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
Urine Hexose Tetrasaccharide
Low
$0
Average
$1.2k
Median
$76
High
$1701.6k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1612 hospitals; the 90th percentile is 10.3× 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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2,227 hospital rates
iThe hospitals that file a Cigna 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 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 2 | $328 | $313 | $131 | 42% | 26–98 | $9 – $523 |
| 2 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $197 | $197 | $39 | 20% | 20–200 | $158 – $236 |
| 3 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $24 | $24 | $8 | 33% | 20–38 | $16 – $32 |
| 4 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $188 | $182 | $100 | 55% | 18–81 | $22 – $364 |
| 5 | St Louis Childrens Hospital Saint Louis, MO percent of total billed charges · bothfrom % of charges | 3 | $54 | $54 | $2 | 4% | 14–32 | $52 – $57 |
| 6 | The Children's Hospital of Alabama Birmingham, AL facility · percent of total billed charges · bothfrom % of charges | 1 | $675 | $930 | $956 | 103% | 13 | $96 – $2.9k |
| 7 | The Children's Hospital of Alabama Birmingham, AL facility · percent of total billed charges · bothfrom % of charges | 1 | $675 | $930 | $956 | 103% | 13 | $96 – $2.9k |
| 8 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $41 | $41 | — | — | 12–120 | $41 – $41 |
| 9 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $158 | $158 | — | — | 10–100 | $158 – $158 |
| 10 | Grant Memorial Hospital Inc Petersburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | 7–70 | $28 – $28 |
| 11 | Brigham and Women's Faulkner Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $92 | $92 | — | — | 5–50 | $92 – $92 |
| 12 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 3 | $82 | $82 | $4 | 4% | 5–50 | $77 – $86 |
| 13 | Newton Wellesley Hospital Newton, MA percent of total billed charges · outpatientfrom % of charges | 1 | $92 | $92 | — | — | 5–50 | $92 – $92 |
| 14 | Salem Hospital Salem, MA percent of total billed charges · outpatientfrom % of charges | 1 | $92 | $92 | — | — | 5–50 | $92 – $92 |
| 15 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $454 | $579 | $565 | 97% | 4–40 | $43 – $1.4k |
| 16 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $454 | $579 | $565 | 97% | 4–40 | $43 – $1.4k |
| 17 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 3 | $27 | $27 | $3 | 11% | 3–30 | $24 – $30 |
| 18 | Progress West Hospital O'Fallon, MO fee schedule · both | 3 | $51 | $45 | $9 | 19% | 3–30 | $33 – $52 |
| 19 | Saint Luke’s Hospital of Chillicothe Chillicothe, MO fee schedule · both | 1 | $21 | $21 | — | — | 3–30 | $21 – $21 |
| 20 | Cooley Dickinson Hospital Northampton, MA percent of total billed charges · outpatientfrom % of charges | 1 | $147 | $147 | — | — | 2–20 | $147 – $147 |
| 21 | Cumberland County Hospital System Inc Fayetteville, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $40 | — | — | 2–20 | $40 – $40 |
| 22 | Duke University Hospital Durham, NC facility · other · outpatient | 1 | $63 | $63 | — | — | 2–20 | $63 – $63 |
| 23 | Duke University Hospital Raleigh, NC facility · other · outpatient | 1 | $63 | $63 | — | — | 2–20 | $63 – $63 |
| 24 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $96 | $96 | $77 | 81% | 2–20 | $19 – $173 |
| 25 | Missouri Baptist Medical Center Saint Louis, MO fee schedule · both | 3 | $51 | $45 | $9 | 19% | 2–20 | $33 – $52 |
← Payers reporting CPT 83789 · Snapshot 20261111T120946Z-9134e7f7