CPT 0126U
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
Fee Schedule
Low
$16
Average
$42
Median
$28
High
$103
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40 hospital rates
iThe hospitals that file a Anthem rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 3 | $28 | $28 | — | — | — | $28 – $28 |
| 2 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $28 | $28 | — | — | — | $28 – $28 |
| 3 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 4 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 6 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 7 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 8 | $28 | $28 | — | — | — | $28 – $28 |
| 8 | Cleveland Clinic Mercy Hospital Canton, OH facility · fee schedule · outpatient | 2 | $30 | $30 | $2 | 8% | — | $28 – $33 |
| 9 | Columbia St. Mary's, Inc. Glendale, WI fee schedule · both | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 10 | Endo Surgery Center Carmel, IN fee schedule · outpatient | 8 | $28 | $28 | — | — | — | $28 – $28 |
| 11 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 12 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 3 | $28 | $28 | — | — | — | $28 – $28 |
| 13 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 14 | LODI COMMUNITY HOSPITAL Lodi, OH facility · fee schedule · outpatient | 2 | $32 | $32 | $3 | 8% | — | $29 – $34 |
| 15 | LUTHERAN HOSPITAL Cleveland, OH facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 16 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 17 | MEDINA HOSPITAL Medina, OH facility · fee schedule · outpatient | 2 | $39 | $39 | $4 | 11% | — | $35 – $44 |
| 18 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 6 | $28 | $28 | — | — | — | $28 – $28 |
| 19 | Memorial Hospital of Boscobel Boscobel, WI facility · fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 20 | Moundview Memorial Hospital and Clinics, Inc. Friendship, WI facility · fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 21 | Naab Road Surgery Center Indianapolis, IN fee schedule · outpatient | 8 | $28 | $28 | — | — | — | $28 – $28 |
| 22 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 23 | St Joseph’s Health Services Inc Hillsboro, WI facility · fee schedule · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 24 | St. Joseph Hospital & Health Center, Inc. Kokomo, IN fee schedule · outpatient | 8 | $28 | $28 | — | — | — | $28 – $28 |
| 25 | St. Mary's Health, Inc. IN 47750; 10388 Warrick Wellness Trail Newburgh, IN fee schedule · outpatient | 8 | $28 | $28 | — | — | — | $28 – $28 |
← Payers reporting CPT 0126U · Snapshot 20261113T090226Z-3ce6c0b8