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
SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-CAC
Low
$1
Average
$343
Median
$241
High
$4.3k
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
267 hospitals; the 90th percentile is 6.5× 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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394 hospital rates
iThe hospitals that file a Caresource 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 | St. Joseph Health System, LLC Wayne, IN facility · other · outpatient | 2 | $381 | $381 | — | — | 40 | $381 – $381 |
| 2 | East Georgia Regional Medical Center LLC Statesboro, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $400 | $400 | — | — | 30 | $400 – $400 |
| 3 | La Porte Hospital Company LLC La Porte, IN facility · other · outpatient | 3 | $381 | $352 | $41 | 12% | 30 | $293 – $381 |
| 4 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · outpatientfrom % of charges | 1 | $218 | $218 | $13 | 6% | 26 | $206 – $231 |
| 5 | Polk Medical Center Inc Cedartown, GA percent of total billed charges · outpatientfrom % of charges | 3 | $137 | $146 | $46 | 32% | 24–33 | $94 – $206 |
| 6 | MEMORIAL HEALTH MEADOWS HOSPITAL Vidalia, GA percent of total billed charges · outpatientfrom % of charges | 1 | $666 | $666 | — | — | 22 | $666 – $666 |
| 7 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $545 | $468 | $204 | 44% | 19 | $132 – $650 |
| 8 | FAIRVIEW PARK HOSPITAL DUBLIN, GA percent of total billed charges · outpatientfrom % of charges | 1 | $666 | $666 | — | — | 18 | $666 – $666 |
| 9 | Bluffton Health System LLC Bluffton, IN facility · other · outpatient | 2 | $381 | $381 | — | — | 17–26 | $381 – $381 |
| 10 | Dukes Health System LLC Peru, IN facility · other · outpatient | 3 | $381 | $352 | $41 | 12% | 17–35 | $293 – $381 |
| 11 | Wheeling Hospital, Inc. Wheeling, WV facility · other · outpatient | 3 | $193 | $190 | $37 | 19% | 14–23 | $58 – $212 |
| 12 | IOM Health System LP Fort Wayne, IN facility · other · outpatient | 2 | $381 | $381 | — | — | 13–22 | $381 – $381 |
| 13 | Tanner Medical Center - Carrollton Carrollton, GA facility · other · outpatient | 1 | $166 | $166 | — | — | 13 | $166 – $166 |
| 14 | Pike Health Services Inc Waverly, OH facility · other · outpatient | 1 | $218 | $218 | — | — | 11 | $218 – $218 |
| 15 | Coffee Regional Medical Center, Inc Douglas, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $98 | $98 | — | — | 5–50 | $98 – $98 |
| 16 | Higgins General Hospital Bremen, GA facility · other · outpatient | 1 | $163 | $163 | — | — | 4–40 | $163 – $163 |
| 17 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · other · outpatient | 3 | $201 | $198 | $75 | 38% | 4–40 | $80 – $287 |
| 18 | Tanner Medical Center - Villa Rica Villa Rica, GA facility · other · outpatient | 1 | $183 | $183 | — | — | 3–30 | $183 – $183 |
| 19 | Barnesville Hospital Association, Inc. Barnesville, OH facility · other · outpatient | 1 | $301 | $301 | — | — | 2–20 | $301 – $301 |
| 20 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · other · outpatient | 3 | $201 | $216 | $68 | 32% | 2–20 | $80 – $287 |
| 21 | Community Health Association Ripley, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $717 | $717 | — | — | 2–20 | $717 – $717 |
| 22 | Dupont Hospital LLC Wayne, IN facility · other · outpatient | 2 | $381 | $381 | — | — | 2–20 | $381 – $381 |
| 23 | Harrison Community Hospital, Inc. Cadiz, OH facility · other · outpatient | 1 | $378 | $378 | — | — | 2–20 | $378 – $378 |
| 24 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $721 | $721 | — | — | 2–20 | $721 – $721 |
| 25 | Knox Hospital Company LLC Knox, IN facility · other · outpatient | 3 | $381 | $352 | $41 | 12% | 2–20 | $293 – $381 |
← Payers reporting CPT 12001 · Snapshot 20261111T120946Z-9134e7f7