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
FTH/GFT FR S/A/L EACH ADDL
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$2.0k
Median
$1.2k
High
$17.3k
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 155 hospitals; the 90th percentile is 50.2× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Hsa Pgh Llc Hialeah, FL | $1.2k | $1.3k | $144 | 11% | 1–10 | $1.2k – $1.5k |
| 2 | OU Health - University of Oklahoma Medical Center Oklahoma City, OK | $56 | $63 | $19 | 30% | — | $55 – $115 |
| 3 | San Joaquin Community Hospital Bakersfield, CA | $57 | $57 | — | — | — | $57 – $57 |
| 4 | Henry Ford Health Novi, MI | $160 | $169 | $13 | 8% | — | $160 – $188 |
| 5 | Northside Hospital, Inc. Lawrenceville, GA | $11.2k | $16.8k | $11.9k | 71% | — | $77 – $50k |
| 6 | Gundersen Luthern Medical Center Inc La Crosse, WI | $868 | $868 | — | — | — | $868 – $868 |
| 7 | City Hospital, Inc. Martinsburg, WV | $63 | $70 | $14 | 20% | — | $59 – $103 |
| 8 | Spohn Hospital Beeville Beeville, TX | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 9 | Northside Hospital, Inc. Atlanta, GA | $12k | $17.3k | $12.0k | 69% | — | $77 – $50k |
| 10 | Spohn Hospital Alice Alice, TX | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
Ask Claude or any MCP client for CPT 15221 pricing at a specific hospital — see how to connect.