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
$54
Average
$129
Median
$79
High
$322
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7 hospital rates
iThe hospitals that file a Magellan 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 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 2 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $322 | $322 | — | — | — | $322 – $322 |
| 3 | University of Illinois Hospital & Clinics Chicago, IL professional · fee schedule · both | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 4 | Vanderbilt Bedford Hospital Shelbyville, TN fee schedule · both | 1 | $70 | $79 | $13 | 16% | — | $70 – $98 |
| 5 | Vanderbilt Tullahoma-Harton Hospital Tullahoma, TN fee schedule · both | 1 | $70 | $79 | $13 | 16% | — | $70 – $98 |
| 6 | Vanderbilt University Medical Center Nashville, TN fee schedule · both | 1 | $70 | $79 | $13 | 16% | — | $70 – $98 |
| 7 | Vanderbilt Wilson County Hospital Lebanon, TN fee schedule · both | 1 | $70 | $79 | $13 | 16% | — | $70 – $98 |
← Payers reporting CPT 90875 · Snapshot 20261113T090226Z-3ce6c0b8