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
Dstrj Loclzd Les Retina 1/> Sess Pc
Low
$208
Average
$3.3k
Median
$1.5k
High
$52.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1191 hospitals; the 90th percentile is 16.9× 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.
Filter by billing methodology
Filter by billing class
1,681 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 | Wills Eye Hospital Philadelphia, PA percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | 29 | $1.2k – $1.2k |
| 2 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $469 | $516 | $120 | 23% | 11 | $399 – $774 |
| 3 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $469 | $516 | $120 | 23% | 11 | $399 – $774 |
| 4 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $9.2k | $12.1k | $8.0k | 66% | 6–60 | $5.8k – $29.7k |
| 5 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · outpatient | 2 | $710 | $829 | $167 | 20% | 3–30 | $710 – $1.1k |
| 6 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $435 | $435 | — | — | 2–20 | $435 – $435 |
| 7 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | $37 | 3% | 2–20 | $1.3k – $1.4k |
| 8 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 3 | $3.6k | $3.6k | $724 | 20% | 2–20 | $2.6k – $4.4k |
| 9 | Henry Ford Health System Plymouth, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $776 | $776 | — | — | 1–10 | $776 – $776 |
| 10 | Memorial Hospital for Cancer and Allied Diseases New York, NY fee schedule · outpatient | 2 | $9.7k | $9.6k | $643 | 7% | 1–10 | $8.8k – $10.3k |
| 11 | Memorial Hospital for Cancer and Allied Diseases Montvale, NJ fee schedule · outpatient | 2 | $9.7k | $9.4k | $460 | 5% | 1–10 | $8.8k – $9.7k |
| 12 | Memorial Hospital for Cancer and Allied Diseases Hauppauge, NY fee schedule · outpatient | 2 | $9.7k | $9.4k | $460 | 5% | 1–10 | $8.8k – $9.7k |
| 13 | Memorial Hospital for Cancer and Allied Diseases Middletown, NJ fee schedule · outpatient | 2 | $9.7k | $9.4k | $460 | 5% | 1–10 | $8.8k – $9.7k |
| 14 | The Cleveland Clinic Foundation Brunswick, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $1.8k | $1.9k | $352 | 18% | 1–10 | $1.6k – $2.5k |
| 15 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 16 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY fee schedule · outpatient | 1 | $499 | $499 | — | — | — | $499 – $499 |
| 17 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $574 | $574 | — | — | — | $574 – $574 |
| 18 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $542 | $542 | — | — | — | $542 – $542 |
| 19 | AGH LAVEEN LLC Phoenix, AZ case rate · outpatient | 2 | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 20 | AGH MESA LLC Mesa, AZ case rate · outpatient | 2 | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 21 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $520 | $520 | — | — | — | $520 – $520 |
| 22 | ALASKA REGIONAL HOSPITAL Anchorage, AK case rate · outpatient | 3 | $9.4k | $9.0k | $1.1k | 12% | — | $7.5k – $10.1k |
| 23 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 1 | $682 | $682 | — | — | — | $682 – $682 |
| 24 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 6 | $958 | $842 | $256 | 30% | — | $479 – $1.1k |
| 25 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 3 | $462 | $602 | $444 | 74% | — | $154 – $1.3k |
← Payers reporting CPT 67210 · Snapshot 20261112T181611Z-3fa9fb76