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
$10
Average
$1.3k
Median
$604
High
$19.3k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
1282 hospitals; the 90th percentile is 12.3× 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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1,982 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | 4 | $516 | $491 | $86 | 17% | 8–80 | $349 – $584 |
| 2 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 6 | $5.0k | $6.6k | $7.7k | 116% | 8–80 | $357 – $29.1k |
| 3 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 4 | $483 | $459 | $80 | 17% | 4–40 | $331 – $539 |
| 4 | Covenant Medical Center Inc Saginaw, MI professional · other · both | 1 | $453 | $453 | — | — | 2–20 | $453 – $453 |
| 5 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 6 | $662 | $665 | $117 | 18% | 2–20 | $519 – $834 |
| 6 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $1.2k | $1.2k | — | — | 2–20 | $1.2k – $1.2k |
| 7 | Baptist Medical Center of the Beaches, INC Beach, FL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.1k | $1.1k | $424 | 38% | 1–10 | $682 – $1.5k |
| 8 | Boston Medical Center Boston, MA fee schedule · both | 1 | $359 | $359 | — | — | 1–10 | $359 – $359 |
| 9 | Buchanan County Health Center Independence, IA facility · other · outpatient | 1 | $597 | $597 | — | — | 1–10 | $597 – $597 |
| 10 | Buchanan County Health Center Independence, IA professional · other · outpatient | 1 | $172 | $172 | — | — | 1–10 | $172 – $172 |
| 11 | FHN Memorial Hospital Freeport, IL percent of total billed charges · bothfrom % of charges | 1 | $615 | $615 | — | — | 1–10 | $615 – $615 |
| 12 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $400 | $400 | — | — | 1–10 | $400 – $400 |
| 13 | Forsyth Memorial Hospital, Inc. Winston-Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $106 | $106 | — | — | 1–10 | $106 – $106 |
| 14 | Jackson HMA LLC Jackson, MS facility · other · outpatient | 1 | $1.0k | $1.0k | — | — | 1–10 | $1.0k – $1.0k |
| 15 | Lexington Medical Center Lexington, NC other · outpatient | 1 | $158 | $158 | — | — | 1–10 | $158 – $158 |
| 16 | Lexington Medical Center Lexington, NC percent of total billed charges · outpatientfrom % of charges | 4 | $676 | $644 | $110 | 17% | 1–10 | $469 – $754 |
| 17 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN fee schedule · both | 4 | $6.2k | $6.0k | $2.7k | 45% | 1–10 | $666 – $8.3k |
| 18 | Natchez Hospital Company LLC Natchez, MS facility · other · outpatient | 1 | $783 | $783 | — | — | 1–10 | $783 – $783 |
| 19 | Nor-Lea Hospital District Lovington, NM professional · fee schedule · outpatient | 1 | $56 | $56 | — | — | 1–10 | $56 – $56 |
| 20 | North Memorial Health Care Robbinsdale, MN facility · other · both | 1 | $682 | $682 | — | — | 1–10 | $682 – $682 |
| 21 | Novant Health Ballantyne Medical Center LLC Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $423 | $423 | — | — | 1–10 | $423 – $423 |
| 22 | Palos Community Hospital Palos Heights, IL other · outpatient | 1 | $3.6k | $3.6k | — | — | 1–10 | $3.6k – $3.6k |
| 23 | Salem Hospital Salem, MA other · outpatient | 1 | $359 | $359 | — | — | 1–10 | $359 – $359 |
| 24 | Saline Memorial Hospital Benton, AR fee schedule · both | 4 | $430 | $418 | $21 | 5% | 1–10 | $382 – $430 |
| 25 | Saline Memorial Hospital Benton, AR fee schedule · inpatient | 4 | $430 | $418 | $21 | 5% | 1–10 | $382 – $430 |
← Payers reporting CPT 12005 · Snapshot 20261111T120946Z-9134e7f7