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
CH PROTEIN TOT REFRACT
Low
$3
Average
$10
Median
$5
High
$71
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
47 hospitals; the 90th percentile is 6.0× 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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50 hospital rates
iThe hospitals that file a Medicaid 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 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 2 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 3 | CentraState Medical Center Freehold Township, NJ fee schedule · both | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 4 | CentraState Medical Center Freehold Township, NJ fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 5 | Chilton Medical Center Pompton Plains, NJ fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 6 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 8 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 9 | Hackettstown Medical Center Hackettstown, NJ fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 10 | Henry Ford Health Novi, MI other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 11 | Henry Ford Health Twp, MI other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | Henry Ford Health Southfield, MI other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 13 | Henry Ford Health Rochester, MI other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 14 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 15 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 16 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 17 | Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 18 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 19 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $5 | $6 | $1 | 19% | — | $5 – $7 |
| 20 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $5 | $6 | $1 | 19% | — | $5 – $7 |
| 21 | Mercy Hospital Jefferson Imperial, MO facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 22 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · fee schedule · outpatient | 3 | $5 | $6 | $1 | 19% | — | $5 – $7 |
| 23 | Mercy Hospital Kingfisher, Inc Kingfisher, OK facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 24 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · fee schedule · outpatient | 2 | $5 | $5 | $0 | 1% | — | $5 – $5 |
| 25 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 2 | $6 | $6 | $1 | 19% | — | $5 – $7 |
← Payers reporting CPT 84160 · Snapshot 20261112T181611Z-3fa9fb76