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
PRO FEE RT TX PLAN; SIMPLE
Low
$68
Average
$2.3k
Median
$81
High
$33.5k
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 8.6× 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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19 hospital rates
iThe hospitals that file a Medical Mutual 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 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 2 | Benefis Hospitals Inc Helena, MT fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 3 | Benefis Hospitals Inc Helena, MT percent of total billed charges · inpatientfrom % of charges | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 4 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 1 | $33.5k | $33.5k | — | — | — | $33.5k – $33.5k |
| 5 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 3 | $693 | $697 | $7 | 1% | — | $693 – $707 |
| 6 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 3 | $446 | $463 | $52 | 11% | — | $410 – $535 |
| 7 | St Peters Hospital Albany, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 8 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $177 | $177 | — | — | — | $177 – $177 |
| 9 | St. Joseph Health System, LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 10 | St. Joseph Health System, LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 11 | University Hospitals Health System Chardon, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 12 | University Hospitals Health System Ravenna, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 13 | University Hospitals Health System Chardon, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 14 | University Hospitals Health System Beachwood, OH facility · fee schedule · outpatient | 5 | $107 | $97 | $15 | 16% | — | $68 – $107 |
| 15 | University Hospitals Health System Concord Township, OH facility · fee schedule · outpatient | 5 | $101 | $95 | $14 | 14% | — | $68 – $101 |
| 16 | University Hospitals Health System Cleveland, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 17 | University Hospitals Health System Parma, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 18 | University Hospitals Health System Beachwood, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 19 | University Hospitals Health System Elyria, OH facility · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
← Payers reporting CPT 77261 · Snapshot 20261112T181611Z-3fa9fb76