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
$200
Median
$169
High
$982
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
192 hospitals; the 90th percentile is 3.4× 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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215 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 professional · percent of total billed charges · outpatientfrom % of charges | 10 | $172 | $177 | $9 | 5% | 1–10 | $168 – $191 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 6 | $128 | $109 | $33 | 30% | — | $63 – $136 |
| 3 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA fee schedule · outpatient | 3 | $116 | $115 | $2 | 2% | — | $111 – $116 |
| 4 | Adventhealth Central Texas Killeen, TX fee schedule · outpatient | 2 | $213 | $213 | $15 | 7% | — | $198 – $228 |
| 5 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 6 | Adventhealth Rollins Brook Lampasas, TX fee schedule · outpatient | 2 | $213 | $213 | $15 | 7% | — | $198 – $228 |
| 7 | Ascension Cedar Park Park, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 8 | Ascension Providence Waco, TX fee schedule · outpatient | 2 | $121 | $121 | $6 | 5% | — | $115 – $127 |
| 9 | Ascension Providence Waco, TX other · outpatient | 2 | $96 | $96 | $11 | 11% | — | $86 – $107 |
| 10 | Ascension Seton Austin, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 11 | Ascension Seton Austin, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 12 | Ascension Seton Austin, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 13 | Ascension Seton Luling, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 14 | Ascension Seton Burnet, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 15 | Ascension Seton Smithville, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 16 | Ascension Seton Bastrop, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 17 | Ascension Seton Austin, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 18 | Ascension Via Christi Hospital Manhattan, Inc. Manhattan, KS other · both | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 19 | Ascension Via Christi Hospital Manhattan, Inc. Manhattan, KS other · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 20 | Austin Center for Outpatient Surgery LP, DBA Northwest Hills Surgical Hospital Austin, TX fee schedule · outpatient | 5 | $175 | $169 | $43 | 25% | — | $88 – $214 |
| 21 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $572 | $572 | — | — | — | $572 – $572 |
| 22 | Beth Israel Deaconess Hospital - Needham Needham, MA fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 23 | Beth Israel Deaconess Hospital - Plymouth Plymouth, MA fee schedule · outpatient | 2 | $144 | $144 | $4 | 3% | — | $140 – $148 |
| 24 | Beth Israel Deaconess Hospital-Milton Inc Milton, MA fee schedule · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 25 | Beth Israel Deaconess Medical Center Boston, MA fee schedule · outpatient | 2 | $179 | $179 | $4 | 2% | — | $175 – $183 |
← Payers reporting CPT 97169 · Snapshot 20261113T090226Z-3ce6c0b8