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
AFB ID M tb Direct Probe
Low
$4
Average
$31
Median
$26
High
$100
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
40 hospitals; the 90th percentile is 4.6× 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.
Filter by billing methodology
Filter by billing class
44 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 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 2 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 4 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN fee schedule · both | 2 | $30 | $30 | $3 | 9% | — | $27 – $32 |
| 5 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both | 16 | $27 | $28 | $2 | 8% | — | $27 – $32 |
| 6 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN fee schedule · both | 2 | $30 | $30 | $3 | 9% | — | $27 – $32 |
| 7 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN fee schedule · both | 2 | $30 | $30 | $3 | 9% | — | $27 – $32 |
| 8 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 9 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 10 | Henry Ford Health Novi, MI other · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 11 | Henry Ford Health Twp, MI other · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 12 | Henry Ford Health Southfield, MI other · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 13 | Henry Ford Health Rochester, MI other · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 14 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 15 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 16 | Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 17 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 18 | Mercy Hospital Booneville Booneville, AR facility · fee schedule · outpatient | 2 | $26 | $26 | $2 | 9% | — | $24 – $29 |
| 19 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $24 | $26 | $2 | 8% | — | $24 – $29 |
| 20 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $24 | $26 | $2 | 8% | — | $24 – $29 |
| 21 | Mercy Hospital Jefferson Imperial, MO facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 22 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 23 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · fee schedule · outpatient | 3 | $24 | $26 | $2 | 8% | — | $24 – $29 |
| 24 | Mercy Hospital Lincoln Troy, MO facility · fee schedule · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 25 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
← Payers reporting CPT 87555 · Snapshot 20261113T090226Z-3ce6c0b8