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
$58
Average
$229
Median
$172
High
$833
Each hospital's average First Health rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 2.4× 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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15 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 | Childrens Hospital at Mission - Cerner 27700 Medical Center Rd facility · percent of total billed charges · outpatientfrom % of charges | 1 | $833 | $833 | $82 | 10% | — | $751 – $915 |
| 2 | Childrens Hospital of Orange County - Profit Orange, CA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $415 | $477 | $250 | 52% | — | $201 – $861 |
| 3 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 4 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 5 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 6 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 7 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 8 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $221 | $221 | — | — | — | $221 – $221 |
| 9 | Jane Phillips Memorial Medical Center Bartlesville, OK fee schedule · both | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 10 | Jane Phillips Nowata Hospital, Inc. Nowata, OK fee schedule · both | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 11 | Owasso Medical Facility, Inc. Owasso, OK fee schedule · both | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 12 | Pemiscot Memorial Health System Hayti, MO percent of total billed charges · outpatientfrom % of charges | 1 | $206 | $206 | — | — | — | $206 – $206 |
| 13 | St. John Medical Center, Inc. Tulsa, OK fee schedule · both | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 14 | St. John Sapulpa, Inc. Sapulpa, OK fee schedule · both | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 15 | UMass Memorial Medical Center MA 01605; 157 Union Street Marlborough, MA percent of total billed charges · bothfrom % of charges | 1 | $58 | $58 | $1 | 2% | — | $57 – $59 |
← Payers reporting CPT 96111 · Snapshot 20261112T124536Z-e251e855