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
Dstrctn Premalg 15+ Lsns
Low
$0
Average
$2.1k
Median
$968
High
$32.8k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1056 hospitals; the 90th percentile is 20.3× 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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1,444 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 | Jennie Stuart Medical Center Hopkinsville, KY facility · other · inpatient | 1 | $116 | $116 | — | — | 82 | $116 – $116 |
| 2 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $508 | $553 | $257 | 46% | 4–40 | $261 – $935 |
| 3 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 4 | $639 | $646 | $13 | 2% | 1–10 | $639 – $673 |
| 4 | Mayo Clinic Rochester, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $619 | $619 | — | — | 1–10 | $619 – $619 |
| 5 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 3 | $653 | $653 | $27 | 4% | 1–10 | $626 – $680 |
| 6 | Memorial Hospital for Cancer and Allied Diseases New York, NY fee schedule · outpatient | 1 | $6.5k | $6.5k | — | — | 1–10 | $6.5k – $6.5k |
| 7 | Memorial Hospital for Cancer and Allied Diseases Hauppauge, NY fee schedule · outpatient | 1 | $6.5k | $6.5k | — | — | 1–10 | $6.5k – $6.5k |
| 8 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $504 | $504 | $61 | 12% | 1–10 | $443 – $565 |
| 9 | Parkland Health Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.1k | $1.1k | $135 | 12% | 1–10 | $978 – $1.2k |
| 10 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA percent of total billed charges · outpatientfrom % of charges | 1 | $357 | $357 | — | — | 1–10 | $357 – $357 |
| 11 | Stanford Health Care Stanford, CA fee schedule · both | 2 | $371 | $353 | $26 | 7% | 1–10 | $315 – $371 |
| 12 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $422 | $422 | — | — | 1–10 | $422 – $422 |
| 13 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $442 | $442 | — | — | 1–10 | $442 – $442 |
| 14 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY case rate · outpatient | 1 | $954 | $954 | — | — | — | $954 – $954 |
| 15 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $899 | $899 | — | — | — | $899 – $899 |
| 16 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $115 | $115 | — | — | — | $115 – $115 |
| 17 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA percent of total billed charges · outpatientfrom % of charges | 1 | $466 | $466 | — | — | — | $466 – $466 |
| 18 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 19 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA percent of total billed charges · outpatientfrom % of charges | 1 | $466 | $466 | — | — | — | $466 – $466 |
| 20 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 21 | AGH LAVEEN LLC Phoenix, AZ case rate · outpatient | 2 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 22 | AGH MESA LLC Mesa, AZ case rate · outpatient | 2 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 23 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $396 | $396 | — | — | — | $396 – $396 |
| 24 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $959 | $959 | — | — | — | $959 – $959 |
| 25 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 2 | $224 | $224 | $19 | 8% | — | $206 – $243 |
← Payers reporting CPT 17004 · Snapshot 20261111T120946Z-9134e7f7