CPT 95903
Low
$1
Average
$170
Median
$118
High
$443
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4 hospital rates
iThe hospitals that file a Tricare 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 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $443 | $443 | — | — | — | $443 – $443 |
| 2 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $186 | $232 | $92 | 40% | — | $150 – $361 |
| 3 | Mercy Rehabilitation Hospital South Louis, MO case rate · inpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 4 | Mercy Rehabilitation Hospital St. Louis Chesterfield, MO case rate · inpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
← Payers reporting CPT 95903 · Snapshot 20261113T090226Z-3ce6c0b8