CPT 84022
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
Assay of phenothiazine
Low
$11
Average
$70
Median
$52
High
$160
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49 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 | Alexian Brothers Behavioral Health Hospital Estates, IL other · both | 3 | $46 | $46 | — | — | — | $46 – $46 |
| 2 | Alexian Brothers Medical Center Village, IL other · both | 4 | $46 | $45 | $1 | 2% | — | $44 – $46 |
| 3 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Benson Hospital Corporation Benson, AZ facility · percent of total billed charges · inpatientfrom % of charges | 1 | $97 | $97 | $3 | 3% | — | $94 – $100 |
| 5 | Benson Hospital Corporation Benson, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $97 | $97 | $3 | 3% | — | $94 – $100 |
| 6 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 7 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO percent of total billed charges · outpatientfrom % of charges | 2 | $106 | $106 | $13 | 12% | — | $93 – $119 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO percent of total billed charges · outpatientfrom % of charges | 2 | $106 | $106 | $13 | 12% | — | $93 – $119 |
| 10 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 11 | Chambers Health Anahuac, TX percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 12 | Danbury Hospital New Milford, CT fee schedule · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 13 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 14 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 15 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 16 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 17 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 18 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 19 | Deaconess Illinois Red Bud Regional Hospital Inc Red Bud, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 20 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 21 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 22 | Doylestown Hospital Doylestown, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $65 | $65 | $6 | 9% | — | $59 – $70 |
| 23 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $29 | $29 | $2 | 9% | — | $26 – $31 |
| 24 | LONGMONT UNITED HOSPITAL Longmont, CO percent of total billed charges · outpatientfrom % of charges | 2 | $106 | $106 | $13 | 12% | — | $93 – $119 |
| 25 | Lancaster General Health Lancaster, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $96 | $96 | — | — | — | $96 – $96 |
← Payers reporting CPT 84022 · Snapshot 20261113T090226Z-3ce6c0b8