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
Molecule mutation identify
Low
$14
Average
$492
Median
$47
High
$13.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 6.6× 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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42 hospital rates
iThe hospitals that file a Aetna 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 | Benson Hospital Corporation Benson, AZ facility · percent of total billed charges · inpatientfrom % of charges | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 2 | Benson Hospital Corporation Benson, AZ facility · percent of total billed charges · outpatientfrom % of charges | 2 | $35 | $35 | $11 | 30% | — | $24 – $45 |
| 3 | Boone Memorial Hospital Madison, WV fee schedule · both | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 4 | Boone Memorial Hospital Madison, WV percent of total billed charges · bothfrom % of charges | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 5 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 6 | Connecticut Children's Hartford, CT percent of total billed charges · outpatientfrom % of charges | 2 | $74 | $87 | $25 | 29% | — | $62 – $128 |
| 7 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 8 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 9 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 10 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 11 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 12 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 13 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 14 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 15 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 16 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 17 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 18 | Doylestown Hospital Doylestown, PA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $105 | $107 | $54 | 50% | — | $52 – $166 |
| 19 | Evans Memorial Hospital Claxton, GA percent of total billed charges · outpatientfrom % of charges | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 20 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $13.9k | $13.9k | — | — | — | $13.9k – $13.9k |
| 21 | HealthAlliance Hospital Kingston, NY facility · fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 22 | HealthAlliance Hospital Kingston, NY facility · other · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 23 | HealthAlliance Hospital Kingston, NY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $35 | $35 | $2 | 5% | — | $33 – $36 |
| 24 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 25 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
← Payers reporting CPT 83904 · Snapshot 20261112T181611Z-3fa9fb76