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
Atc Eval Low Complexity
Low
$0
Average
$144
Median
$161
High
$361
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 2.3× 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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16 hospital rates
iThe hospitals that file a Ambetter 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 | CLAIBORNE MEDICAL CENTER Tazewell, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 2 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 3 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 4 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 5 | Florida Coast Medical and Surgical Center, Inc. Port St. Lucie, FL case rate · outpatient | 3 | $0 | $0 | $0 | 14% | — | $0 – $0 |
| 6 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $361 | $361 | $11 | 3% | — | $350 – $372 |
| 7 | LECONTE MEDICAL CENTER Sevierville, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 8 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 9 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 10 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $73 | $69 | $24 | 35% | — | $29 – $107 |
| 11 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $72 | $72 | $27 | 37% | — | $29 – $109 |
| 12 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $97 | $43 | 45% | — | $54 – $208 |
| 13 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $97 | $43 | 45% | — | $54 – $208 |
| 14 | PARKWEST MEDICAL CENTER Knoxville, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 15 | PARKWEST MEDICAL CENTER Louisville, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 16 | ROANE COUNTY MEDICAL CENTER Harriman, TN other · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
← Payers reporting CPT 97169 · Snapshot 20261113T090226Z-3ce6c0b8