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
HC ALYS BRN NPGT PRGRMG ADDL 15
Low
$21
Average
$72
Median
$64
High
$214
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
12 hospitals; the 90th percentile is 3.4× 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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16 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 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $80 | $67 | $23 | 34% | — | $34 – $85 |
| 2 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 3 | $40 | $42 | $7 | 17% | — | $35 – $52 |
| 3 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 4 | Highland Hospital Rochester, NY fee schedule · outpatient | 4 | $8 | $21 | $23 | 109% | — | $8 – $60 |
| 5 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 3 | $33 | $30 | $3 | 10% | — | $26 – $33 |
| 7 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 8 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 3 | $37 | $41 | $13 | 30% | — | $29 – $58 |
| 9 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 10 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 2 | $29 | $29 | $5 | 18% | — | $24 – $35 |
| 11 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $122 | $122 | $78 | 64% | — | $44 – $200 |
| 12 | Samaritan Medical Center Watertown, NY professional · fee schedule · both | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 13 | Strong Memorial Hospital Rochester, NY fee schedule · both | 3 | $84 | $86 | $41 | 48% | — | $24 – $169 |
| 14 | Strong Memorial Hospital Rochester, NY fee schedule · outpatient | 4 | $35 | $35 | $25 | 74% | — | $9 – $60 |
| 15 | United Memorial Medical Center Batavia, NY facility · fee schedule · outpatient | 2 | $99 | $99 | $69 | 69% | — | $31 – $168 |
| 16 | University of Vermont Medical Center Inc Colchester, VT professional · fee schedule · both | 3 | $44 | $62 | $33 | 53% | — | $35 – $109 |
← Payers reporting CPT 95984 · Snapshot 20261112T124536Z-e251e855