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 Cmplx Rpr S/a/L Addl 5 Cm/>
Low
$1
Average
$1.7k
Median
$706
High
$72.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1443 hospitals; the 90th percentile is 30.0× 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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2,373 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 Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $9.6k | $11.7k | $15.1k | 129% | 40–76 | $155 – $49.1k |
| 2 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 6 | $4.2k | $8.9k | $9.1k | 102% | 6–60 | $191 – $23.1k |
| 3 | Northern Illinois Medical Center DBA Northwestern Medicine McHenry Hospital Woodstock, IL percent of total billed charges · outpatientfrom % of charges | 5 | $4.1k | $7.6k | $7.8k | 102% | 5–50 | $257 – $20.4k |
| 4 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 4 | $16.4k | $21.3k | $13.0k | 61% | 4–40 | $9.3k – $43.2k |
| 5 | ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Springfield, IL case rate · outpatient | 1 | $2.3k | $2.3k | — | — | 4–40 | $2.3k – $2.3k |
| 6 | Tanner Medical Center - Carrollton Carrollton, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.4k | $1.4k | — | — | 3–30 | $1.4k – $1.4k |
| 7 | University of Virginia Medical Center Charlottesville, VA fee schedule · both | 4 | $1.3k | $1.2k | $207 | 17% | 3–30 | $812 – $1.3k |
| 8 | DOCTORS HOSPITAL CORAL GABLES, FL percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | 2–20 | $1.2k – $1.2k |
| 9 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $360 | $360 | $44 | 12% | 2–20 | $316 – $404 |
| 10 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 1 | $355 | $355 | $38 | 11% | 2–20 | $317 – $392 |
| 11 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $346 | $346 | — | — | 1–10 | $346 – $346 |
| 12 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 1 | $4.9k | $4.9k | — | — | 1–10 | $4.9k – $4.9k |
| 13 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $360 | $360 | — | — | 1–10 | $360 – $360 |
| 14 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 4 | $2.6k | $2.5k | $381 | 15% | 1–10 | $1.9k – $2.9k |
| 15 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $9.2k | $9.2k | — | — | 1–10 | $9.2k – $9.2k |
| 16 | Memorial Hospital for Cancer and Allied Diseases New York, NY fee schedule · outpatient | 2 | $6.9k | $7.0k | $328 | 5% | 1–10 | $6.8k – $7.5k |
| 17 | Memorial Hospital for Cancer and Allied Diseases Montvale, NJ fee schedule · outpatient | 2 | $6.8k | $6.9k | $429 | 6% | 1–10 | $6.5k – $7.5k |
| 18 | Memorial Hospital for Cancer and Allied Diseases Hauppauge, NY fee schedule · outpatient | 2 | $6.8k | $6.9k | $429 | 6% | 1–10 | $6.5k – $7.5k |
| 19 | Memorial Hospital for Cancer and Allied Diseases Middletown, NJ fee schedule · outpatient | 2 | $6.8k | $6.9k | $429 | 6% | 1–10 | $6.5k – $7.5k |
| 20 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 1 | $334 | $334 | — | — | 1–10 | $334 – $334 |
| 21 | Naples HMA LLC Naples, FL facility · other · outpatient | 2 | $2.9k | $2.9k | $29 | 1% | 1–10 | $2.8k – $2.9k |
| 22 | Northwestern Lake Forest Hospital Grayslake, IL percent of total billed charges · outpatientfrom % of charges | 3 | $590 | $2.4k | $3.3k | 139% | 1–10 | $221 – $8.1k |
| 23 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC percent of total billed charges · bothfrom % of charges | 2 | $548 | $514 | $49 | 10% | 1–10 | $444 – $548 |
| 24 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 2 | $548 | $514 | $49 | 10% | 1–10 | $444 – $548 |
| 25 | Strong Memorial Hospital Rochester, NY percent of total billed charges · outpatientfrom % of charges | 1 | $246 | $246 | — | — | 1–10 | $246 – $246 |
← Payers reporting CPT 13122 · Snapshot 20261111T120946Z-9134e7f7