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
Exc Les Mucosa & Sbmcsl Vestibule Smpl Rpr
Low
$9
Average
$2.2k
Median
$1.7k
High
$23.5k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1289 hospitals; the 90th percentile is 13.8× 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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1,945 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 | Seattle Children's Hospital Seattle, WA professional · fee schedule · both | 1 | $502 | $502 | — | — | 81 | $502 – $502 |
| 2 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 6 | $4.5k | $4.4k | $1.2k | 28% | 6–60 | $2.0k – $5.9k |
| 3 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $12.5k | $14.2k | $7.4k | 52% | 6–60 | $7.9k – $29.7k |
| 4 | Arkansas Childrens Hospital Little Rock, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.5k | $1.5k | — | — | 1–10 | $1.5k – $1.5k |
| 5 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $4.2k | $4.2k | — | — | 1–10 | $4.2k – $4.2k |
| 6 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $3.5k | $3.5k | — | — | 1–10 | $3.5k – $3.5k |
| 7 | HARTFORD HOSPITAL HARTFORD, CT other · outpatient | 1 | $650 | $650 | — | — | 1–10 | $650 – $650 |
| 8 | Massachusetts Eye and Ear Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | 1–10 | $1.3k – $1.3k |
| 9 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $12.3k | $12.3k | — | — | 1–10 | $12.3k – $12.3k |
| 10 | MedStar Washington Hospital Center NW, WA facility · case rate · outpatient | 1 | $3.2k | $3.2k | — | — | 1–10 | $3.2k – $3.2k |
| 11 | Northwestern Lake Forest Hospital Grayslake, IL percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 1–10 | $4.9k – $4.9k |
| 12 | ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Springfield, IL case rate · outpatient | 1 | $3.0k | $3.0k | — | — | 1–10 | $3.0k – $3.0k |
| 13 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 1 | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 14 | Samaritan Medical Center Watertown, NY professional · other · both | 1 | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 15 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 1 | $921 | $921 | — | — | 1–10 | $921 – $921 |
| 16 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.6k | $4.6k | — | — | 1–10 | $4.6k – $4.6k |
| 17 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · percent of total billed charges · outpatientfrom % of charges | 8 | $3.1k | $3.4k | $1.2k | 36% | 1–10 | $1.5k – $5.2k |
| 18 | THE COMMUNITY HOSPITAL OF BRAZOSPORT Lake Jackson, TX percent of total billed charges · outpatientfrom % of charges | 1 | $917 | $917 | — | — | 1–10 | $917 – $917 |
| 19 | The Cleveland Clinic Foundation Brunswick, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $5.0k | $5.3k | $950 | 18% | 1–10 | $4.3k – $6.8k |
| 20 | University Of Miami Hosp & Clinics Miami, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14.1k | $14.1k | — | — | 1–10 | $14.1k – $14.1k |
| 21 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $20.8k | $20.8k | — | — | 1–10 | $20.8k – $20.8k |
| 22 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY case rate · outpatient | 1 | $922 | $922 | $424 | 46% | — | $498 – $1.3k |
| 23 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
| 24 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA percent of total billed charges · outpatientfrom % of charges | 1 | $470 | $470 | — | — | — | $470 – $470 |
| 25 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $177 | $177 | — | — | — | $177 – $177 |
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