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
"ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 3-5 , IMIPRAMINE"
Low
$61
Average
$150
Median
$140
High
$525
Each hospital's average Premera rate, under the methodology and billing class chosen below.
19 hospitals; the 90th percentile is 1.9× 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
19 hospital rates
iThe hospitals that file a Premera 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 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · outpatientfrom % of charges | 4 | $146 | $146 | — | — | — | $146 – $146 |
| 2 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 3 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 4 | Mary Bridge Children's Hospital Tacoma, WA percent of total billed charges · outpatientfrom % of charges | 4 | $146 | $146 | — | — | — | $146 – $146 |
| 5 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 6 | MultiCare Auburn Medical Center Auburn, WA percent of total billed charges · outpatientfrom % of charges | 4 | $146 | $146 | — | — | — | $146 – $146 |
| 7 | MultiCare Capital Medical Center Lacey, WA percent of total billed charges · outpatientfrom % of charges | 4 | $146 | $146 | — | — | — | $146 – $146 |
| 8 | MultiCare Covington Medical Center Covington, WA percent of total billed charges · outpatientfrom % of charges | 4 | $146 | $146 | — | — | — | $146 – $146 |
| 9 | MultiCare Deaconess Hospital Spokane, WA percent of total billed charges · outpatientfrom % of charges | 4 | $134 | $134 | — | — | — | $134 – $134 |
| 10 | MultiCare Valley Hospital Spokane Valley, WA percent of total billed charges · outpatientfrom % of charges | 4 | $134 | $134 | — | — | — | $134 – $134 |
| 11 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA percent of total billed charges · outpatientfrom % of charges | 3 | $134 | $134 | — | — | — | $134 – $134 |
| 12 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 13 | St Joseph Mercy Chelsea Chelsea, MI facility · fee schedule · both | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 14 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · fee schedule · both | 1 | $187 | $187 | — | — | — | $187 – $187 |
| 15 | St Joseph Mercy Oakland Pontiac, MI facility · fee schedule · both | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 16 | St Mary Mercy Livonia Livonia, MI facility · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 17 | St Peters Hospital Albany, NY facility · fee schedule · both | 1 | $525 | $525 | — | — | — | $525 – $525 |
| 18 | Tacoma General Allenmore Hospital Bremerton, WA percent of total billed charges · outpatientfrom % of charges | 4 | $146 | $146 | — | — | — | $146 – $146 |
| 19 | Virginia Mason Medical Center Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $61 | $61 | — | — | — | $61 – $61 |
← Payers reporting CPT 80336 · Snapshot 20261113T090226Z-3ce6c0b8