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
Team Conf Pt/Pt Not Present IP
Low
$14
Average
$109
Median
$111
High
$207
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
27 hospitals; the 90th percentile is 5.6× 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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32 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 | Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient | 2 | $150 | $150 | — | — | — | $150 – $150 |
| 2 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 2 | $26 | $26 | — | — | — | $26 – $26 |
| 3 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 4 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $28 | $22 | $9 | 42% | — | $9 – $28 |
| 5 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 2 | $9 | $6 | $4 | 59% | — | $1 – $9 |
| 6 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 7 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 8 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN per diem · both | 1 | $159 | $159 | — | — | — | $159 – $159 |
| 9 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN per diem · both | 14 | $159 | $167 | $14 | 8% | — | $159 – $191 |
| 10 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN per diem · both | 14 | $159 | $167 | $14 | 8% | — | $159 – $191 |
| 11 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN per diem · both | 16 | $159 | $166 | $13 | 8% | — | $159 – $191 |
| 12 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 13 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 14 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY LAPORTE PORTE, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 15 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 16 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 17 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 18 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 19 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · outpatientfrom % of charges | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 20 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 21 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 22 | Mercy Hospital Healdton Inc Healdton, OK facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 23 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 24 | Mercy Hospital Springfield Ozark, MO facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 25 | Mercy Hospital Springfield Springfield, MO facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
← Payers reporting CPT 99368 · Snapshot 20261113T090226Z-3ce6c0b8