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
PHOTOGRAPH OF ENTIRE BODY
Low
$65
Average
$272
Median
$106
High
$1.7k
Each hospital's average First Health rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 7.4× 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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34 hospital rates
iThe hospitals that file a First Health 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 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 2 | Childrens Hospital of Orange County - Profit Orange, CA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 3 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 5 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 6 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 7 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 9 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $151 | $151 | — | — | — | $151 – $151 |
| 10 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $499 | $499 | — | — | — | $499 – $499 |
| 11 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $499 | $499 | — | — | — | $499 – $499 |
| 12 | Jane Phillips Memorial Medical Center Bartlesville, OK fee schedule · both | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 13 | Jane Phillips Nowata Hospital, Inc. Nowata, OK fee schedule · both | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 14 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 1 | $865 | $865 | — | — | — | $865 – $865 |
| 15 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 2 | $400 | $400 | $4 | 1% | — | $396 – $404 |
| 16 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 1 | $395 | $395 | — | — | — | $395 – $395 |
| 17 | Mount Desert Island Hospital Bar Harbor, ME facility · percent of total billed charges · bothfrom % of charges | 1 | $736 | $736 | — | — | — | $736 – $736 |
| 18 | Owasso Medical Facility, Inc. Owasso, OK fee schedule · both | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 19 | Penn State Health Milton S. Hershey Medical Center Hershey, PA percent of total billed charges · bothfrom % of charges | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 20 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · bothfrom % of charges | 2 | $406 | $406 | $23 | 6% | — | $383 – $428 |
| 21 | St Luke's McCall, LTD McCall, ID percent of total billed charges · inpatientfrom % of charges | 1 | $428 | $428 | — | — | — | $428 – $428 |
| 22 | St Luke's Nampa Medical Center, LTD Nampa, ID percent of total billed charges · bothfrom % of charges | 2 | $378 | $378 | $6 | 1% | — | $372 – $383 |
| 23 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 2 | $378 | $378 | $6 | 1% | — | $372 – $383 |
| 24 | St Luke's Wood River Medical Center, LTD Ketchum, ID percent of total billed charges · bothfrom % of charges | 2 | $433 | $433 | $5 | 1% | — | $428 – $437 |
| 25 | St. John Medical Center, Inc. Tulsa, OK fee schedule · both | 1 | $71 | $71 | — | — | — | $71 – $71 |
← Payers reporting CPT 96904 · Snapshot 20261113T090226Z-3ce6c0b8