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
Litholapaxy Smpl/Sm <2.5 Cm
Low
$7
Average
$4.3k
Median
$3.5k
High
$48.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1527 hospitals; the 90th percentile is 9.0× 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
2,154 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 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $13.3k | $18.9k | $11.2k | 59% | 458 | $8.3k – $35.8k |
| 2 | Northern Illinois Medical Center DBA Northwestern Medicine McHenry Hospital Woodstock, IL percent of total billed charges · outpatientfrom % of charges | 5 | $16.4k | $15.5k | $3.4k | 22% | 130 | $8.9k – $18.5k |
| 3 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 6 | $10.7k | $10.3k | $2.9k | 28% | 120 | $4.6k – $13.7k |
| 4 | Northwestern Medicine Delnor Hospital Geneva, IL case rate · outpatient | 2 | $724 | $724 | $35 | 5% | 50 | $690 – $759 |
| 5 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 4 | $18.9k | $24.5k | $14.9k | 61% | 44 | $10.7k – $49.6k |
| 6 | Northwestern Medicine Delnor Hospital Geneva, IL percent of total billed charges · outpatientfrom % of charges | 1 | $6.4k | $6.4k | — | — | 25 | $6.4k – $6.4k |
| 7 | Northwestern Lake Forest Hospital Grayslake, IL percent of total billed charges · outpatientfrom % of charges | 1 | $4.2k | $4.2k | — | — | 14 | $4.2k – $4.2k |
| 8 | Northwestern Medicine Kishwaukee Hospital DeKalb, IL percent of total billed charges · outpatientfrom % of charges | 6 | $12.5k | $12.8k | $6.0k | 47% | 6–60 | $4.4k – $20.8k |
| 9 | BATON ROUGE GENERAL MEDICAL CENTER BATON ROUGE, LA case rate · outpatient | 1 | $569 | $569 | — | — | 3–30 | $569 – $569 |
| 10 | Pemiscot Memorial Health System Hayti, MO other · outpatient | 1 | $126 | $126 | — | — | 3–30 | $126 – $126 |
| 11 | University of Virginia Haymarket Medical Center Haymarket, VA other · both | 1 | $3.7k | $3.7k | — | — | 3–30 | $3.7k – $3.7k |
| 12 | University of Virginia Medical Center Charlottesville, VA other · both | 1 | $3.5k | $3.5k | — | — | 3–30 | $3.5k – $3.5k |
| 13 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · outpatient | 1 | $3.7k | $3.7k | — | — | 2–20 | $3.7k – $3.7k |
| 14 | BETHESDA HOSPITAL BOYNTON BEACH, FL percent of total billed charges · outpatientfrom % of charges | 1 | $3.9k | $3.9k | — | — | 2–20 | $3.9k – $3.9k |
| 15 | Fairview Health Services Minneapolis, MN percent of total billed charges · bothfrom % of charges | 1 | $2.5k | $2.5k | — | — | 2–20 | $2.5k – $2.5k |
| 16 | ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS O'Fallon, IL fee schedule · outpatient | 1 | $3.5k | $3.5k | — | — | 2–20 | $3.5k – $3.5k |
| 17 | ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Springfield, IL fee schedule · outpatient | 1 | $3.5k | $3.5k | — | — | 2–20 | $3.5k – $3.5k |
| 18 | Samaritan Medical Center Watertown, NY professional · other · both | 1 | $1.7k | $1.7k | — | — | 2–20 | $1.7k – $1.7k |
| 19 | Beaufort Memorial Hospital Beaufort, SC professional · percent of total billed charges · bothfrom % of charges | 1 | $225 | $225 | — | — | 1–10 | $225 – $225 |
| 20 | Crestview Hospital Corporation Crestview, FL facility · other · outpatient | 3 | $5.4k | $18.7k | $19.1k | 103% | 1–10 | $4.9k – $45.7k |
| 21 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 1 | $803 | $803 | — | — | 1–10 | $803 – $803 |
| 22 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN percent of total billed charges · outpatientfrom % of charges | 1 | $6.1k | $6.1k | — | — | 1–10 | $6.1k – $6.1k |
| 23 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $1.5k | $1.5k | — | — | 1–10 | $1.5k – $1.5k |
| 24 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $6.8k | $6.8k | — | — | 1–10 | $6.8k – $6.8k |
| 25 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · inpatient | 1 | $1.8k | $1.8k | — | — | 1–10 | $1.8k – $1.8k |
← Payers reporting CPT 52317 · Snapshot 20261111T120946Z-9134e7f7