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 ANRCT MANO RCT SNSATN & BALO
Low
$341
Average
$347
Median
$345
High
$356
Filter by billing methodology
Filter by billing class
5 hospital rates
iThe hospitals that file a Premera 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 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $381 | $381 | — | — | — | $381 – $381 |
| 2 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $364 | $364 | — | — | — | $364 – $364 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $291 | $291 | — | — | — | $291 – $291 |
| 4 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $341 | $341 | $15 | 4% | — | $327 – $356 |
| 5 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $356 | $356 | — | — | — | $356 – $356 |
← Payers reporting CPT 91125 · Snapshot 20261112T181611Z-3fa9fb76