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
HC TBS TECHNICAL CALCULATION ONLY
Low
$10
Average
$149
Median
$93
High
$6.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1019 hospitals; the 90th percentile is 4.2× 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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1,469 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 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 3 | $227 | $227 | — | — | 189–198 | $227 – $227 |
| 2 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 6 | $93 | $103 | $41 | 40% | 180–198 | $40 – $161 |
| 3 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 2 | $126 | $126 | $82 | 65% | 86 | $45 – $208 |
| 4 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $92 | $111 | $29 | 26% | 66 | $88 – $151 |
| 5 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · inpatient | 1 | $89 | $89 | — | — | 63 | $89 – $89 |
| 6 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 2 | $105 | $105 | $6 | 6% | 47 | $98 – $111 |
| 7 | Northwestern Medicine Delnor Hospital Geneva, IL percent of total billed charges · outpatientfrom % of charges | 3 | $174 | $136 | $65 | 47% | 36–45 | $46 – $190 |
| 8 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 1 | $246 | $246 | — | — | 25 | $246 – $246 |
| 9 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · both | 1 | $92 | $92 | — | — | 16 | $92 – $92 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $246 | $246 | $201 | 82% | 2–20 | $45 – $447 |
| 11 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI percent of total billed charges · inpatientfrom % of charges | 1 | $152 | $152 | $11 | 7% | 2–20 | $141 – $163 |
| 12 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $152 | $152 | $11 | 7% | 2–20 | $141 – $163 |
| 13 | Mount Graham Regional Medical Center Safford, AZ percent of total billed charges · outpatientfrom % of charges | 2 | $300 | $300 | — | — | 2–20 | $300 – $300 |
| 14 | St Luke's Regional Medical Center, LTD Mountain Home, ID other · outpatient | 1 | $72 | $72 | $31 | 43% | 2–20 | $41 – $103 |
| 15 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $327 | $327 | — | — | 1–10 | $327 – $327 |
| 16 | HCA FLORIDA SOUTH SHORE HOSPITAL APOLLO BEACH, FL percent of total billed charges · outpatientfrom % of charges | 2 | $136 | $115 | $40 | 35% | 1–10 | $58 – $150 |
| 17 | Lafayette County Darlington, WI facility · other · inpatient | 1 | $213 | $213 | — | — | 1–10 | $213 – $213 |
| 18 | Lafayette County Darlington, WI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $129 | $129 | $21 | 16% | 1–10 | $109 – $150 |
| 19 | MCLAREN GREATER LANSING LANSING, MI percent of total billed chargesfrom % of charges | 1 | $68 | $68 | — | — | 1–10 | $68 – $68 |
| 20 | Massachusetts General Hospital Boston, MA other · both | 1 | $108 | $108 | — | — | 1–10 | $108 – $108 |
| 21 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $265 | $265 | — | — | 1–10 | $265 – $265 |
| 22 | Mayo Clinic Health System St, NE facility · percent of total billed charges · bothfrom % of charges | 1 | $245 | $245 | — | — | 1–10 | $245 – $245 |
| 23 | Mayo Clinic Health System Waseca 56093-2811 facility · percent of total billed charges · bothfrom % of charges | 1 | $245 | $245 | — | — | 1–10 | $245 – $245 |
| 24 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $245 | $245 | — | — | 1–10 | $245 – $245 |
| 25 | Mayo Clinic Health System Red Wing 55066-2848 facility · percent of total billed charges · bothfrom % of charges | 1 | $245 | $245 | — | — | 1–10 | $245 – $245 |
← Payers reporting CPT 77091 · Snapshot 20261111T120946Z-9134e7f7