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
$18
Average
$245
Median
$198
High
$11.1k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
624 hospitals; the 90th percentile is 3.9× 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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905 hospital rates
iThe hospitals that file a WellCare 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 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $234 | $234 | — | — | 71 | $234 – $234 |
| 2 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 1 | $222 | $222 | — | — | 71 | $222 – $222 |
| 3 | The Charlotte Mecklenburg Hospital Authority Waxhaw, NC percent of total billed charges · outpatientfrom % of charges | 1 | $100 | $100 | — | — | 71 | $100 – $100 |
| 4 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 1 | $119 | $119 | — | — | 67 | $119 – $119 |
| 5 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $108 | $108 | — | — | 48 | $108 – $108 |
| 6 | HOULTON REGIONAL HOSPITAL HOULTON, ME fee schedule · outpatient | 1 | $122 | $122 | — | — | 22 | $122 – $122 |
| 7 | Forsyth Memorial Hospital, Inc. Winston-Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $106 | $106 | — | — | 18 | $106 – $106 |
| 8 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $114 | $114 | — | — | 17–170 | $114 – $114 |
| 9 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $89 | $89 | — | — | 17 | $89 – $89 |
| 10 | Fairview Health Services Burnsville, MN other · inpatient | 1 | $117 | $117 | — | — | 16–160 | $117 – $117 |
| 11 | Fairview Health Services Wyoming, MN other · inpatient | 1 | $79 | $79 | — | — | 16–160 | $79 – $79 |
| 12 | Fairview Health Services Princeton, MN other · inpatient | 1 | $89 | $89 | — | — | 16–160 | $89 – $89 |
| 13 | HealthEast St John's Hospital Maplewood, MN other · inpatient | 1 | $117 | $117 | — | — | 16–160 | $117 – $117 |
| 14 | HealthEast Woodwinds Hospital Woodbury, MN other · inpatient | 1 | $89 | $89 | — | — | 16–160 | $89 – $89 |
| 15 | High Point Regional Health High Point, NC percent of total billed charges · outpatientfrom % of charges | 1 | $139 | $139 | — | — | 16 | $139 – $139 |
| 16 | Scotland Memorial Hospital Inc. Laurinburg, NC facility · fee schedule · both | 1 | $44 | $44 | — | — | 16 | $44 – $44 |
| 17 | Novant Health New Hanover Regional Medical Center LLC Wilmington, NC percent of total billed charges · outpatientfrom % of charges | 1 | $349 | $349 | — | — | 15 | $349 – $349 |
| 18 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $166 | $166 | — | — | 14 | $166 – $166 |
| 19 | The Charlotte Mecklenburg Hospital Authority Albemarle, NC percent of total billed charges · outpatientfrom % of charges | 1 | $91 | $91 | — | — | 14 | $91 – $91 |
| 20 | Brunswick Community Hospital, LLC Bolivia, NC percent of total billed charges · outpatientfrom % of charges | 1 | $256 | $256 | — | — | 13 | $256 – $256 |
| 21 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 3 | $311 | $433 | $283 | 66% | 4–40 | $218 – $1.0k |
| 22 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 3 | $235 | $332 | $293 | 88% | 3–30 | $41 – $1.0k |
| 23 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | — | — | 3–30 | $81 – $81 |
| 24 | NORTHERN MAINE MEDICAL CENTER FORT KENT, ME percent of total billed charges · outpatientfrom % of charges | 1 | $268 | $211 | $99 | 47% | 3–30 | $40 – $268 |
| 25 | Appalachian Regional Healthcare, Inc. Whitesburg, KY other · outpatient | 1 | $106 | $106 | — | — | 2–20 | $106 – $106 |
← Payers reporting CPT 12001 · Snapshot 20261111T120946Z-9134e7f7