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
$1
Average
$204
Median
$134
High
$8.9k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
699 hospitals; the 90th percentile is 4.1× 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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935 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | 11 | $215 | $191 | $61 | 32% | 2,146–2,173 | $50 – $232 |
| 2 | Mayo Clinic Rochester, MN facility · other · both | 3 | $105 | $105 | $1 | 1% | 666–675 | $102 – $105 |
| 3 | Mayo Clinic Health System Eau Claire 54703-5270 facility · other · both | 1 | $95 | $95 | — | — | 137 | $95 – $95 |
| 4 | Mayo Clinic Rochester, MN facility · fee schedule · both | 1 | $95 | $95 | — | — | 110 | $95 – $95 |
| 5 | Mayo Clinic Health System St, NE facility · percent of total billed charges · bothfrom % of charges | 7 | $220 | $200 | $54 | 27% | 74–101 | $108 – $250 |
| 6 | Northwestern Medicine Central DuPage Hospital Winfield, IL other · outpatient | 2 | $88 | $88 | $5 | 5% | 70 | $84 – $93 |
| 7 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 8 | $231 | $207 | $51 | 25% | 69–87 | $114 – $250 |
| 8 | Northwestern Medicine Delnor Hospital Geneva, IL other · outpatient | 2 | $64 | $64 | $28 | 43% | 69 | $37 – $92 |
| 9 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $264 | $233 | $66 | 28% | 60–69 | $89 – $272 |
| 10 | Mayo Clinic Health System Waseca 56093-2811 facility · percent of total billed charges · bothfrom % of charges | 8 | $231 | $205 | $54 | 26% | 51–78 | $106 – $250 |
| 11 | St Luke's Regional Medical Center, LTD Mountain Home, ID other · outpatient | 2 | $95 | $148 | $118 | 80% | 50–68 | $38 – $312 |
| 12 | Mayo Clinic Health System Fairmont 56031-4575 facility · other · both | 2 | $104 | $105 | $1 | 1% | 42–51 | $104 – $106 |
| 13 | Mayo Clinic Health System Saint James 56081-5550 facility · percent of total billed charges · bothfrom % of charges | 8 | $231 | $212 | $41 | 19% | 41–59 | $137 – $250 |
| 14 | NYU Langone New York, NY percent of total billed charges · bothfrom % of charges | 50 | $109 | $107 | $5 | 5% | 31–94 | $87 – $109 |
| 15 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 6 | $231 | $233 | $10 | 4% | 27–45 | $219 – $250 |
| 16 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $264 | $264 | $20 | 7% | 2–20 | $245 – $284 |
| 17 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $89 | $89 | — | — | 2–20 | $89 – $89 |
| 18 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 6 | $209 | $196 | $68 | 35% | 2–20 | $116 – $294 |
| 19 | Stony Brook University Hospital Stony Brook, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $113 | $113 | — | — | 2–20 | $113 – $113 |
| 20 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $158 | $158 | $1 | 0% | 1–10 | $157 – $159 |
| 21 | Mayo Clinic Health System Saint James 56081-5550 facility · fee schedule · both | 1 | $95 | $95 | — | — | 1–10 | $95 – $95 |
| 22 | Mayo Clinic Health System Fairmont 56031-4575 facility · fee schedule · both | 1 | $95 | $95 | — | — | 1–10 | $95 – $95 |
| 23 | Mayo Clinic Health System St, NE facility · fee schedule · both | 1 | $95 | $95 | — | — | 1–10 | $95 – $95 |
| 24 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 5 | $261 | $232 | $72 | 31% | 1–10 | $58 – $272 |
| 25 | Mayo Clinic Health System Waseca 56093-2811 facility · fee schedule · both | 1 | $95 | $95 | — | — | 1–10 | $95 – $95 |
← Payers reporting CPT 77091 · Snapshot 20261111T120946Z-9134e7f7