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
$27
Average
$663
Median
$187
High
$28.5k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
75 hospitals; the 90th percentile is 15.9× 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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85 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | $76 | $76 | — | — | — | $76 – $76 |
| 2 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $1.1k | $1.1k | $640 | 61% | — | $411 – $1.7k |
| 3 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $1.0k | $1.0k | $663 | 64% | — | $366 – $1.7k |
| 4 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 2 | $1.4k | $1.4k | $320 | 23% | — | $1.1k – $1.7k |
| 5 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 2 | $1.0k | $1.0k | $652 | 63% | — | $389 – $1.7k |
| 6 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 2 | $1.0k | $1.0k | $652 | 63% | — | $389 – $1.7k |
| 7 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 2 | $1.0k | $1.0k | $686 | 68% | — | $320 – $1.7k |
| 8 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · both | 2 | $209 | $209 | — | — | — | $209 – $209 |
| 9 | Atrium Health Hospitals Inc Kings Mountain, NC fee schedule · both | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 10 | Atrium Health Hospitals Inc Lincolnton, NC fee schedule · both | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 11 | Atrium Health Hospitals Inc Wadesboro, NC fee schedule · both | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 12 | Bluffton Health System LLC Bluffton, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 13 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 14 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 15 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 16 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 17 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $89 | $89 | — | — | — | $89 – $89 |
| 18 | Carmel AmbSurg Carmel, IN fee schedule · both | 2 | $209 | $209 | — | — | — | $209 – $209 |
| 19 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 1 | $142 | $142 | — | — | — | $142 – $142 |
| 20 | Carolinas Medical Center Charlotte, NC fee schedule · both | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 21 | Carolinas Medical Center Charlotte, NC fee schedule · both | 2 | $305 | $305 | — | — | — | $305 – $305 |
| 22 | Carolinas Medical Center Charlotte, NC fee schedule · both | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 23 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 24 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 3 | $105 | $295 | $268 | 91% | — | $105 – $674 |
| 25 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
← Payers reporting CPT 0504T · Snapshot 20261113T090226Z-3ce6c0b8