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
Mod Cs Diff Phys<5Yrs 1St 15
Low
$13
Average
$306
Median
$201
High
$10.6k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
987 hospitals; the 90th percentile is 6.4× 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.
Filter by billing methodology
Filter by billing class
1,623 hospital rates
iThe hospitals that file a Aetna 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 | Norton Hospitals INC Louisville, KY other · inpatient | 1 | $139 | $139 | — | — | 17 | $139 – $139 |
| 2 | HEALTHPARK MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $199 | $199 | — | — | 11 | $199 – $199 |
| 3 | Baystate Medical Center Springfield, MA percent of total billed charges · bothfrom % of charges | 1 | $190 | $190 | — | — | 5–50 | $190 – $190 |
| 4 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 2 | $123 | $123 | $3 | 2% | 4–40 | $120 – $126 |
| 5 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 3 | $316 | $408 | $214 | 52% | 4–40 | $230 – $824 |
| 6 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 3 | $299 | $387 | $203 | 52% | 4–40 | $218 – $780 |
| 7 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $332 | $332 | $27 | 8% | 2–20 | $305 – $358 |
| 8 | NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA percent of total billed charges · outpatientfrom % of charges | 2 | $882 | $882 | — | — | 2–20 | $882 – $882 |
| 9 | OU Health - University of Oklahoma Medical Center Edmond, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.9k | $3.9k | — | — | 2–20 | $3.9k – $3.9k |
| 10 | NEMOURS CHILDREN'S HOSPITAL STE 100 LAKE MARY, FL percent of total billed charges · bothfrom % of charges | 1 | $502 | $502 | — | — | 1–10 | $502 – $502 |
| 11 | Norton Hospitals INC Louisville, KY other · inpatient | 1 | $46 | $46 | — | — | 1–10 | $46 – $46 |
| 12 | Norton Hospitals INC Louisville, KY other · inpatient | 1 | $93 | $93 | — | — | 1–10 | $93 – $93 |
| 13 | Norton Hospitals INC Louisville, KY other · inpatient | 1 | $46 | $46 | — | — | 1–10 | $46 – $46 |
| 14 | Norton Hospitals INC Louisville, KY other · inpatient | 1 | $232 | $232 | — | — | 1–10 | $232 – $232 |
| 15 | Norton Hospitals INC Louisville, KY other · inpatient | 1 | $139 | $139 | — | — | 1–10 | $139 – $139 |
| 16 | Seattle Children's Hospital Seattle, WA professional · fee schedule · both | 1 | $186 | $186 | — | — | 1–10 | $186 – $186 |
| 17 | St Louis Childrens Hospital Saint Louis, MO percent of total billed charges · bothfrom % of charges | 4 | $336 | $340 | $9 | 3% | 1–10 | $334 – $356 |
| 18 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ other · outpatient | 1 | $336 | $336 | — | — | 1–10 | $336 – $336 |
| 19 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | — | — | 1–10 | $59 – $59 |
| 20 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ other · outpatient | 1 | $336 | $336 | — | — | 1–10 | $336 – $336 |
| 21 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | — | — | 1–10 | $59 – $59 |
| 22 | AHS Claremore Hospital, LLC Claremore, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $275 | $275 | — | — | — | $275 – $275 |
| 23 | AHS Hillcrest Medical Center, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $295 | $295 | — | — | — | $295 – $295 |
| 24 | AHS Southcrest Hospital, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $97 | $97 | — | — | — | $97 – $97 |
| 25 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 1 | $81 | $81 | — | — | — | $81 – $81 |
← Payers reporting CPT 99155 · Snapshot 20261111T120946Z-9134e7f7