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
HC INT RPR F/E/EY/NO/L/M 5.1-7.5
Low
$55
Average
$1.5k
Median
$672
High
$366.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1762 hospitals; the 90th percentile is 9.4× 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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3,051 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 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 3 | $290 | $375 | $196 | 52% | 8–80 | $211 – $757 |
| 2 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $275 | $355 | $186 | 52% | 8–80 | $200 – $717 |
| 3 | Northern Illinois Medical Center DBA Northwestern Medicine McHenry Hospital Woodstock, IL percent of total billed charges · outpatientfrom % of charges | 5 | $2.5k | $4.3k | $4.1k | 94% | 5–50 | $327 – $11.0k |
| 4 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $710 | $2.7k | $4.5k | 165% | 4–40 | $219 – $15.2k |
| 5 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $856 | $856 | $182 | 21% | 2–20 | $674 – $1.0k |
| 6 | Community Health Association Ripley, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $351 | $351 | — | — | 2–20 | $351 – $351 |
| 7 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · inpatient | 1 | $207 | $207 | — | — | 2–20 | $207 – $207 |
| 8 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 4 | $771 | $765 | $115 | 15% | 2–20 | $569 – $896 |
| 9 | North Carolina Baptist Hospital Winston Salem, NC other · outpatient | 1 | $266 | $266 | — | — | 2–20 | $266 – $266 |
| 10 | St. Charles Bend Bend, OR percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | $96 | 7% | 2–20 | $1.2k – $1.4k |
| 11 | St. Charles Redmond Redmond, OR percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | $96 | 7% | 2–20 | $1.2k – $1.4k |
| 12 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 3 | $1.1k | $1.0k | $210 | 20% | 2–20 | $766 – $1.3k |
| 13 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.1k | $1.3k | $336 | 26% | 1–10 | $1.0k – $1.8k |
| 14 | Carteret County General Hospital Corporation Morehead City, NC facility · percent of total billed charges · bothfrom % of charges | 1 | $204 | $204 | — | — | 1–10 | $204 – $204 |
| 15 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.3k | $2.3k | $1.6k | 68% | 1–10 | $737 – $3.9k |
| 16 | Curators of the University of Missouri Jefferson City, MO facility · percent of total billed charges · outpatientfrom % of charges | 3 | $604 | $668 | $245 | 37% | 1–10 | $274 – $930 |
| 17 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 1 | $343 | $343 | — | — | 1–10 | $343 – $343 |
| 18 | Jennie Stuart Medical Center Hopkinsville, KY facility · other · inpatient | 1 | $94 | $94 | — | — | 1–10 | $94 – $94 |
| 19 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $913 | $913 | — | — | 1–10 | $913 – $913 |
| 20 | Northwestern Lake Forest Hospital Grayslake, IL percent of total billed charges · outpatientfrom % of charges | 3 | $750 | $840 | $468 | 56% | 1–10 | $281 – $1.6k |
| 21 | St Josephs Community Hospital of West Bend Inc West Bend, WI other · inpatient | 1 | $105 | $105 | — | — | 1–10 | $105 – $105 |
| 22 | The Cleveland Clinic Foundation Brunswick, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $875 | $925 | $167 | 18% | 1–10 | $751 – $1.2k |
| 23 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
| 24 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY case rate · outpatient | 1 | $498 | $498 | — | — | — | $498 – $498 |
| 25 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY fee schedule · outpatient | 1 | $363 | $363 | — | — | — | $363 – $363 |
← Payers reporting CPT 12053 · Snapshot 20261111T120946Z-9134e7f7