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
PR PERC TESTS ALLERGENIC EXTRACTS
Low
$3
Average
$804
Median
$305
High
$2.6k
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 597.8× 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 Excellus 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 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 3 | $4 | $4 | $0 | 10% | — | $3 – $4 |
| 2 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 3 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $877 | $877 | — | — | — | $877 – $877 |
| 4 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $3 | $4 | $1 | 20% | — | $3 – $5 |
| 5 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 2 | $2.4k | $2.4k | $523 | 21% | — | $1.9k – $3.0k |
| 6 | Highland Hospital Rochester, NY fee schedule · outpatient | 7 | $25 | $611 | $701 | 115% | — | $3 – $1.5k |
| 7 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 2 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 8 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $877 | $877 | — | — | — | $877 – $877 |
| 9 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 10 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 2 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 11 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $3.0k | $3.0k | $1.9k | 64% | — | $1.1k – $4.9k |
| 12 | Samaritan Medical Center Watertown, NY professional · fee schedule · both | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 13 | St. James Hospital Hornell, NY fee schedule · outpatient | 2 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 14 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · fee schedule · inpatient | 3 | $3 | $4 | $1 | 20% | — | $3 – $5 |
| 15 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · fee schedule · outpatient | 3 | $3 | $4 | $1 | 20% | — | $3 – $5 |
| 16 | Strong Memorial Hospital Rochester, NY fee schedule · both | 3 | $6 | $7 | $3 | 49% | — | $3 – $14 |
| 17 | Strong Memorial Hospital Rochester, NY fee schedule · outpatient | 8 | $1.2k | $1.1k | $1.1k | 103% | — | $3 – $3.4k |
| 18 | United Memorial Medical Center Batavia, NY facility · fee schedule · outpatient | 2 | $9 | $9 | $7 | 69% | — | $3 – $16 |
| 19 | University of Vermont Medical Center Inc Colchester, VT professional · fee schedule · both | 3 | $4 | $6 | $3 | 52% | — | $4 – $10 |
← Payers reporting CPT 95004 · Snapshot 20261111T120946Z-9134e7f7