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
$1
Average
$975
Median
$138
High
$21.5k
Each hospital's average Carefirst rate, under the methodology and billing class chosen below.
63 hospitals; the 90th percentile is 24.6× 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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79 hospital rates
iThe hospitals that file a Carefirst 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 | NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA percent of total billed charges · outpatientfrom % of charges | 1 | $54 | $54 | — | — | 1–10 | $54 – $54 |
| 2 | University of Virginia Prince William Medical Center Manassas, VA percent of total billed charges · bothfrom % of charges | 2 | $120 | $120 | — | — | 1–10 | $120 – $120 |
| 3 | University of Virginia Prince William Medical Center Manassas, VA percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $86 | — | — | 1–10 | $86 – $86 |
| 4 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · outpatient | 1 | $608 | $608 | — | — | — | $608 – $608 |
| 5 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · outpatient | 1 | $6.8k | $6.8k | — | — | — | $6.8k – $6.8k |
| 6 | Children's National Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 7 | Children's National Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $105 | $105 | $32 | 31% | — | $73 – $137 |
| 8 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $451 | $451 | — | — | — | $451 – $451 |
| 9 | GRMC, Inc. Oakland, MD percent of total billed charges · bothfrom % of charges | 2 | $36 | $37 | $1 | 3% | — | $36 – $39 |
| 10 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 11 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $57 | $56 | $2 | 3% | — | $54 – $58 |
| 12 | Inova Alexandria Hospital Alexandria, VA percent of total billed charges · bothfrom % of charges | 2 | $212 | $212 | $6 | 3% | — | $206 – $218 |
| 13 | Inova Fair Oaks Hospital Fairfax, VA percent of total billed charges · bothfrom % of charges | 2 | $212 | $212 | $6 | 3% | — | $206 – $218 |
| 14 | Inova Fairfax Hospital Falls Church, VA percent of total billed charges · bothfrom % of charges | 2 | $212 | $212 | $6 | 3% | — | $206 – $218 |
| 15 | Inova Loudoun Hospital Leesburg, VA percent of total billed charges · bothfrom % of charges | 2 | $212 | $212 | $6 | 3% | — | $206 – $218 |
| 16 | Inova Mount Vernon Hospital Alexandria, VA percent of total billed charges · bothfrom % of charges | 2 | $212 | $212 | $6 | 3% | — | $206 – $218 |
| 17 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $335 | $335 | — | — | — | $335 – $335 |
| 18 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $69 | $69 | — | — | — | $69 – $69 |
| 19 | MedStar Georgetown Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $217 | $217 | — | — | — | $217 – $217 |
| 20 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $64 | $64 | — | — | — | $64 – $64 |
| 21 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $30 | $30 | — | — | — | $30 – $30 |
| 22 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 3 | $82 | $82 | — | — | — | $82 – $82 |
| 23 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 3 | $54 | $54 | — | — | — | $54 – $54 |
| 24 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 3 | $49 | $49 | — | — | — | $49 – $49 |
| 25 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $63 | $63 | — | — | — | $63 – $63 |
← Payers reporting CPT 96376 · Snapshot 20261111T120946Z-9134e7f7