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
$34
Median
$16
High
$2.0k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
866 hospitals; the 90th percentile is 4.1× 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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1,129 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 | Parkland Health Dallas, TX facility · other · both | 4 | $31 | $32 | $19 | 58% | 800–827 | $13 – $51 |
| 2 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 2 | $21 | $21 | $8 | 36% | 203–212 | $13 – $28 |
| 3 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 2 | $31 | $41 | $28 | 68% | 91–181 | $19 – $98 |
| 4 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER GRENADA, MS fee schedule · outpatient | 2 | $21 | $21 | $8 | 36% | 89–98 | $13 – $28 |
| 5 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $61 | $60 | $12 | 20% | 19 | $49 – $88 |
| 6 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Rio Rancho, NM facility · other · outpatient | 2 | $35 | $32 | $7 | 23% | 19 | $17 – $35 |
| 7 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS fee schedule · outpatient | 2 | $21 | $21 | $8 | 36% | 17–26 | $13 – $28 |
| 8 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $33 | $30 | $3 | 10% | 15 | $27 – $33 |
| 9 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $31 | $31 | — | — | 12 | $31 – $31 |
| 10 | West Virginia University Hospitals, Inc. Morgantown, WV facility · other · outpatient | 2 | $14 | $14 | $0 | 0% | 11–110 | $14 – $14 |
| 11 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $34 | $31 | 91% | 9–90 | $3 – $93 |
| 12 | DIGNITY HEALTH San Bernardino, CA fee schedule · outpatient | 3 | $9 | $10 | $5 | 55% | 7–70 | $6 – $26 |
| 13 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · other · outpatient | 2 | $14 | $11 | $4 | 31% | 6–60 | $7 – $14 |
| 14 | Nor-Lea Hospital District Lovington, NM facility · fee schedule · both | 1 | $45 | $45 | $26 | 59% | 6–60 | $18 – $71 |
| 15 | DIGNITY HEALTH Carmichael, CA fee schedule · outpatient | 2 | $10 | $12 | $5 | 42% | 5–50 | $7 – $24 |
| 16 | DIGNITY HEALTH Sacramento, CA fee schedule · outpatient | 2 | $10 | $12 | $5 | 42% | 5–50 | $7 – $24 |
| 17 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · other · outpatient | 2 | $11 | $11 | $4 | 33% | 5–50 | $7 – $14 |
| 18 | Wetzel County Hospital, Inc. New Martinsville, WV facility · other · outpatient | 2 | $11 | $11 | $4 | 33% | 5–50 | $7 – $14 |
| 19 | Buchanan County Health Center Independence, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $69 | $69 | — | — | 2–20 | $69 – $69 |
| 20 | OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS fee schedule · outpatient | 2 | $16 | $16 | $3 | 18% | 2–20 | $13 – $19 |
| 21 | PeaceHealth Southwest Medical Center Vancouver, WA facility · other · outpatient | 3 | $8 | $10 | $4 | 44% | 2–20 | $6 – $15 |
| 22 | Wheeling Hospital, Inc. Wheeling, WV facility · other · outpatient | 2 | $11 | $11 | $4 | 33% | 2–20 | $7 – $14 |
| 23 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · outpatientfrom % of charges | 1 | $43 | $43 | — | — | 1–10 | $43 – $43 |
| 24 | Appalachian Regional Healthcare, Inc. McDowell, KY percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | — | — | 1–10 | $35 – $35 |
| 25 | Appalachian Regional Healthcare, Inc. Whitesburg, KY fee schedule · outpatient | 1 | $14 | $14 | — | — | 1–10 | $14 – $14 |
← Payers reporting CPT 86762 · Snapshot 20261111T120946Z-9134e7f7