CPT 0458T
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
$170
Average
$1.6k
Median
$710
High
$8.2k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
66 hospitals; the 90th percentile is 21.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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67 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $707 | $707 | — | — | — | $707 – $707 |
| 2 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $170 | $170 | — | — | — | $170 – $170 |
| 3 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $686 | $686 | — | — | — | $686 – $686 |
| 4 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $761 | $761 | — | — | — | $761 – $761 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $777 | $777 | — | — | — | $777 – $777 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $810 | $810 | — | — | — | $810 – $810 |
| 8 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 9 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 8 | $170 | $170 | — | — | — | $170 – $170 |
| 10 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $690 | $690 | — | — | — | $690 – $690 |
| 11 | Columbia St. Mary's, Inc. Glendale, WI fee schedule · both | 4 | $6.8k | $8.2k | $3.7k | 45% | — | $4.8k – $14.5k |
| 12 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 13 | Endo Surgery Center Carmel, IN fee schedule · outpatient | 8 | $170 | $170 | — | — | — | $170 – $170 |
| 14 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $730 | $730 | — | — | — | $730 – $730 |
| 15 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $497 | $497 | — | — | — | $497 – $497 |
| 16 | Floyd Healthcare Management Inc Rome, GA case rate · outpatient | 2 | $2.2k | $2.2k | $303 | 14% | — | $1.9k – $2.5k |
| 17 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $673 | $673 | — | — | — | $673 – $673 |
| 18 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $695 | $695 | — | — | — | $695 – $695 |
| 20 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $686 | $686 | — | — | — | $686 – $686 |
| 21 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $712 | $712 | — | — | — | $712 – $712 |
| 22 | MaineHealth Brunswick, ME fee schedule · both | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 23 | MaineHealth Rockport, ME fee schedule · both | 1 | $271 | $271 | — | — | — | $271 – $271 |
| 24 | MaineHealth Westbrook, ME fee schedule · both | 1 | $310 | $310 | — | — | — | $310 – $310 |
| 25 | MaineHealth Damariscotta, ME fee schedule · both | 1 | $349 | $349 | — | — | — | $349 – $349 |
← Payers reporting CPT 0458T · Snapshot 20261113T090226Z-3ce6c0b8