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
$0
Average
$1.8k
Median
$132
High
$3081.5k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1975 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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3,222 hospital rates
iThe hospitals that file a Aetna 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 | Eskenazi Health Indianapolis, IN facility · percent of total billed charges · bothfrom % of charges | 2 | $178 | $178 | $19 | 10% | 169 | $159 – $196 |
| 2 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.4k | $1.0k | 72% | 117 | $263 – $3.4k |
| 3 | DIGNITY HEALTH Santa Maria, CA fee schedule · outpatient | 4 | $245 | $193 | $117 | 61% | 108 | $42 – $360 |
| 4 | St. Charles Bend Bend, OR percent of total billed charges · bothfrom % of charges | 1 | $558 | $735 | $364 | 49% | 102 | $405 – $1.2k |
| 5 | St. Charles Bend Bend, OR percent of total billed charges · outpatientfrom % of charges | 1 | $204 | $251 | $106 | 42% | 102 | $168 – $428 |
| 6 | St. Charles Redmond Redmond, OR percent of total billed charges · bothfrom % of charges | 1 | $558 | $735 | $364 | 49% | 102 | $405 – $1.2k |
| 7 | St. Charles Redmond Redmond, OR percent of total billed charges · outpatientfrom % of charges | 1 | $204 | $251 | $106 | 42% | 102 | $168 – $428 |
| 8 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 5 | $237 | $364 | $398 | 109% | 75–750 | $44 – $3.0k |
| 9 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $525 | $525 | — | — | 75 | $525 – $525 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $520 | $664 | $477 | 72% | 54 | $123 – $1.6k |
| 11 | Beebe Medical Center Inc. Lewes, DE facility · percent of total billed charges · outpatientfrom % of charges | 1 | $452 | $452 | — | — | 37 | $452 – $452 |
| 12 | NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA percent of total billed charges · outpatientfrom % of charges | 2 | $442 | $411 | $254 | 62% | 36–117 | $72 – $837 |
| 13 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 4 | $125 | $162 | $125 | 77% | 30–300 | $49 – $851 |
| 14 | SOUTH COUNTY HEALTH Greenwich, RI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $155 | $182 | $38 | 21% | 29–47 | $155 – $236 |
| 15 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ percent of total billed charges · outpatientfrom % of charges | 3 | $248 | $237 | $58 | 24% | 21–39 | $161 – $301 |
| 16 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ percent of total billed charges · outpatientfrom % of charges | 3 | $248 | $237 | $58 | 24% | 21–39 | $161 – $301 |
| 17 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $109 | $109 | — | — | 20–29 | $109 – $109 |
| 18 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 1 | $276 | $276 | — | — | 20 | $276 – $276 |
| 19 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 1 | $70 | $70 | — | — | 19 | $70 – $70 |
| 20 | Wentworth Douglass Hospital Dover, NH percent of total billed charges · bothfrom % of charges | 1 | $564 | $564 | — | — | 15 | $564 – $564 |
| 21 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 3 | $335 | $336 | $42 | 13% | 14–140 | $259 – $417 |
| 22 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 4 | $338 | $336 | $92 | 27% | 12–120 | $171 – $484 |
| 23 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 1 | $435 | $473 | $267 | 57% | 11–110 | $54 – $1.2k |
| 24 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 4 | $239 | $236 | $23 | 10% | 10–100 | $205 – $276 |
| 25 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 3 | $146 | $155 | $84 | 54% | 10–100 | $45 – $316 |
← Payers reporting CPT 87801 · Snapshot 20261111T120946Z-9134e7f7