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
ALL IMM EXT TWO OR MORE INJ
Low
$7
Average
$69
Median
$26
High
$506
Each hospital's average First Health rate, under the methodology and billing class chosen below.
20 hospitals; the 90th percentile is 7.3× 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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21 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 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 2 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 3 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 4 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 5 | El Paso Children's Hospital El Paso, TX percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 6 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 7 | Fairview Health Services Minneapolis, MN percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 8 | Jane Phillips Memorial Medical Center Bartlesville, OK fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 9 | Jane Phillips Nowata Hospital, Inc. Nowata, OK fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 10 | Mayo Clinic Health System Osseo, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 11 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 12 | Mayo Clinic Health System Bloomer, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 13 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 14 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 15 | Owasso Medical Facility, Inc. Owasso, OK fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 16 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · both | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 17 | St. John Medical Center, Inc. Tulsa, OK fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 18 | St. John Sapulpa, Inc. Sapulpa, OK fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 19 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 1 | $506 | $506 | — | — | — | $506 – $506 |
| 20 | Webster Memorial Hospital Inc Cowen, WV professional · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 21 | Yale New Haven Hospital Haven, CT fee schedule · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
← Payers reporting CPT 95125 · Snapshot 20261113T090226Z-3ce6c0b8