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
OPTX RAD/ULN DISLC AQT/CHRNC
Low
$16
Average
$738
Median
$337
High
$3.5k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
20 hospitals; the 90th percentile is 102.7× 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.
Filter by billing methodology
Filter by billing class
24 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $337 | $337 | — | — | — | $337 – $337 |
| 2 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $337 | $337 | — | — | — | $337 – $337 |
| 3 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $301 | $301 | — | — | — | $301 – $301 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $514 | $514 | — | — | — | $514 – $514 |
| 6 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $301 | $301 | — | — | — | $301 – $301 |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $496 | $496 | — | — | — | $496 – $496 |
| 9 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $437 | $437 | — | — | — | $437 – $437 |
| 10 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 1 | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 11 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 12 | Holyoke Medical Center Holyoke, MA facility · fee schedule · outpatient | 1 | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 13 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 14 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 15 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · inpatient | 1 | $478 | $478 | — | — | — | $478 – $478 |
| 16 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 1 | $478 | $478 | — | — | — | $478 – $478 |
| 17 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · inpatient | 1 | $478 | $478 | — | — | — | $478 – $478 |
| 18 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 1 | $478 | $478 | — | — | — | $478 – $478 |
| 19 | REEDLEY COMMUNITY HOSPITAL Reedley, CA fee schedule · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 20 | SAN JOAQUIN COMMUNITY HOSPITAL Bakersfield, CA fee schedule · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 21 | SONORA COMMUNITY HOSPITAL Sonora, CA fee schedule · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 22 | UKIAH ADVENTIST HOSPITAL Ukiah, CA fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 23 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI professional · fee schedule · inpatient | 1 | $414 | $414 | — | — | — | $414 – $414 |
| 24 | WILLITS HOSPITAL INC Willits, CA fee schedule · outpatient | 1 | $337 | $337 | — | — | — | $337 – $337 |
← Payers reporting CPT 25676 · Snapshot 20261113T090226Z-3ce6c0b8