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 Intmd Rpr S/a/T/Ext 2.5 Cm/<
Low
$4
Average
$1.5k
Median
$613
High
$366.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1926 hospitals; the 90th percentile is 11.7× 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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3,522 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 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 6 | $976 | $1.6k | $1.3k | 80% | 138 | $210 – $4.2k |
| 2 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $4.9k | $7.0k | $8.4k | 120% | 90–126 | $162 – $23.0k |
| 3 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 3 | $783 | $840 | $261 | 31% | 31–49 | $479 – $1.3k |
| 4 | The Cleveland Clinic Foundation Brunswick, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $875 | $925 | $167 | 18% | 17 | $751 – $1.2k |
| 5 | Curators of the University of Missouri Jefferson City, MO facility · percent of total billed charges · outpatientfrom % of charges | 3 | $412 | $428 | $187 | 44% | 13–130 | $220 – $747 |
| 6 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 3 | $240 | $311 | $163 | 52% | 8–80 | $175 – $626 |
| 7 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $228 | $294 | $154 | 52% | 8–80 | $165 – $593 |
| 8 | Baystate Franklin Medical Center Greenfield, MA facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | 5–50 | $1.3k – $1.3k |
| 9 | Northern Illinois Medical Center DBA Northwestern Medicine McHenry Hospital Woodstock, IL percent of total billed charges · outpatientfrom % of charges | 5 | $2.7k | $4.7k | $4.5k | 95% | 5–50 | $328 – $12.1k |
| 10 | HOMESTEAD HOSPITAL Homestead, FL percent of total billed charges · outpatientfrom % of charges | 2 | $1.8k | $1.8k | $221 | 12% | 4–40 | $1.6k – $2.0k |
| 11 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 4 | $1.7k | $2.7k | $2.8k | 105% | 4–40 | $287 – $9.4k |
| 12 | The Mercy Hospital Inc Springfield, MA professional · fee schedule · outpatient | 5 | $67 | $94 | $50 | 53% | 4–40 | $55 – $172 |
| 13 | University of Virginia Prince William Medical Center Manassas, VA other · both | 1 | $425 | $425 | — | — | 4–40 | $425 – $425 |
| 14 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 3 | $831 | $775 | $128 | 16% | 3–30 | $566 – $921 |
| 15 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $916 | $836 | $448 | 54% | 3–30 | $250 – $1.3k |
| 16 | Grant Memorial Hospital Inc Petersburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $506 | $529 | $33 | 6% | 3–30 | $506 – $577 |
| 17 | Mercy St. Francis Hospital View, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $147 | $207 | $86 | 42% | 3–30 | $145 – $328 |
| 18 | ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS O'Fallon, IL case rate · outpatient | 1 | $1.3k | $1.3k | — | — | 3–30 | $1.3k – $1.3k |
| 19 | ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Springfield, IL fee schedule · outpatient | 1 | $205 | $205 | — | — | 3–30 | $205 – $205 |
| 20 | Samaritan Medical Center Watertown, NY professional · other · both | 1 | $282 | $282 | — | — | 3–30 | $282 – $282 |
| 21 | University of Virginia Medical Center Charlottesville, VA fee schedule · both | 4 | $1.3k | $1.2k | $207 | 17% | 3–30 | $812 – $1.3k |
| 22 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 3 | $130 | $131 | $4 | 3% | 3–30 | $127 – $137 |
| 23 | Windom Area Hospital Lakefield, MN facility · other · inpatient | 1 | $94 | $94 | — | — | 3–30 | $94 – $94 |
| 24 | Windom Area Hospital Lakefield, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $933 | $1.1k | 122% | 3–30 | $50 – $2.5k |
| 25 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 1 | $4.0k | $4.0k | — | — | 2–20 | $4.0k – $4.0k |
← Payers reporting CPT 12031 · Snapshot 20261111T120946Z-9134e7f7