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
AMMONIUM
Low
$1
Average
$40
Median
$17
High
$1.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
863 hospitals; the 90th percentile is 6.9× 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.
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1,114 hospital rates
iThe hospitals that file a Molina 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 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 2 | $21 | $21 | $8 | 36% | 67–76 | $14 – $29 |
| 2 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 2 | $98 | $98 | $48 | 49% | 50 | $50 – $146 |
| 3 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $100 | $101 | $49 | 49% | 50 | $51 – $153 |
| 4 | ARH Mary Breckinridge Health Services, Inc Barbourville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $45 | $45 | — | — | 25 | $45 – $45 |
| 5 | FAIRFIELD MEMORIAL HOSPITAL FAIRFIELD, IL percent of total billed charges · outpatientfrom % of charges | 2 | $60 | $60 | — | — | 22 | $60 – $60 |
| 6 | Parkland Health Dallas, TX facility · other · both | 4 | $32 | $32 | $19 | 58% | 22–31 | $13 – $52 |
| 7 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $31 | $31 | — | — | 14 | $31 – $31 |
| 8 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 2 | $115 | $115 | $1 | 1% | 13–31 | $114 – $117 |
| 9 | Appalachian Regional Healthcare, Inc. Middlesboro, KY fee schedule · outpatient | 1 | $15 | $15 | — | — | 12 | $15 – $15 |
| 10 | PeaceHealth United General Medical Center Sedro Woolley, WA facility · other · outpatient | 1 | $64 | $64 | — | — | 12 | $64 – $64 |
| 11 | DIGNITY HEALTH San Bernardino, CA fee schedule · outpatient | 3 | $26 | $22 | $5 | 25% | 11 | $15 – $26 |
| 12 | Nor-Lea Hospital District Lovington, NM facility · fee schedule · both | 1 | $49 | $49 | $30 | 62% | 4–40 | $18 – $79 |
| 13 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · other · outpatient | 2 | $15 | $13 | $2 | 12% | 4–40 | $11 – $15 |
| 14 | Sparta Community Hospital Sparta, IL facility · fee schedule · both | 2 | $34 | $34 | $17 | 52% | 4–40 | $16 – $51 |
| 15 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $41 | $27 | 66% | 4–40 | $18 – $85 |
| 16 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $62 | $62 | — | — | 3–30 | $62 – $62 |
| 17 | Pana Community Hospital Association Pana, IL facility · other · outpatient | 1 | $20 | $20 | — | — | 3–30 | $20 – $20 |
| 18 | Wheeling Hospital, Inc. Wheeling, WV facility · other · outpatient | 2 | $13 | $13 | $2 | 13% | 3–30 | $11 – $15 |
| 19 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | 3–30 | $15 – $15 |
| 20 | Buchanan County Health Center Independence, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $65 | $65 | — | — | 2–20 | $65 – $65 |
| 21 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $87 | $87 | $10 | 11% | 2–20 | $78 – $97 |
| 22 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $19 | $19 | $1 | 5% | 2–20 | $18 – $20 |
| 23 | Sparta Community Hospital Sparta, IL professional · fee schedule · both | 1 | $16 | $16 | — | — | 2–20 | $16 – $16 |
| 24 | Trinity Health Grand Haven Hospital Grand Haven, MI facility · fee schedule · both | 1 | $15 | $15 | — | — | 2–20 | $15 – $15 |
| 25 | Valley County Hospital NE 68862-1240; 400 S 23rd St Ord, NE facility · percent of total billed charges · outpatientfrom % of charges | 2 | $56 | $56 | $34 | 61% | 2–20 | $22 – $91 |
← Payers reporting CPT 82140 · Snapshot 20261111T120946Z-9134e7f7