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
HB Rpr S/N/a/Gen/Trk12.6-20.0cm
Low
$55
Average
$1.6k
Median
$614
High
$366.8k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1829 hospitals; the 90th percentile is 13.8× 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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3,200 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 | The Charlotte Mecklenburg Hospital Authority Waxhaw, NC percent of total billed charges · outpatientfrom % of charges | 5 | $300 | $310 | $79 | 26% | 8–80 | $190 – $438 |
| 2 | The Charlotte Mecklenburg Hospital Authority Huntersville, NC percent of total billed charges · outpatientfrom % of charges | 5 | $293 | $333 | $139 | 42% | 8–80 | $190 – $597 |
| 3 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $677 | $677 | $25 | 4% | 4–40 | $652 – $702 |
| 4 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 4 | $3.6k | $7.4k | $9.3k | 125% | 4–40 | $196 – $29.1k |
| 5 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · outpatientfrom % of charges | 2 | $440 | $437 | $4 | 1% | 3–30 | $431 – $440 |
| 6 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | 2–20 | $1.1k – $1.1k |
| 7 | Springhill Memorial Hospital Mobile, AL other · outpatient | 2 | $116 | $116 | — | — | 2–20 | $116 – $116 |
| 8 | West Virginia Health Care Cooperative Inc. Summersville, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $280 | $280 | — | — | 2–20 | $280 – $280 |
| 9 | ARH Mary Breckinridge Health Services, Inc Barbourville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $111 | $111 | — | — | 1–10 | $111 – $111 |
| 10 | Buchanan County Health Center Independence, IA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $277 | $277 | $119 | 43% | 1–10 | $158 – $396 |
| 11 | Carteret County General Hospital Corporation Morehead City, NC facility · percent of total billed charges · bothfrom % of charges | 1 | $204 | $204 | — | — | 1–10 | $204 – $204 |
| 12 | DIGNITY HEALTH Mt Shasta, CA percent of total billed charges · outpatientfrom % of charges | 1 | $237 | $237 | — | — | 1–10 | $237 – $237 |
| 13 | Forsyth Memorial Hospital, Inc. Winston-Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
| 14 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $164 | $164 | — | — | 1–10 | $164 – $164 |
| 15 | HOMESTEAD HOSPITAL Homestead, FL percent of total billed charges · outpatientfrom % of charges | 1 | $6.3k | $6.3k | — | — | 1–10 | $6.3k – $6.3k |
| 16 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · case rate · outpatient | 1 | $2.9k | $2.9k | — | — | 1–10 | $2.9k – $2.9k |
| 17 | Kirby Medical Center Monticello, IL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $791 | $791 | $305 | 39% | 1–10 | $485 – $1.1k |
| 18 | Knox Hospital Company LLC Knox, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5.1k | $5.1k | $147 | 3% | 1–10 | $5.0k – $5.3k |
| 19 | Lexington Medical Center Lexington, NC percent of total billed charges · outpatientfrom % of charges | 5 | $1.7k | $1.5k | $488 | 32% | 1–10 | $658 – $2.0k |
| 20 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.0k | $1.0k | $150 | 14% | 1–10 | $899 – $1.2k |
| 21 | MEMORIAL HEALTH CARE SYSTEM INC. Hixson, TN percent of total billed charges · outpatientfrom % of charges | 1 | $646 | $646 | — | — | 1–10 | $646 – $646 |
| 22 | Mat-Su Valley Medical Center LLC Palmer, AK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $6.6k | $6.6k | — | — | 1–10 | $6.6k – $6.6k |
| 23 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $402 | $1.0k | $1.8k | 179% | 1–10 | $183 – $7.9k |
| 24 | St. Joseph Medical Center Bellingham, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.7k | — | — | 1–10 | $1.7k – $1.7k |
| 25 | Strong Memorial Hospital Rochester, NY percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
← Payers reporting CPT 12005 · Snapshot 20261111T120946Z-9134e7f7