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
$25
Average
$1.1k
Median
$26
High
$26.0k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
32 hospitals; the 90th percentile is 57.7× 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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49 hospital rates
iThe hospitals that file a Anthem 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 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · both | 3 | $45 | $45 | — | — | — | $45 – $45 |
| 2 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $19 | $19 | — | — | — | $19 – $19 |
| 3 | Carmel AmbSurg Carmel, IN fee schedule · both | 3 | $45 | $45 | — | — | — | $45 – $45 |
| 4 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 8 | $19 | $19 | — | — | — | $19 – $19 |
| 5 | Denver Health and Hospital Authority Denver, CO facility · fee schedule · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 6 | Endo Surgery Center Carmel, IN fee schedule · both | 3 | $45 | $45 | — | — | — | $45 – $45 |
| 7 | Endo Surgery Center Carmel, IN fee schedule · outpatient | 8 | $19 | $19 | — | — | — | $19 – $19 |
| 8 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 3 | $25.9k | $26.0k | $165 | 1% | — | $25.9k – $26.3k |
| 9 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $275 | $275 | — | — | — | $275 – $275 |
| 10 | Memorial Hospital of Boscobel Boscobel, WI facility · fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 11 | Montefiore Medical Center Bronx, NY fee schedule · outpatient | 4 | $245 | $255 | $93 | 36% | — | $163 – $368 |
| 12 | Montefiore Mount Vernon Hospital Mount Vernon, NY fee schedule · outpatient | 4 | $245 | $255 | $93 | 36% | — | $163 – $368 |
| 13 | Montefiore New Rochelle Hospital New Rochelle, NY fee schedule · outpatient | 4 | $245 | $255 | $93 | 36% | — | $163 – $368 |
| 14 | Moundview Memorial Hospital and Clinics, Inc. Friendship, WI facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 15 | Naab Road Surgery Center Indianapolis, IN fee schedule · both | 3 | $45 | $45 | — | — | — | $45 – $45 |
| 16 | Naab Road Surgery Center Indianapolis, IN fee schedule · outpatient | 8 | $19 | $19 | — | — | — | $19 – $19 |
| 17 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 18 | Norton Kings Daughters Health Inc Madison, IN professional · fee schedule · both | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 19 | Renown Regional Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 20 | Renown South Meadows Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 21 | Renown South Meadows Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 22 | St Joseph’s Health Services Inc Hillsboro, WI facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 23 | St. Joseph Hospital & Health Center, Inc. Kokomo, IN fee schedule · both | 3 | $45 | $45 | — | — | — | $45 – $45 |
| 24 | St. Joseph Hospital & Health Center, Inc. Kokomo, IN fee schedule · outpatient | 8 | $19 | $19 | — | — | — | $19 – $19 |
| 25 | St. Mary's Health, Inc. IN 47750; 10388 Warrick Wellness Trail Newburgh, IN fee schedule · both | 3 | $45 | $45 | — | — | — | $45 – $45 |
← Payers reporting CPT 96102 · Snapshot 20261112T124536Z-e251e855