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Mount St. Marys Hospital

Trinity Health
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Hospital Overview
Facility Details

CCN

330188

NPI

1043394745

Type

Short Term Acute Care Hospital

Ownership

Voluntary Non-Profit - Church

Beds

175

Contact Information

Address

5300 Military Road

Lewiston, NY 14092

Phone

(716) 297-4800

Insurance Accepted
Medicare
Medicaid
Aetna
BCBS
Cigna
United (incl Optum)

💡

Important Notice

Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.

Price Transparency Contract Information
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💡 The data below comes from CMS-mandated price transparency data. Learn more.

💡 Tip: Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.

PayerCategoryCode Type & GroupContract TypeRate Compared to State Average

Aetna

Outpatient

CPT

Medicine Services and Procedures

Range: 90281 - 99607

Percentage of Bill Charged

Aetna

Facility

RC

Other Imaging Services

Range: 0400 - 0409

Percentage of Bill Charged

Aetna

Facility

RC

Room and Board (3 and 4 beds)

Range: 0130 - 0139

Per Diem

Very Low

Aetna

Outpatient

HCPCS

Administrative, Miscellaneous and Investigational

Range: A9150 - A9999

Percentage of Bill Charged

Aetna

Facility

RC

All-inclusive Rate

Range: 0100 - 0109

Percentage of Bill Charged

Aetna

Outpatient

HCPCS

Prosthetic Procedures

Range: L5000 - L9900

Percentage of Bill Charged

Aetna

Outpatient

CPT

Surgery

Range: 10004 - 69990

Percentage of Bill Charged

Aetna

Facility

RC

Pharmacy (Also see 063X, an extension of 250X)

Range: 0250 - 0259

Percentage of Bill Charged

Aetna

Facility

RC

Room and Board Deluxe Private

Range: 0140 - 0149

Per Diem

Very Low

Aetna

Facility

RC

Coronary Care Unit

Range: 0210 - 0219

Percentage of Bill Charged

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