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
HC INCAL BX SKN EA SEP/ADDL
Low
$36
Average
$237
Median
$198
High
$680
Each hospital's average Premera rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 5.2× 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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36 hospital rates
iThe hospitals that file a Premera 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 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · inpatient | 1 | $341 | $341 | — | — | — | $341 – $341 |
| 2 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · outpatient | 1 | $363 | $363 | — | — | — | $363 – $363 |
| 3 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 3 | $163 | $159 | $6 | 4% | — | $149 – $163 |
| 4 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $164 | $162 | $69 | 43% | — | $66 – $255 |
| 5 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $359 | $359 | — | — | — | $359 – $359 |
| 7 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $680 | $680 | — | — | — | $680 – $680 |
| 8 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 9 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 10 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 1 | $88 | $88 | — | — | — | $88 – $88 |
| 11 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 12 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $261 | $261 | — | — | — | $261 – $261 |
| 13 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 1 | $88 | $88 | — | — | — | $88 – $88 |
| 14 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 15 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $304 | $304 | — | — | — | $304 – $304 |
| 16 | Nazareth Hospital Philadelphia, PA facility · fee schedule · both | 1 | $549 | $549 | — | — | — | $549 – $549 |
| 17 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $215 | $215 | — | — | — | $215 – $215 |
| 18 | Plymouth Medical Center Plymouth, IN professional · fee schedule · inpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 19 | Plymouth Medical Center Plymouth, IN professional · fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 20 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · both | 1 | $46 | $39 | $11 | 28% | — | $23 – $46 |
| 21 | Public Hospital District No 4 King County WA Snoqualmie, WA fee schedule · both | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 22 | Public Hospital District No 4 King County WA Snoqualmie, WA percent of total billed charges · bothfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 23 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 24 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 25 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · inpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
← Payers reporting CPT 11107 · Snapshot 20261112T181611Z-3fa9fb76