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
Pra (Monthly Screen)
Low
$30
Average
$55
Median
$55
High
$97
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
34 hospitals; the 90th percentile is 2.3× 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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37 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 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 2 | $34 | $34 | $2 | 5% | — | $32 – $35 |
| 2 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 2 | $34 | $34 | $2 | 5% | — | $32 – $35 |
| 3 | Boston Medical Center Boston, MA fee schedule · both | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Boston Medical Center Brighton Boston, MA fee schedule · both | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 5 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 7 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 9 | DOCTORS HOSPITAL CORAL GABLES, FL fee schedule · both | 2 | $33 | $33 | $2 | 5% | — | $31 – $34 |
| 10 | FISHERMENS HEALTH, INC MARATHON, FL fee schedule · both | 2 | $33 | $33 | $2 | 5% | — | $31 – $34 |
| 11 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 12 | HOMESTEAD HOSPITAL Homestead, FL fee schedule · both | 2 | $33 | $33 | $2 | 5% | — | $31 – $34 |
| 13 | Henry Ford Health Novi, MI other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 14 | Henry Ford Health Twp, MI other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 15 | Henry Ford Health Southfield, MI other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 16 | Henry Ford Health Rochester, MI other · outpatient | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 17 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 18 | Lancaster General Health Lancaster, PA facility · fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 19 | MARINERS HOSPITAL TAVERNIER, FL fee schedule · both | 2 | $33 | $33 | $2 | 5% | — | $31 – $34 |
| 20 | Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 21 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 22 | Mercy Hospital Booneville Booneville, AR facility · fee schedule · outpatient | 2 | $52 | $52 | $18 | 36% | — | $33 – $70 |
| 23 | Mercy Hospital Jefferson Imperial, MO facility · fee schedule · outpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 24 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 25 | Mercy Hospital Kingfisher, Inc Kingfisher, OK facility · fee schedule · outpatient | 1 | $70 | $70 | — | — | — | $70 – $70 |
← Payers reporting CPT 86807 · Snapshot 20261113T090226Z-3ce6c0b8