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
$44
Average
$204
Median
$176
High
$467
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 4.0× 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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29 hospital rates
iThe hospitals that file a Cigna 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 | Alexian Brothers Behavioral Health Hospital Estates, IL other · both | 3 | $460 | $460 | — | — | — | $460 – $460 |
| 2 | Alexian Brothers Medical Center Village, IL other · both | 4 | $460 | $388 | $126 | 32% | — | $170 – $460 |
| 3 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $201 | $201 | — | — | — | $201 – $201 |
| 4 | AnMed Health Anderson, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 5 | AnMed Health Anderson, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 6 | AnMed Health Cannon Pickens, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 7 | AnMed Health Cannon Pickens, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 8 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 9 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 10 | Baptist Memorial Hospital-Carroll County Huntingdon, TN facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 11 | Baptist Memorial Hospital-Carroll County Huntingdon, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $165 | $165 | — | — | — | $165 – $165 |
| 12 | Baptist Memorial Hospital-Golden Triangle Columbus, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 13 | Baptist Memorial Hospital-Golden Triangle Columbus, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 14 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 1 | $255 | $255 | — | — | — | $255 – $255 |
| 15 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 1 | $255 | $255 | — | — | — | $255 – $255 |
| 16 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · both | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 17 | Chambers Health Anahuac, TX percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 18 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $96 | $96 | — | — | — | $96 – $96 |
| 19 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 20 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $99 | $99 | $9 | 9% | — | $90 – $107 |
| 21 | Henry Ford Health Twp, MI other · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 22 | Memorial Hospital of Laramie County Cheyenne, WY fee schedule · both | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 23 | Montefiore Medical Center Bronx, NY percent of total billed charges · bothfrom % of charges | 4 | $273 | $273 | $137 | 50% | — | $136 – $410 |
| 24 | Navicent Health Baldwin Inc Milledgeville, GA fee schedule · both | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 25 | St. Alexius Medical Center Estates, IL other · both | 4 | $460 | $388 | $126 | 32% | — | $170 – $460 |
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