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 Perq Replacement Gtube Not Req Revj Gstrst Trc
Low
$1
Average
$475
Median
$256
High
$8.2k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
793 hospitals; the 90th percentile is 10.3× 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.
Filter by billing methodology
Filter by billing class
1,159 hospital rates
iThe hospitals that file a Molina 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 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 2 | $299 | $299 | $108 | 36% | 58–67 | $191 – $408 |
| 2 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 2 | $409 | $409 | $200 | 49% | 58 | $209 – $610 |
| 3 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $197 | $197 | — | — | 58 | $197 – $197 |
| 4 | Seattle Children's Hospital Seattle, WA professional · fee schedule · both | 2 | $41 | $41 | $19 | 46% | 55 | $22 – $60 |
| 5 | Parkland Health Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 7 | $673 | $1.1k | $716 | 66% | 34–43 | $507 – $2.5k |
| 6 | Parkland Health Dallas, TX facility · fee schedule · both | 4 | $289 | $324 | $202 | 62% | 33 | $127 – $589 |
| 7 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 4 | $878 | $985 | $630 | 64% | 33 | $372 – $1.8k |
| 8 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 1 | $337 | $337 | $16 | 5% | 18 | $321 – $353 |
| 9 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $171 | $171 | — | — | 3–30 | $171 – $171 |
| 10 | DIGNITY COMMUNITY CARE Sacramento, CA fee schedule · outpatient | 1 | $386 | $386 | — | — | 3–30 | $386 – $386 |
| 11 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Rio Rancho, NM facility · other · outpatient | 2 | $603 | $488 | $163 | 33% | 3–30 | $257 – $603 |
| 12 | Brigham and Women's Hospital Boston, MA other · both | 1 | $283 | $283 | — | — | 2–20 | $283 – $283 |
| 13 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 6 | $15 | $12 | $6 | 49% | 2–20 | $4 – $16 |
| 14 | Massachusetts General Hospital Boston, MA other · both | 1 | $283 | $283 | — | — | 2–20 | $283 – $283 |
| 15 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 1 | $167 | $167 | $39 | 23% | 2–20 | $128 – $206 |
| 16 | PeaceHealth Southwest Medical Center Vancouver, WA facility · other · outpatient | 3 | $144 | $184 | $81 | 44% | 2–20 | $111 – $296 |
| 17 | St. Joseph Medical Center Bellingham, WA facility · other · outpatient | 2 | $248 | $248 | $63 | 26% | 2–20 | $185 – $312 |
| 18 | Appalachian Regional Healthcare, Inc. Williamson, KY percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $84 | — | — | 1–10 | $84 – $84 |
| 19 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT other · inpatient | 1 | $231 | $231 | — | — | 1–10 | $231 – $231 |
| 20 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | 1–10 | $126 – $126 |
| 21 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $144 | $200 | $130 | 65% | 1–10 | $38 – $412 |
| 22 | Las Cruces Medical Center LLC Las Cruces, NM facility · other · outpatient | 1 | $295 | $295 | — | — | 1–10 | $295 – $295 |
| 23 | Mission Regional Medical Center Mission, TX percent of total billed charges · outpatientfrom % of charges | 1 | $207 | $207 | — | — | 1–10 | $207 – $207 |
| 24 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 1 | $136 | $136 | — | — | 1–10 | $136 – $136 |
| 25 | Wesley Health System LLC Hattiesburg, MS facility · other · outpatient | 2 | $194 | $194 | $6 | 3% | 1–10 | $187 – $200 |
← Payers reporting CPT 43762 · Snapshot 20261111T120946Z-9134e7f7