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
$5
Average
$141
Median
$123
High
$3.0k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
280 hospitals; the 90th percentile is 4.9× 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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422 hospital rates
iThe hospitals that file a Medica 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 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 12 | $112 | $135 | $46 | 34% | 59–95 | $58 – $194 |
| 2 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 8 | $140 | $138 | $10 | 8% | 42 | $112 – $148 |
| 3 | Spooner Health System, Inc Spooner, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $86 | $111 | $37 | 33% | 35–44 | $84 – $164 |
| 4 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $121 | $121 | — | — | 27 | $121 – $121 |
| 5 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $121 | $121 | — | — | 27 | $121 – $121 |
| 6 | Lakes Regional Hospital Spirit Lake, IA percent of total billed charges · outpatientfrom % of charges | 2 | $59 | $62 | $31 | 51% | 25 | $28 – $101 |
| 7 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 7 | $134 | $124 | $23 | 18% | 17 | $74 – $139 |
| 8 | Methodist Hospital St. Louis Park, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $113 | $113 | $28 | 25% | 14–23 | $85 – $141 |
| 9 | Regions Hospital St. Paul, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $105 | $105 | $25 | 24% | 14–23 | $79 – $130 |
| 10 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 3 | $132 | $134 | $2 | 2% | 13–31 | $132 – $137 |
| 11 | Mercy Hospital Oklahoma City Inc City, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $71 | $71 | — | — | 12 | $71 – $71 |
| 12 | Avera Granite Falls Health Center Granite Falls, MN percent of total billed charges · outpatientfrom % of charges | 2 | $180 | $181 | $18 | 10% | 4–40 | $161 – $201 |
| 13 | Northfield Hospital Northfield, MN fee schedule · both | 1 | $151 | $151 | — | — | 4–40 | $151 – $151 |
| 14 | Prairie Lakes Health Care System Inc. Watertown, SD percent of total billed charges · bothfrom % of charges | 2 | $49 | $49 | — | — | 4–40 | $49 – $49 |
| 15 | Avera McKennan Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $93 | $77 | $34 | 45% | 3–30 | $27 – $111 |
| 16 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 4 | $19 | $51 | $56 | 110% | 2–20 | $18 – $149 |
| 17 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 4 | $19 | $51 | $56 | 110% | 2–20 | $18 – $149 |
| 18 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 4 | $19 | $51 | $56 | 110% | 2–20 | $18 – $149 |
| 19 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 4 | $19 | $51 | $56 | 110% | 2–20 | $18 – $149 |
| 20 | Avera Holy Family Hospital Estherville, IA percent of total billed charges · outpatientfrom % of charges | 2 | $123 | $124 | $16 | 13% | 2–20 | $102 – $148 |
| 21 | Avera Marshall Hospital Marshall, MN percent of total billed charges · outpatientfrom % of charges | 2 | $124 | $132 | $79 | 60% | 2–20 | $49 – $230 |
| 22 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 2 | $157 | $160 | $33 | 20% | 2–20 | $119 – $205 |
| 23 | Avera St. Luke's Aberdeen, SD percent of total billed charges · outpatientfrom % of charges | 2 | $134 | $134 | $12 | 9% | 2–20 | $120 – $148 |
| 24 | Avera Tyler Hospital Tyler, MN percent of total billed charges · outpatientfrom % of charges | 2 | $130 | $138 | $84 | 61% | 2–20 | $50 – $241 |
| 25 | GOOD SAMARITAN HOSPITAL Kearney, NE fee schedule · outpatient | 4 | $19 | $60 | $71 | 119% | 2–20 | $18 – $183 |
← Payers reporting CPT 96376 · Snapshot 20261111T120946Z-9134e7f7