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
facility
Low
$0
Average
$825
Median
$151
High
$33.8k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 173 hospitals; the 90th percentile is 12.2× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Mercy Hospital Springfield Ozark, MO | $131 | $140 | $28 | 20% | 1,976–2,003 | $131 – $252 |
| 2 | Mercy Hospital Springfield Springfield, MO | $131 | $140 | $28 | 20% | 1,976–2,003 | $131 – $252 |
| 3 | Tufts Medical Center BOSTON, MA | $159 | $159 | — | — | 748–874 | $159 – $159 |
| 4 | Robert Packer Hospital Sayre, PA | $142 | $206 | $73 | 36% | 215 | $142 – $290 |
| 5 | Childrens Hospital Colorado Aurora, CO | $194 | $194 | — | — | 135–144 | $194 – $194 |
| 6 | Stony Brook University Hospital Stony Brook, NY | $165 | $188 | $45 | 24% | 128–146 | $153 – $331 |
| 7 | Vanderbilt University Medical Center Nashville, TN | $121 | $75 | $79 | 105% | 8–80 | $0 – $260 |
| 8 | Denver Health and Hospital Authority Denver, CO | $39 | $37 | $17 | 46% | 4–40 | $13 – $54 |
| 9 | Hartford Hospital HARTFORD, CT | $54 | $55 | $1 | 1% | 3–30 | $54 – $56 |
| 10 | Boston Medical Center Boston, MA | $155 | $188 | $73 | 39% | 2–20 | $145 – $380 |
Ask Claude or any MCP client for CPT 92004 pricing at a specific hospital — see how to connect.