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
$49
Average
$2.5k
Median
$142
High
$13.1k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
36 hospitals; the 90th percentile is 114.4× 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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44 hospital rates
iThe hospitals that file a Cigna 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 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 2 | Bluffton Health System LLC Bluffton, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $76 | $76 | $4 | 6% | — | $72 – $80 |
| 3 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $504 | $504 | — | — | — | $504 – $504 |
| 4 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 5 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 6 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 7 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 9 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 10 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 11 | Deaconess Illinois Red Bud Regional Hospital Inc Red Bud, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 12 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 13 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $97 | $97 | — | — | — | $97 – $97 |
| 14 | Dukes Health System LLC Peru, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $162 | $162 | $65 | 40% | — | $96 – $227 |
| 15 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $78 | $78 | $5 | 6% | — | $73 – $82 |
| 16 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $78 | $78 | $5 | 6% | — | $73 – $82 |
| 17 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $49 | $49 | $4 | 9% | — | $45 – $53 |
| 18 | HOLY ROSARY HEALTHCARE DBA INTERMOUNTAIN HEALTH HOLY ROSARY HOSPITAL CITY, MT professional · fee schedule · outpatient | 4 | $102 | $102 | — | — | — | $102 – $102 |
| 19 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $78 | $78 | $5 | 6% | — | $73 – $82 |
| 20 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $78 | $78 | $5 | 6% | — | $73 – $82 |
| 21 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA percent of total billed charges · outpatientfrom % of charges | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 22 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $90 | $132 | $67 | 51% | — | $80 – $227 |
| 23 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $90 | $132 | $67 | 51% | — | $80 – $227 |
| 24 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 25 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
← Payers reporting CPT 0504T · Snapshot 20261113T090226Z-3ce6c0b8