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
facility
Low
$1
Average
$46
Median
$22
High
$2.0k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
857 hospitals; the 90th percentile is 6.2× 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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1,102 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 | $31 | $31 | $11 | 36% | 29 | $20 – $42 |
| 2 | Parkland Health Dallas, TX facility · other · both | 4 | $46 | $47 | $27 | 58% | 24 | $20 – $76 |
| 3 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $157 | $192 | $122 | 64% | 14–32 | $62 – $391 |
| 4 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 2 | $121 | $121 | $59 | 49% | 13–22 | $62 – $180 |
| 5 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · other · outpatient | 2 | $13 | $13 | $8 | 58% | 5–50 | $6 – $21 |
| 6 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN fee schedule · both | 2 | $21 | $21 | $2 | 11% | 4–40 | $19 – $24 |
| 7 | Wheeling Hospital, Inc. Wheeling, WV facility · other · outpatient | 2 | $13 | $13 | $8 | 58% | 3–30 | $6 – $21 |
| 8 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | 3–30 | $21 – $21 |
| 9 | Fairfield Medical Center 401 N Ewing St facility · other · outpatient | 1 | $35 | $35 | — | — | 2–20 | $35 – $35 |
| 10 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $130 | $130 | — | — | 2–20 | $130 – $130 |
| 11 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $24 | $24 | $3 | 12% | 2–20 | $21 – $27 |
| 12 | Stony Brook University Hospital Stony Brook, NY facility · other · outpatient | 1 | $21 | $21 | — | — | 2–20 | $21 – $21 |
| 13 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · outpatientfrom % of charges | 1 | $176 | $176 | — | — | 1–10 | $176 – $176 |
| 14 | FAIRFIELD MEMORIAL HOSPITAL FAIRFIELD, IL percent of total billed charges · outpatientfrom % of charges | 2 | $73 | $73 | — | — | 1–10 | $73 – $73 |
| 15 | HARRISON MEDICAL CENTER Silverdale, WA fee schedule · outpatient | 2 | $36 | $36 | $13 | 36% | 1–10 | $23 – $49 |
| 16 | Loring Hospital Sac City, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | 1–10 | $36 – $36 |
| 17 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 1 | $102 | $102 | — | — | 1–10 | $102 – $102 |
| 18 | PeaceHealth United General Medical Center Sedro Woolley, WA facility · other · outpatient | 1 | $82 | $82 | — | — | 1–10 | $82 – $82 |
| 19 | Pekin Memorial Hospital Pekin, IL percent of total billed charges · outpatientfrom % of charges | 1 | $153 | $153 | — | — | 1–10 | $153 – $153 |
| 20 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $84 | $84 | — | — | 1–10 | $84 – $84 |
| 21 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $46 | $46 | — | — | 1–10 | $46 – $46 |
| 22 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 23 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 24 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 25 | AMH Cath Labs LLC Arlington, TX fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
← Payers reporting CPT 83921 · Snapshot 20261111T120946Z-9134e7f7