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
$0
Average
$1.9k
Median
$482
High
$32.8k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1065 hospitals; the 90th percentile is 38.6× 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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1,605 hospital rates
iThe hospitals that file a Cigna 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 | 4 | $5.2k | $17.2k | $20.0k | 116% | 20–47 | $149 – $49.1k |
| 2 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 4 | $23.5k | $24.5k | $14.7k | 60% | 4–40 | $7.9k – $43.2k |
| 3 | Northern Illinois Medical Center DBA Northwestern Medicine McHenry Hospital Woodstock, IL percent of total billed charges · outpatientfrom % of charges | 3 | $4.3k | $8.4k | $10.2k | 122% | 3–30 | $263 – $29.1k |
| 4 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 3 | $5.2k | $11.9k | $15.3k | 128% | 3–30 | $285 – $43.2k |
| 5 | Northwestern Lake Forest Hospital Grayslake, IL percent of total billed charges · outpatientfrom % of charges | 2 | $9.6k | $12.8k | $13.0k | 101% | 2–20 | $503 – $31.6k |
| 6 | Carlsbad Medical Center LLC Carlsbad, NM facility · percent of total billed charges · outpatientfrom % of charges | 2 | $20.9k | $20.9k | $5.3k | 25% | 1–10 | $15.6k – $26.2k |
| 7 | GOOD SAMARITAN MEDICAL CENTER, LLC DBA LAFAYETTE, CO facility · percent of total billed charges · outpatientfrom % of charges | 12 | $370 | $301 | $93 | 31% | 1–10 | $162 – $370 |
| 8 | INTERMOUNTAIN FRONT RANGE INC. DBA INTERMOUNTAIN HEALTH LUTHERAN HOSPITAL WHEAT RIDGE, CO facility · percent of total billed charges · outpatientfrom % of charges | 12 | $370 | $301 | $93 | 31% | 1–10 | $162 – $370 |
| 9 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN per diem · outpatient | 4 | $5.7k | $5.6k | $283 | 5% | 1–10 | $5.1k – $5.9k |
| 10 | Memorial Hospital for Cancer and Allied Diseases New York, NY fee schedule · outpatient | 1 | $7.0k | $7.0k | — | — | 1–10 | $7.0k – $7.0k |
| 11 | Memorial Hospital for Cancer and Allied Diseases Montvale, NJ fee schedule · outpatient | 1 | $6.3k | $6.3k | — | — | 1–10 | $6.3k – $6.3k |
| 12 | Memorial Hospital for Cancer and Allied Diseases Hauppauge, NY fee schedule · outpatient | 1 | $7.0k | $7.0k | — | — | 1–10 | $7.0k – $7.0k |
| 13 | Memorial Hospital for Cancer and Allied Diseases Middletown, NJ fee schedule · outpatient | 1 | $6.3k | $6.3k | — | — | 1–10 | $6.3k – $6.3k |
| 14 | SAINT JOSEPH HOSPITAL, INC. DBA INTERMOUNTAIN NHEALTH SAINT JOSEPH HOSPITAL DENVER, CO facility · percent of total billed charges · outpatientfrom % of charges | 12 | $370 | $301 | $93 | 31% | 1–10 | $162 – $370 |
| 15 | The Cleveland Clinic Foundation Brunswick, OH facility · percent of total billed charges · outpatientfrom % of charges | 3 | $539 | $492 | $98 | 20% | 1–10 | $356 – $581 |
| 16 | University of Florida Health Gainesville, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.5k | $1.5k | — | — | 1–10 | $1.5k – $1.5k |
| 17 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 18 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA percent of total billed charges · outpatientfrom % of charges | 1 | $344 | $344 | — | — | — | $344 – $344 |
| 19 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 20 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA percent of total billed charges · outpatientfrom % of charges | 1 | $344 | $344 | — | — | — | $344 – $344 |
| 21 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 22 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $581 | $581 | — | — | — | $581 – $581 |
| 23 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 2 | $171 | $171 | $14 | 8% | — | $157 – $186 |
| 24 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $222 | $222 | — | — | — | $222 – $222 |
| 25 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $162 | $165 | $39 | 23% | — | $118 – $219 |
← Payers reporting CPT 13122 · Snapshot 20261111T120946Z-9134e7f7