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
Test to assess the ability to complete specific functional tasks applicable to environment
Low
$1
Average
$284
Median
$234
High
$8.2k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1269 hospitals; the 90th percentile is 4.1× 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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1,913 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 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 4 | $321 | $329 | $44 | 13% | 19 | $280 – $395 |
| 2 | Advocate Good Samaritan Hospital Downers Grove, IL percent of total billed charges · outpatientfrom % of charges | 1 | $200 | $221 | $174 | 79% | 8–80 | $44 – $439 |
| 3 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $254 | $254 | — | — | 4–40 | $254 – $254 |
| 4 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $351 | $356 | $14 | 4% | 4–40 | $343 – $379 |
| 5 | The Charlotte Mecklenburg Hospital Authority Waxhaw, NC percent of total billed charges · outpatientfrom % of charges | 3 | $371 | $388 | $72 | 18% | 3–30 | $310 – $484 |
| 6 | Beebe Medical Center Inc. Lewes, DE facility · percent of total billed charges · outpatientfrom % of charges | 1 | $752 | $752 | — | — | 2–20 | $752 – $752 |
| 7 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT other · inpatient | 1 | $287 | $287 | — | — | 2–20 | $287 – $287 |
| 8 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · outpatientfrom % of charges | 2 | $369 | $369 | $51 | 14% | 2–20 | $318 – $420 |
| 9 | Pitt County Memorial Hospital, Inc. Greenville, NC percent of total billed charges · bothfrom % of charges | 8 | $32 | $32 | $4 | 13% | 2–20 | $27 – $38 |
| 10 | Pitt County Memorial Hospital, Inc. Washington, NC percent of total billed charges · bothfrom % of charges | 8 | $32 | $32 | $4 | 13% | 2–20 | $27 – $38 |
| 11 | Shannon Medical Center San Angelo, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $410 | $410 | $9 | 2% | 2–20 | $402 – $419 |
| 12 | Shannon Medical Center Big Spring Big Spring, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $410 | $410 | $9 | 2% | 2–20 | $402 – $419 |
| 13 | Shannon River Crest Hospital San Angelo, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $410 | $410 | $9 | 2% | 2–20 | $402 – $419 |
| 14 | Baystate Franklin Medical Center Greenfield, MA facility · fee schedule · both | 1 | $62 | $62 | — | — | 1–10 | $62 – $62 |
| 15 | Cooperman Barnabas Medical Center Livingston, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $65 | $65 | — | — | 1–10 | $65 – $65 |
| 16 | HARTFORD HOSPITAL HARTFORD, CT case rate · outpatient | 1 | $178 | $178 | — | — | 1–10 | $178 – $178 |
| 17 | Memorial Hospital of Laramie County Cheyenne, WY other · both | 1 | $323 | $323 | — | — | 1–10 | $323 – $323 |
| 18 | Memorial Hospital of Laramie County Cheyenne, WY percent of total billed charges · outpatientfrom % of charges | 1 | $323 | $323 | — | — | 1–10 | $323 – $323 |
| 19 | NATIONAL JEWISH HEALTH GOLDEN, CO percent of total billed charges · bothfrom % of charges | 2 | $148 | $148 | $33 | 22% | 1–10 | $115 – $181 |
| 20 | OU Health - University of Oklahoma Medical Center Edmond, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $139 | $139 | — | — | 1–10 | $139 – $139 |
| 21 | Robert Wood Johnson University Hospital Somerset Somerville, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $125 | $125 | — | — | 1–10 | $125 – $125 |
| 22 | SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT case rate · outpatient | 1 | $245 | $245 | — | — | 1–10 | $245 – $245 |
| 23 | THE WILLIAM W BACKUS HOSPITAL PLAINFIELD, CT case rate · outpatient | 1 | $205 | $205 | — | — | 1–10 | $205 – $205 |
| 24 | WINDHAM COMMUNITY MEMORIAL HOSPITAL INC WILLIMANTIC, CT case rate · outpatient | 1 | $161 | $161 | — | — | 1–10 | $161 – $161 |
| 25 | Yampa Valley Medical Center Steamboat Springs, CO percent of total billed charges · outpatientfrom % of charges | 2 | $466 | $466 | $25 | 5% | 1–10 | $441 – $492 |
← Payers reporting CPT 96125 · Snapshot 20261111T120946Z-9134e7f7