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
SPECIAL REPORTS OR FORMS
Low
$0
Average
$18
Median
$2
High
$90
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 6200.0× 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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31 hospital rates
iThe hospitals that file a WellCare 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 | Blue Hill Memorial Hospital Hill, ME facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 2 | Blue Hill Memorial Hospital Hill, ME professional · percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 3 | CHI MEMORIAL HOSPITAL - GEORGIA Ringgold, GA fee schedule · outpatient | 1 | $3 | $3 | $1 | 33% | — | $2 – $4 |
| 4 | Charles A. Dean Memorial Hospital Greenville, ME professional · percent of total billed charges · outpatientfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 5 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · outpatientfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 14 | Jennie Stuart Medical Center Hopkinsville, KY professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | MaineHealth Belfast, ME percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 16 | Mayo Regional Hospital Dover Foxcroft, ME professional · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 17 | Morrison Community Hospital District Morrison, IL professional · fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 18 | Mount Desert Island Hospital Bar Harbor, ME facility · percent of total billed charges · bothfrom % of charges | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 19 | NORTHERN MAINE MEDICAL CENTER FORT KENT, ME percent of total billed charges · outpatientfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 20 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | PRISMA HEALTH HILLCREST HOSPITAL SIMPSONVILLE, SC percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | PRISMA HEALTH NORTH GREENVILLE LTACH HOSPITAL TRAVELERS REST, SC percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | PRISMA HEALTH OCONEE MEMORIAL HOSPITAL SENECA, SC percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | PRISMA HEALTH PATEWOOD HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting CPT 99080 · Snapshot 20261113T090226Z-3ce6c0b8