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
$0
Average
$376
Median
$250
High
$8.9k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
664 hospitals; the 90th percentile is 6.5× 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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931 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 | Pitt County Memorial Hospital, Inc. Greenville, NC percent of total billed charges · bothfrom % of charges | 3 | $704 | $925 | $312 | 34% | 75 | $704 – $1.4k |
| 2 | Pitt County Memorial Hospital, Inc. Washington, NC percent of total billed charges · bothfrom % of charges | 3 | $704 | $925 | $312 | 34% | 75 | $704 – $1.4k |
| 3 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 4 | $232 | $221 | $38 | 17% | 64 | $160 – $259 |
| 4 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 4 | $220 | $209 | $36 | 17% | 64 | $152 – $245 |
| 5 | Baystate Medical Center Springfield, MA percent of total billed charges · bothfrom % of charges | 3 | $190 | $190 | — | — | 15–150 | $190 – $190 |
| 6 | Baystate Medical Center Springfield, MA fee schedule · both | 1 | $190 | $190 | — | — | 5–50 | $190 – $190 |
| 7 | St Louis Childrens Hospital Saint Louis, MO percent of total billed charges · bothfrom % of charges | 6 | $295 | $324 | $50 | 16% | 3–30 | $248 – $383 |
| 8 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 2 | $117 | $117 | $6 | 5% | 2–20 | $112 – $123 |
| 9 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 2 | $417 | $417 | $4 | 1% | 2–20 | $413 – $421 |
| 10 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ other · outpatient | 2 | $410 | $410 | — | — | 2–20 | $410 – $410 |
| 11 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ other · outpatient | 2 | $410 | $410 | — | — | 2–20 | $410 – $410 |
| 12 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $331 | $331 | $0 | 0% | 2–20 | $330 – $331 |
| 13 | NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA percent of total billed charges · outpatientfrom % of charges | 1 | $679 | $679 | — | — | 1–10 | $679 – $679 |
| 14 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 1 | $385 | $385 | — | — | 1–10 | $385 – $385 |
| 15 | The University of Texas Medical Branch Webster, TX fee schedule · inpatient | 5 | $77 | $84 | $18 | 21% | 1–10 | $71 – $119 |
| 16 | ACADIAN MEDICAL CENTER EUNICE, LA fee schedule · both | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | AGH LAVEEN LLC Phoenix, AZ fee schedule · outpatient | 3 | $335 | $373 | $53 | 14% | — | $335 – $447 |
| 18 | AGH MESA LLC Mesa, AZ fee schedule · outpatient | 3 | $335 | $373 | $53 | 14% | — | $335 – $447 |
| 19 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 4 | $96 | $113 | $63 | 55% | — | $46 – $215 |
| 20 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 18 | $80 | $100 | $40 | 40% | — | $64 – $175 |
| 21 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · inpatient | 2 | $175 | $175 | $4 | 3% | — | $171 – $180 |
| 22 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · outpatient | 3 | $171 | $155 | $28 | 18% | — | $115 – $180 |
| 23 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 24 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $175 | $175 | $4 | 3% | — | $171 – $180 |
| 25 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · outpatient | 2 | $175 | $175 | $4 | 3% | — | $171 – $180 |
← Payers reporting CPT 99155 · Snapshot 20261111T120946Z-9134e7f7