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
HC Immun <= 18 Yrs W Couns 1st
Low
$1
Average
$24
Median
$18
High
$173
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
68 hospitals; the 90th percentile is 5.6× 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.
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81 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 | $27 | $27 | $1 | 5% | — | $25 – $28 |
| 2 | Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient | 2 | $46 | $46 | — | — | — | $46 – $46 |
| 3 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 2 | $20 | $20 | — | — | — | $20 – $20 |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 5 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 6 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 8 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Fairview Hospital Great Barrington, MA facility · fee schedule · outpatient | 2 | $94 | $94 | — | — | — | $94 – $94 |
| 10 | Fairview Hospital Great Barrington, MA professional · fee schedule · outpatient | 2 | $20 | $20 | — | — | — | $20 – $20 |
| 11 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 12 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 13 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 14 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $173 | $173 | $6 | 3% | — | $167 – $178 |
| 15 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 16 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 17 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 18 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 19 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 20 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · inpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 21 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 22 | Mercy Hospital Columbus Columbus, KS facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 23 | Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 24 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 25 | Mercy Hospital Berryville Berryville, AR facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
← Payers reporting CPT 90460 · Snapshot 20261111T120946Z-9134e7f7