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
Cciiv4 vacc abx free im
Low
$0
Average
$203
Median
$31
High
$3.3k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
19 hospitals; the 90th percentile is 7179.2× 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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19 hospital rates
iThe hospitals that file a Ambetter 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 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 2 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 3 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 4 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 5 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $9 | $9 | $1 | 10% | — | $8 – $10 |
| 6 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Florida Coast Medical and Surgical Center, Inc. Port St. Lucie, FL case rate · outpatient | 3 | $0 | $0 | $0 | 14% | — | $0 – $0 |
| 10 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 11 | Little Company of Mary Hospital of Indiana Inc Jasper, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 12 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 13 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 14 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 15 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 16 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS percent of total billed charges · bothfrom % of charges | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 17 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS percent of total billed charges · bothfrom % of charges | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 18 | Sarasota Memorial Hospital Sarasota, FL fee schedule · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 19 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
← Payers reporting CPT 90756 · Snapshot 20261112T181611Z-3fa9fb76