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
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Low
$1
Average
$20.3k
Median
$17.6k
High
$128.2k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1281 hospitals; the 90th percentile is 13.9× 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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1,870 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | 3 | $179.9k | $174.6k | $10.7k | 6% | 5–50 | $153.2k – $179.9k |
| 2 | OREGON HEALTH & SCIENCE UNIVERSITY PORTLAND, OR fee schedule · outpatient | 2 | $51.6k | $51.6k | $29.0k | 56% | 4–40 | $22.6k – $80.6k |
| 3 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 3 | $116.5k | $127.9k | $38.6k | 30% | 3–30 | $87.4k – $179.9k |
| 4 | Northwestern Lake Forest Hospital Grayslake, IL case rate · outpatient | 2 | $5.5k | $5.5k | $287 | 5% | 2–20 | $5.2k – $5.7k |
| 5 | Northwestern Memorial Hospital Chicago, IL case rate · outpatient | 2 | $12.3k | $12.3k | $647 | 5% | 2–20 | $11.6k – $12.9k |
| 6 | Palos Community Hospital Palos Heights, IL case rate · outpatient | 2 | $5.5k | $5.5k | $287 | 5% | 2–20 | $5.2k – $5.7k |
| 7 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 2 | $140.0k | $140.0k | — | — | 2–20 | $140.0k – $140.0k |
| 8 | ST JOSEPHS HOSPITAL HOSPITAL SISTERS THIRD ORDER OF ST FRANCIS Carlyle, IL percent of total billed charges · outpatientfrom % of charges | 1 | $78.2k | $78.2k | — | — | 2–20 | $78.2k – $78.2k |
| 9 | ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Oconto Falls, WI case rate · outpatient | 1 | $2.0k | $2.0k | — | — | 2–20 | $2.0k – $2.0k |
| 10 | ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Oconto Falls, WI fee schedule · outpatient | 1 | $20.4k | $20.4k | — | — | 2–20 | $20.4k – $20.4k |
| 11 | HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5.5k | $5.5k | — | — | 1–10 | $5.5k – $5.5k |
| 12 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $23.5k | $23.5k | — | — | 1–10 | $23.5k – $23.5k |
| 13 | Hospital Development Co Spencer, WV percent of total billed charges · bothfrom % of charges | 1 | $22.0k | $22.0k | — | — | 1–10 | $22.0k – $22.0k |
| 14 | Mayo Clinic Rochester, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $19.8k | $19.8k | — | — | 1–10 | $19.8k – $19.8k |
| 15 | Mount Carmel Dublin Dublin, OH facility · case rate · outpatient | 2 | $81.5k | $81.5k | $20.1k | 25% | 1–10 | $61.5k – $101.6k |
| 16 | Northwestern Lake Forest Hospital Grayslake, IL percent of total billed charges · outpatientfrom % of charges | 1 | $292.0k | $292.0k | — | — | 1–10 | $292.0k – $292.0k |
| 17 | SAINT FRANCIS MEDICAL CENTER Grand Island, NE percent of total billed charges · outpatientfrom % of charges | 1 | $31.3k | $31.3k | — | — | 1–10 | $31.3k – $31.3k |
| 18 | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. DBA INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL JUNCTION, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6.8k | $6.8k | — | — | 1–10 | $6.8k – $6.8k |
| 19 | St Josephs Hospital Health Center Syracuse, NY facility · other · outpatient | 3 | $38.9k | $44.4k | $30.4k | 69% | 1–10 | $10.2k – $84.1k |
| 20 | St Luke's Regional Medical Center, LTD Mountain Home, ID other · outpatient | 1 | $22.0k | $22.0k | — | — | 1–10 | $22.0k – $22.0k |
| 21 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 1 | $8.7k | $8.7k | — | — | 1–10 | $8.7k – $8.7k |
| 22 | The University of Texas Medical Branch Webster, TX fee schedule · both | 1 | $17.4k | $17.4k | — | — | 1–10 | $17.4k – $17.4k |
| 23 | The University of Texas Medical Branch Webster, TX fee schedule · inpatient | 2 | $529 | $529 | $83 | 16% | 1–10 | $446 – $611 |
| 24 | The University of Texas Medical Branch Webster, TX fee schedule · outpatient | 3 | $24.3k | $22.0k | $3.2k | 15% | 1–10 | $17.4k – $24.3k |
| 25 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY case rate · outpatient | 1 | $9.9k | $9.9k | $9.6k | 96% | — | $376 – $19.5k |
← Payers reporting CPT 63655 · Snapshot 20261112T181611Z-3fa9fb76