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
PR PENTOXIFLLINE STIM SPERM
Low
$11
Average
$47
Median
$51
High
$295
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 4.4× 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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26 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | BYRD REGIONAL HOSPITAL LEESVILLE, LA percent of total billed charges · bothfrom % of charges | 2 | $11 | $11 | $0 | 4% | — | $11 – $12 |
| 2 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 3 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 4 | Bay Park Community Hospital Oregon, OH facility · other · outpatient | 1 | $295 | $295 | — | — | — | $295 – $295 |
| 5 | Bayhealth Hospital, Sussex Campus Milton, DE fee schedule · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 6 | Bayhealth Medical Center, Kent Campus Dover, DE fee schedule · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 7 | East Liverpool City Hospital Liverpool, OH fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 8 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 9 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 10 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 11 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 12 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 13 | Independence Health System Frick Hospital Mt Plesant, PA fee schedule · both | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 14 | Independence Health System Latrobe Area Hospital Latrobe, PA fee schedule · both | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 15 | Independence Health System Westmoreland Regional Hospital Greeensburg, PA fee schedule · both | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 16 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 17 | Sarasota Memorial Hospital Sarasota, FL case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 18 | Sarasota Memorial Hospital - Venice North Venice, FL case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 19 | Southern Baptist Hospital of Florida, INC Fleming Island, FL facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 20 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 21 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 22 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 23 | UPMC Magee-Womens Hospital Pittsburgh, PA facility · fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 24 | UPMC Presbyterian Pittsburgh, PA facility · fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 25 | UPMC Williamsport Lock Haven, PA facility · fee schedule · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
← Payers reporting CPT 89240 · Snapshot 20261112T181611Z-3fa9fb76