CPT 95904
Low
$48
Average
$8.4k
Median
$75
High
$25k
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3 hospital rates
iThe hospitals that file a Molina 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 | Fairfield Medical Center 401 N Ewing St facility · other · outpatient | 1 | $25k | $25k | — | — | — | $25k – $25k |
| 2 | HCA FLORIDA LARGO WEST HOSPITAL LARGO, FL percent of total billed charges · outpatientfrom % of charges | 2 | $75 | $75 | $13 | 17% | — | $62 – $89 |
| 3 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
← Payers reporting CPT 95904 · Snapshot 20261113T090226Z-3ce6c0b8