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
THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC
Low
$0
Average
$289
Median
$110
High
$21.5k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
1111 hospitals; the 90th percentile is 13.2× 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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1,650 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Saint Luke’s East Hospital Summit, MO percent of total billed charges · bothfrom % of charges | 19 | $156 | $163 | $29 | 18% | 3,721–3,775 | $130 – $217 |
| 2 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 5 | $227 | $236 | $81 | 34% | 1,131–1,167 | $160 – $391 |
| 3 | Allina Health Systems Owatonna, MN facility · other · outpatient | 5 | $32 | $34 | $11 | 33% | 1,072 | $15 – $48 |
| 4 | Allina Health Systems Shakopee, MN facility · other · outpatient | 5 | $32 | $34 | $11 | 33% | 1,064 | $15 – $48 |
| 5 | Allina Health Systems Faribualt, MN facility · other · outpatient | 5 | $32 | $34 | $11 | 33% | 1,060 | $15 – $48 |
| 6 | Allina Health Systems Buffalo, MN facility · other · outpatient | 5 | $32 | $34 | $11 | 33% | 1,060 | $15 – $48 |
| 7 | Allina Health Systems Cambridge, MN facility · other · outpatient | 5 | $32 | $34 | $11 | 33% | 1,050 | $15 – $48 |
| 8 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 2 | $71 | $107 | $67 | 63% | 713–758 | $71 – $242 |
| 9 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $228 | $228 | $52 | 23% | 541 | $176 – $279 |
| 10 | Pitt County Memorial Hospital, Inc. Greenville, NC percent of total billed charges · bothfrom % of charges | 3 | $184 | $241 | $81 | 34% | 508 | $184 – $356 |
| 11 | Pitt County Memorial Hospital, Inc. Washington, NC percent of total billed charges · bothfrom % of charges | 3 | $184 | $241 | $81 | 34% | 508 | $184 – $356 |
| 12 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 2 | $257 | $260 | $94 | 36% | 498–552 | $150 – $377 |
| 13 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 6 | $223 | $241 | $31 | 13% | 485–494 | $174 – $275 |
| 14 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 11 | $112 | $129 | $55 | 42% | 432–504 | $25 – $198 |
| 15 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 19 | $255 | $251 | $49 | 20% | 418–526 | $165 – $307 |
| 16 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 4 | $121 | $138 | $42 | 30% | 395–449 | $104 – $206 |
| 17 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 2 | $122 | $122 | — | — | 356 | $122 – $122 |
| 18 | Saint Luke’s North Hospital Smithville, MO percent of total billed charges · bothfrom % of charges | 19 | $178 | $170 | $27 | 16% | 346–400 | $130 – $217 |
| 19 | Saint Luke’s North Hospital City, KS percent of total billed charges · bothfrom % of charges | 19 | $178 | $170 | $27 | 16% | 346–400 | $130 – $217 |
| 20 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 6 | $122 | $133 | $46 | 35% | 344–362 | $78 – $211 |
| 21 | DIGNITY HEALTH Gilbert, AZ fee schedule · outpatient | 4 | $121 | $138 | $42 | 30% | 301–355 | $104 – $206 |
| 22 | Baystate Franklin Medical Center Greenfield, MA facility · percent of total billed charges · bothfrom % of charges | 3 | $1.1k | $1.1k | — | — | 294 | $1.1k – $1.1k |
| 23 | ST VINCENT INFIRMARY MEDICAL CENTER Little Rock, AR fee schedule · outpatient | 2 | $33 | $33 | — | — | 286 | $33 – $33 |
| 24 | Hutchinson Regional Medical Center, Inc. Hutchinson, KS facility · fee schedule · both | 1 | $50 | $50 | $0 | 0% | 285 | $50 – $50 |
| 25 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $143 | $143 | — | — | 250 | $143 – $143 |
← Payers reporting CPT 96376 · Snapshot 20261111T120946Z-9134e7f7