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
PR QHP R&I MOTION ANALYSIS
Low
$120
Average
$705
Median
$548
High
$1.8k
Each hospital's average First Health rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 11.5× 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.
Filter by billing methodology
Filter by billing class
46 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 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $548 | $548 | $309 | 56% | — | $240 – $857 |
| 2 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $548 | $548 | $309 | 56% | — | $240 – $857 |
| 3 | BayCare Alliant Hospital Dunedin, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 4 | BayCare Alliant Hospital Dunedin, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 5 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 6 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 7 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 8 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · inpatientfrom % of charges | 1 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 9 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 10 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 11 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 12 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · inpatientfrom % of charges | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 13 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · outpatientfrom % of charges | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 14 | Jane Phillips Memorial Medical Center Bartlesville, OK fee schedule · both | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 15 | Jane Phillips Nowata Hospital, Inc. Nowata, OK fee schedule · both | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 16 | Mary Bridge Children's Hospital Tacoma, WA percent of total billed charges · inpatientfrom % of charges | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | Mary Bridge Children's Hospital Tacoma, WA percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 18 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 2 | $588 | $588 | $6 | 1% | — | $582 – $595 |
| 19 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 1 | $482 | $482 | — | — | — | $482 – $482 |
| 20 | Mease Countryside Hospital Harbor, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $548 | $548 | $309 | 56% | — | $240 – $857 |
| 21 | Mease Countryside Hospital Harbor, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $548 | $548 | $309 | 56% | — | $240 – $857 |
| 22 | Mease Dunedin Hospital Dunedin, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 23 | Mease Dunedin Hospital Dunedin, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 24 | Morton Plant Hospital Clearwater, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $548 | $548 | $309 | 56% | — | $240 – $857 |
| 25 | Morton Plant Hospital Clearwater, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $548 | $548 | $309 | 56% | — | $240 – $857 |
← Payers reporting CPT 96004 · Snapshot 20261112T181611Z-3fa9fb76