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
$37
Median
$26
High
$1.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
827 hospitals; the 90th percentile is 4.0× 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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1,093 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 | $53 | $53 | $31 | 58% | 3,540 | $22 – $86 |
| 2 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 2 | $35 | $35 | $13 | 36% | 1,571 | $22 – $48 |
| 3 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 2 | $47 | $52 | $23 | 44% | 274–310 | $25 – $89 |
| 4 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $52 | $52 | — | — | 274 | $52 – $52 |
| 5 | Nor-Lea Hospital District Lovington, NM facility · fee schedule · both | 1 | $99 | $77 | $33 | 43% | 152–161 | $30 – $102 |
| 6 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $27 | $27 | $3 | 11% | 151 | $24 – $30 |
| 7 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $23 | $5 | 21% | 50 | $20 – $30 |
| 8 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 1 | $71 | $71 | $0 | 0% | 46 | $71 – $71 |
| 9 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · inpatient | 1 | $26 | $26 | — | — | 42 | $26 – $26 |
| 10 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · outpatient | 1 | $26 | $26 | — | — | 42 | $26 – $26 |
| 11 | Appalachian Regional Healthcare, Inc. Whitesburg, KY fee schedule · outpatient | 1 | $24 | $24 | — | — | 41 | $24 – $24 |
| 12 | DIGNITY HEALTH San Bernardino, CA fee schedule · outpatient | 3 | $17 | $19 | $9 | 47% | 34 | $10 – $29 |
| 13 | Public Hospital District No 4 King County WA Snoqualmie, WA other · both | 2 | $91 | $91 | $1 | 1% | 33 | $90 – $91 |
| 14 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $21 | $22 | $4 | 16% | 31 | $16 – $26 |
| 15 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS fee schedule · outpatient | 2 | $35 | $35 | $13 | 36% | 30–39 | $22 – $48 |
| 16 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 2 | $72 | $73 | $36 | 49% | 29–47 | $37 – $110 |
| 17 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $141 | $141 | $69 | 49% | 28–37 | $72 – $210 |
| 18 | Appalachian Regional Healthcare, Inc. Middlesboro, KY fee schedule · outpatient | 1 | $24 | $24 | — | — | 27 | $24 – $24 |
| 19 | HARRISON MEDICAL CENTER Silverdale, WA fee schedule · outpatient | 2 | $41 | $41 | $15 | 36% | 26 | $26 – $55 |
| 20 | HOLLAND COMMUNITY HOSPITAL Holland, MI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $27 | — | — | 23 | $27 – $27 |
| 21 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $23 | $5 | 21% | 21 | $17 – $29 |
| 22 | Adena Health System Chillicothe, OH facility · other · outpatient | 1 | $19 | $19 | — | — | 20 | $19 – $19 |
| 23 | DIGNITY COMMUNITY CARE Northridge, CA fee schedule · outpatient | 3 | $28 | $27 | $2 | 8% | 17 | $24 – $28 |
| 24 | Buchanan County Health Center Independence, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $46 | $46 | — | — | 16 | $46 – $46 |
| 25 | PeaceHealth Peace Island Medical Center Friday Harbor, WA facility · other · outpatient | 1 | $5 | $5 | — | — | 14 | $5 – $5 |
← Payers reporting CPT 87389 · Snapshot 20261111T120946Z-9134e7f7