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
$1
Average
$60
Median
$39
High
$163
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 51.9× 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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37 hospital rates
iThe hospitals that file a Medicaid 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 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 3 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 6 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 9 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 10 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 14 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 15 | Holyoke Medical Center Holyoke, MA facility · fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 16 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 17 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · fee schedule · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 18 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 19 | Mercy Hospital Carthage Carthage, MO facility · fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 20 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $11 | $3 | 25% | — | $8 – $14 |
| 21 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $11 | $3 | 25% | — | $8 – $14 |
| 22 | Montefiore Medical Center Bronx, NY fee schedule · outpatient | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 23 | Montefiore Mount Vernon Hospital Mount Vernon, NY fee schedule · outpatient | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 24 | Montefiore New Rochelle Hospital New Rochelle, NY fee schedule · outpatient | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 25 | NYU Langone New York, NY case rate · both | 15 | $163 | $163 | — | — | — | $163 – $163 |
← Payers reporting CPT 95984 · Snapshot 20261112T124536Z-e251e855