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
Im Adm Thru 18yr Any Rte Addl Vac/Tox Compt
Low
$0
Average
$42
Median
$22
High
$4.7k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
521 hospitals; the 90th percentile is 6.4× 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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783 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA fee schedule · both | 1 | $41 | $41 | — | — | 19,116 | $41 – $41 |
| 2 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA fee schedule · outpatient | 2 | $39 | $39 | $9 | 22% | 6,409 | $30 – $47 |
| 3 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 7 | $38 | $38 | $1 | 3% | 3,143–3,170 | $37 – $41 |
| 4 | Mayo Clinic Health System Owatonna 55060-5503 professional · percent of total billed charges · outpatientfrom % of charges | 6 | $27 | $27 | $1 | 5% | 2,926–2,944 | $26 – $29 |
| 5 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 6 | $27 | $27 | $1 | 5% | 2,647 | $26 – $29 |
| 6 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 5 | $7 | $8 | $3 | 39% | 1,514 | $5 – $12 |
| 7 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 2 | $83 | $83 | $5 | 6% | 936–954 | $78 – $88 |
| 8 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 3 | $9 | $18 | $12 | 67% | 621 | $7 – $33 |
| 9 | Mayo Clinic Health System St, NE professional · percent of total billed charges · outpatientfrom % of charges | 4 | $24 | $25 | $3 | 11% | 585–603 | $23 – $29 |
| 10 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 2 | $64 | $70 | $8 | 11% | 542–569 | $64 – $80 |
| 11 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 3 | $15 | $12 | $3 | 25% | 529–637 | $8 – $15 |
| 12 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC percent of total billed charges · bothfrom % of charges | 4 | $8 | $9 | $3 | 35% | 495 | $6 – $15 |
| 13 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 4 | $8 | $9 | $3 | 35% | 495 | $6 – $15 |
| 14 | Mayo Clinic Health System Eau Claire 54703-5270 professional · percent of total billed charges · outpatientfrom % of charges | 3 | $42 | $43 | $1 | 2% | 416–425 | $42 – $44 |
| 15 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 3 | $10 | $11 | $3 | 27% | 372 | $8 – $15 |
| 16 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 3 | $10 | $11 | $3 | 27% | 372 | $8 – $15 |
| 17 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 3 | $10 | $12 | $3 | 22% | 301 | $10 – $15 |
| 18 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 11 | $27 | $26 | $4 | 15% | 183–192 | $17 – $29 |
| 19 | Mayo Clinic Health System Sparta, WI professional · percent of total billed charges · outpatientfrom % of charges | 4 | $43 | $43 | $2 | 5% | 181 | $39 – $45 |
| 20 | Mayo Clinic Health System Bloomer, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $43 | $38 | $11 | 28% | 179–188 | $17 – $44 |
| 21 | Reynolds Memorial Hospital, Inc. Glen Dale, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | 173 | $49 – $49 |
| 22 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $43 | $38 | $12 | 31% | 153 | $15 – $44 |
| 23 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | — | — | 142–196 | $26 – $26 |
| 24 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | — | — | 131–212 | $26 – $26 |
| 25 | PRISMA HEALTH OCONEE MEMORIAL HOSPITAL SENECA, SC percent of total billed charges · bothfrom % of charges | 4 | $5 | $7 | $5 | 69% | 115 | $2 – $14 |
← Payers reporting CPT 90461 · Snapshot 20261111T120946Z-9134e7f7