Hysteroscopy, biopsy $8,792 $3,618
66982 Cataract surgery, complex $6,227 $1,958
66984 Cataract surg w/iol, 1 stage 66984 $5,830 $2,127
Inpatient Surgical
766 Cesarean section w/o cc/mcc $25,878 $9,632
765 Cesarean section w cc/mcc $29,817 $9,416
460 Spinal fusion except cervical w/o mcc $146,634 $46,496
460 Excision of intervertebral disc $208,371 $85,015
470 Major joint replacement or reattachment of lower extremity w/o mcc $63,646 $18,746
470 Hip replacement $70,202 $19,417
470 Knee replacement $59,728 $18,329
621 O.R. procedures for obesity w/o cc/mcc $53,642 $16,585
743 Uterine & adnexa proc for non-malignancy w/o cc/mcc $27,375 $9,585
481 Hip & femur procedures except major joint w cc $57,160 $14,257
330 Major small & large bowel procedures w cc $86,925 $24,659
853 Infectious & parasitic diseases w o.r. procedure w mcc $162,038 $47,565
331 Major small & large bowel procedures w/o cc/mcc $65,809 $17,781
419 Laparoscopic cholecystectomy w/o c.d.e. w/o cc/mcc $44,076 $11,675
473 Cervical spinal fusion w/o cc/mcc $61,769 $23,628
494 Lower extrem & humer proc except hip,foot,femur w/o cc/mcc $42,335 $13,008
329 Major small & large bowel procedures w mcc $128,509 $44,780
483 Major joint/limb reattachment procedure of upper extremities $70,522 $19,949
253 Other vascular procedures w cc $65,659 $17,030
343 Appendectomy w/o complicated principal diag w/o cc/mcc $33,295 $8,007
418 Laparoscopic cholecystectomy w/o c.d.e. w cc $64,155 $17,678
742 Uterine & adnexa proc for non-malignancy w cc/mcc $51,787 $14,403
493 Lower extrem & humer proc except hip,foot,femur w cc $47,073 $14,998
N/A Esophagogastroduodenoscopy $52,888 $12,095


Your out-of-pocket cost will be based on your specific insurance coverage level at the time of the procedure.  For more detailed information, please contact your insurance company directly.

 

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