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
$1
Average
$129
Median
$69
High
$1.9k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
63 hospitals; the 90th percentile is 8.0× 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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70 hospital rates
iThe hospitals that file a Medicaid 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 | ACADIAN MEDICAL CENTER EUNICE, LA percent of total billed charges · bothfrom % of charges | 6 | $831 | $831 | $567 | 68% | — | $264 – $1.4k |
| 2 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $145 | $145 | — | — | — | $145 – $145 |
| 3 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 4 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 2 | $15 | $15 | $1 | 5% | — | $14 – $15 |
| 5 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 2 | $15 | $15 | $1 | 5% | — | $14 – $15 |
| 6 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 2 | $60 | $60 | — | — | — | $60 – $60 |
| 7 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 9 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 10 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 11 | Chapman Global Medical Center Orange, CA facility · fee schedule · outpatient | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 12 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 13 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 14 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 15 | DOCTORS HOSPITAL CORAL GABLES, FL fee schedule · both | 2 | $14 | $14 | $1 | 5% | — | $13 – $15 |
| 16 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · both | 3 | $78 | $78 | — | — | — | $78 – $78 |
| 17 | FISHERMENS HEALTH, INC MARATHON, FL fee schedule · both | 2 | $14 | $14 | $1 | 5% | — | $13 – $15 |
| 18 | Fairview Hospital Great Barrington, MA professional · fee schedule · outpatient | 2 | $60 | $60 | — | — | — | $60 – $60 |
| 19 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 20 | Geisinger Bloomsburg Hospital Bloomsburg, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 21 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 22 | Geisinger Jersey Shore Hospital Jersey Shore, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 25 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
← Payers reporting CPT 99155 · Snapshot 20261111T120946Z-9134e7f7