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
Fee Schedule
Low
$21
Average
$519
Median
$44
High
$13.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
37 hospitals; the 90th percentile is 20.6× 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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40 hospital rates
iThe hospitals that file a Aetna 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 2 | Baptist Memorial Hospital-Carroll County Huntingdon, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $173 | $173 | $66 | 38% | — | $107 – $239 |
| 3 | Baptist Memorial Hospital-Golden Triangle Columbus, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $173 | $173 | $66 | 38% | — | $107 – $239 |
| 4 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · inpatientfrom % of charges | 1 | $272 | $272 | — | — | — | $272 – $272 |
| 5 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $263 | $263 | $10 | 4% | — | $253 – $272 |
| 6 | Carle Eureka Hospital Eureka, IL percent of total billed charges · inpatientfrom % of charges | 1 | $272 | $272 | — | — | — | $272 – $272 |
| 7 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 3 | $253 | $237 | $37 | 16% | — | $185 – $272 |
| 8 | Carolinas Medical Center Davidson, NC fee schedule · both | 1 | $107 | $107 | — | — | — | $107 – $107 |
| 9 | Chambers Health Anahuac, TX percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 10 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $118 | $118 | $46 | 39% | — | $71 – $164 |
| 11 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $300 | $300 | — | — | — | $300 – $300 |
| 12 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 13 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 14 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 15 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $13.9k | $13.9k | — | — | — | $13.9k – $13.9k |
| 16 | GLENS FALLS HOSPITAL INC Falls, NY facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 17 | Jane Phillips Memorial Medical Center Bartlesville, OK other · both | 2 | $33 | $33 | $6 | 20% | — | $26 – $39 |
| 18 | Jane Phillips Nowata Hospital, Inc. Nowata, OK other · both | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 19 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $875 | $875 | — | — | — | $875 – $875 |
| 20 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 1 | $300 | $300 | — | — | — | $300 – $300 |
| 21 | MEDICAL CITY GREEN OAKS HOSPITAL DALLAS, TX fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 22 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $604 | $604 | — | — | — | $604 – $604 |
| 23 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 3 | $164 | $149 | $35 | 23% | — | $71 – $164 |
| 24 | Memorial Hospital of Laramie County Cheyenne, WY percent of total billed charges · bothfrom % of charges | 1 | $107 | $107 | $53 | 50% | — | $54 – $160 |
| 25 | ONEIDA HEALTH ONEIDA, NY other · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
← Payers reporting CPT 96102 · Snapshot 20261112T124536Z-e251e855