CPT 0504T
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
$26
Average
$322
Median
$123
High
$3.1k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
28 hospitals; the 90th percentile is 4.8× 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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39 hospital rates
iThe hospitals that file a Aetna 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 | Ascension Via Christi Rehabilitation Hospital, Inc. Wichita, KS fee schedule · outpatient | 1 | $226 | $226 | — | — | — | $226 – $226 |
| 2 | Bluffton Health System LLC Bluffton, IN facility · other · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 3 | Bluffton Health System LLC Bluffton, IN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $82 | $89 | $9 | 10% | — | $82 – $101 |
| 4 | Bluffton Health System LLC Bluffton, IN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $82 | $89 | $9 | 10% | — | $82 – $101 |
| 5 | Charleston Area Medical Center Charleston, WV fee schedule · both | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 6 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 7 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 8 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 9 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 10 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 11 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 12 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 13 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 14 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $138 | $138 | — | — | — | $138 – $138 |
| 15 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 16 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 17 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 18 | Dukes Health System LLC Peru, IN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $82 | $82 | — | — | — | $82 – $82 |
| 19 | Dukes Health System LLC Peru, IN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $82 | $91 | $12 | 14% | — | $82 – $108 |
| 20 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $84 | $90 | $8 | 9% | — | $84 – $101 |
| 21 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $84 | $90 | $8 | 9% | — | $84 – $101 |
| 22 | Garnet Health Medical Center Middletown, NY facility · fee schedule · outpatient | 1 | $420 | $420 | — | — | — | $420 – $420 |
| 23 | Garnet Health Medical Center Catskills Harris, NY facility · fee schedule · outpatient | 1 | $384 | $384 | — | — | — | $384 – $384 |
| 24 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $91 | $97 | $8 | 8% | — | $91 – $108 |
| 25 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $91 | $97 | $8 | 8% | — | $91 – $108 |
← Payers reporting CPT 0504T · Snapshot 20261113T090226Z-3ce6c0b8