CPT 90875
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
90875
Low
$48
Average
$183
Median
$192
High
$551
Each hospital's average First Health rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 3.7× 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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54 hospital rates
iThe hospitals that file a First Health 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 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 2 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 3 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 4 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 5 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 6 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 7 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 8 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 9 | Boston Children's Hospital Needham, MA percent of total billed charges · bothfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 10 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $66 | $66 | $0 | 1% | — | $65 – $66 |
| 11 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 12 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 13 | Children's Specialized Hospital Toms River, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 14 | Craig Hospital Englewood, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $551 | $551 | — | — | — | $551 – $551 |
| 15 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $66 | $66 | $0 | 1% | — | $65 – $66 |
| 16 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 17 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 18 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 19 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 20 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 21 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 22 | El Paso Children's Hospital El Paso, TX percent of total billed charges · bothfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 23 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $107 | $107 | — | — | — | $107 – $107 |
| 24 | Jane Phillips Memorial Medical Center Bartlesville, OK fee schedule · both | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 25 | Jane Phillips Nowata Hospital, Inc. Nowata, OK fee schedule · both | 1 | $74 | $74 | — | — | — | $74 – $74 |
← Payers reporting CPT 90875 · Snapshot 20261113T090226Z-3ce6c0b8