CPT 0875T
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
Prgrm subq prtl asct pmp sys
Low
$21
Average
$41
Median
$40
High
$90
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152 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 3 | Adventhealth Manchester Manchester, KY fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 4 | Adventhealth Palm Coast Parkway Palm Coast, FL fee schedule · outpatient | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 5 | Aspirus Divine Savior Hospital Portage, WI fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 6 | Aspirus Plover Hospital Stevens Point, WI fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 7 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 8 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 9 | Aspirus Stevens Point Hospital Stevens Point, WI fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 10 | Aspirus Wausau Hospital Wausau, WI fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 11 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 12 | Boone Hospital Center Columbia, MO fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 13 | Boulder Community Health Lafayette, CO facility · case rate · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 14 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 15 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 16 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 17 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 18 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 4 | $48 | $49 | $1 | 2% | — | $48 – $50 |
| 19 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 20 | CRAWFORD LONG HOSPITAL Atlanta, GA facility · fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 21 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 22 | Cleveland Clinic Mercy Hospital Canton, OH facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 23 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 24 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 25 | Covenant Medical Center Inc Saginaw, MI facility · case rate · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
← Payers reporting CPT 0875T · Snapshot 20261113T090226Z-3ce6c0b8