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
HC ADMN RSV MONOC ANTB IM INJECTION
Low
$15
Average
$49
Median
$38
High
$160
Each hospital's average Medica rate, under the methodology and billing class chosen below.
95 hospitals; the 90th percentile is 3.9× 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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191 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 Health System Bloomer, WI facility · percent of total billed charges · bothfrom % of charges | 9 | $47 | $46 | $9 | 19% | 3–30 | $19 – $52 |
| 2 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 5 | $42 | $43 | $1 | 3% | 2–20 | $41 – $45 |
| 3 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 9 | $47 | $45 | $9 | 20% | 2–20 | $17 – $52 |
| 4 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 7 | $53 | $54 | $1 | 2% | 1–10 | $52 – $56 |
| 5 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 9 | $42 | $39 | $7 | 19% | 1–10 | $24 – $45 |
| 6 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $17 | $20 | $10 | 47% | — | $12 – $36 |
| 7 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $17 | $20 | $10 | 47% | — | $12 – $36 |
| 8 | Amery Hospital Amery, WI facility · fee schedule · both | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 9 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 10 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 11 | Avera Behavioral Health Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $27 | $28 | $17 | 60% | — | $11 – $49 |
| 12 | Avera McKennan Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $27 | $28 | $17 | 60% | — | $11 – $49 |
| 13 | Avera Specialty Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $27 | $28 | $17 | 60% | — | $11 – $49 |
| 14 | Avera St. Luke's Aberdeen, SD percent of total billed charges · inpatientfrom % of charges | 2 | $56 | $56 | $5 | 8% | — | $51 – $60 |
| 15 | Avera St. Luke's Aberdeen, SD percent of total billed charges · outpatientfrom % of charges | 2 | $56 | $56 | $5 | 8% | — | $52 – $61 |
| 16 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 4 | $37 | $35 | $17 | 50% | — | $13 – $52 |
| 17 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 18 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 2 | $45 | $45 | $3 | 6% | — | $42 – $48 |
| 19 | Black River Health Inc Black River Falls, WI professional · percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 20 | Bowdle Healthcare Center Bowdle, SD percent of total billed charges · inpatientfrom % of charges | 2 | $44 | $44 | $4 | 9% | — | $41 – $48 |
| 21 | Bowdle Healthcare Center Bowdle, SD percent of total billed charges · outpatientfrom % of charges | 2 | $45 | $45 | $4 | 9% | — | $42 – $49 |
| 22 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $25 | $25 | $12 | 48% | — | $13 – $36 |
| 23 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $25 | $25 | $12 | 48% | — | $13 – $36 |
| 24 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $31 | $31 | $11 | 37% | — | $19 – $42 |
| 25 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | $13 | 48% | — | $14 – $40 |
← Payers reporting CPT 96381 · Snapshot 20261111T120946Z-9134e7f7