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
$11
Average
$3.2k
Median
$30
High
$50k
Each hospital's average Humana rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 8.7× 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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17 hospital rates
iThe hospitals that file a Humana 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 · outpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 2 | Boone Memorial Hospital Madison, WV other · both | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 3 | Connecticut Children's Hartford, CT percent of total billed charges · outpatientfrom % of charges | 1 | $78 | $92 | $26 | 28% | — | $69 – $128 |
| 4 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 5 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 6 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 7 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 8 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 9 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 10 | NGMC Barrow, LLC Winder, GA fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 11 | NGMC Lumpkin, LLC Dahlonega, GA fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 12 | Northeast Georgia Medical Center Habersham, LLC Demorest, GA fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 13 | Northeast Georgia Medical Center, Inc. Gainesville, GA fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 14 | Northeast Georgia Medical Center, Inc. Braselton, GA fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 15 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 16 | TWIN CITY HOSPITAL CORPORATION Dennison, OH fee schedule · inpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 17 | TWIN CITY HOSPITAL CORPORATION Dennison, OH fee schedule · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
← Payers reporting CPT 83904 · Snapshot 20261112T181611Z-3fa9fb76