CPT 0691T
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
Auto alys xst ct std vrt fx
Low
$24
Average
$100
Median
$78
High
$301
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59 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 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $45 | $45 | $6 | 12% | — | $40 – $51 |
| 2 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $78 | $78 | — | — | — | $78 – $78 |
| 3 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $77 | $77 | — | — | — | $77 – $77 |
| 4 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $14 | $24 | $17 | 71% | — | $11 – $49 |
| 5 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $112 | $112 | — | — | — | $112 – $112 |
| 6 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 8 | $78 | $78 | — | — | — | $78 – $78 |
| 7 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 2 | $77 | $77 | — | — | — | $77 – $77 |
| 8 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $102 | $102 | — | — | — | $102 – $102 |
| 9 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 2 | $77 | $77 | — | — | — | $77 – $77 |
| 10 | Endo Surgery Center Carmel, IN fee schedule · outpatient | 8 | $78 | $78 | — | — | — | $78 – $78 |
| 11 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 12 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 13 | Maine Coast Regional Health Facilities Ellsworth, ME professional · fee schedule · outpatient | 2 | $77 | $77 | — | — | — | $77 – $77 |
| 14 | MaineHealth Brunswick, ME fee schedule · both | 1 | $77 | $77 | $22 | 28% | — | $56 – $99 |
| 15 | MaineHealth Rockport, ME fee schedule · both | 1 | $85 | $85 | $24 | 28% | — | $61 – $109 |
| 16 | MaineHealth Westbrook, ME fee schedule · both | 1 | $100 | $100 | $28 | 28% | — | $72 – $128 |
| 17 | MaineHealth Damariscotta, ME fee schedule · both | 1 | $113 | $113 | $32 | 28% | — | $81 – $145 |
| 18 | MaineHealth North Conway, NH fee schedule · both | 1 | $104 | $104 | $31 | 30% | — | $73 – $135 |
| 19 | MaineHealth Belfast, ME fee schedule · both | 1 | $113 | $113 | $32 | 28% | — | $81 – $145 |
| 20 | MaineHealth Farmington, ME fee schedule · both | 1 | $100 | $100 | $28 | 28% | — | $72 – $128 |
| 21 | MaineHealth Portland, ME fee schedule · both | 1 | $139 | $139 | $39 | 28% | — | $100 – $178 |
| 22 | MaineHealth Biddeford, ME fee schedule · both | 1 | $139 | $139 | $39 | 28% | — | $100 – $178 |
| 23 | MaineHealth Norway, ME fee schedule · both | 1 | $113 | $113 | $32 | 28% | — | $81 – $145 |
| 24 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 5 | $94 | $104 | $27 | 27% | — | $80 – $167 |
| 25 | Mayo Regional Hospital Dover Foxcroft, ME professional · fee schedule · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
← Payers reporting CPT 0691T · Snapshot 20261113T090226Z-3ce6c0b8