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
PR PREV MED NEW PAT 65+ YRS
Low
$0
Average
$246
Median
$171
High
$13.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
628 hospitals; the 90th percentile is 3.8× 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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978 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 | Baystate Medical Center Springfield, MA percent of total billed charges · bothfrom % of charges | 1 | $233 | $233 | — | — | 3–30 | $233 – $233 |
| 2 | Mount Carmel St Ann's Lewis Center, OH professional · fee schedule · both | 2 | $242 | $214 | $39 | 18% | 3–30 | $159 – $242 |
| 3 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $185 | $185 | — | — | 2–20 | $185 – $185 |
| 4 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $122 | $122 | $72 | 59% | 2–20 | $50 – $194 |
| 5 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $329 | $329 | $40 | 12% | 2–20 | $289 – $369 |
| 6 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 3 | $402 | $407 | $11 | 3% | 2–20 | $402 – $429 |
| 7 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 4 | $266 | $234 | $76 | 32% | 2–20 | $129 – $340 |
| 8 | Samaritan Hospital Troy, NY professional · fee schedule · outpatient | 2 | $254 | $216 | $54 | 25% | 2–20 | $139 – $254 |
| 9 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 11 | $182 | $186 | $22 | 12% | 2–20 | $127 – $221 |
| 10 | Stanford Health Care Stanford, CA fee schedule · both | 1 | $534 | $534 | — | — | 2–20 | $534 – $534 |
| 11 | CAPE CORAL HOSPITAL CAPE CORAL, FL professional · fee schedule · both | 1 | $230 | $230 | — | — | 1–10 | $230 – $230 |
| 12 | Community Health Association Ripley, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $196 | $196 | — | — | 1–10 | $196 – $196 |
| 13 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · inpatient | 4 | $185 | $178 | $9 | 5% | 1–10 | $165 – $185 |
| 14 | Lake Charles Memorial Hospital Charles., LA other · outpatient | 1 | $146 | $146 | — | — | 1–10 | $146 – $146 |
| 15 | Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges | 2 | $91 | $87 | $6 | 6% | 1–10 | $79 – $91 |
| 16 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 2 | $539 | $539 | — | — | 1–10 | $539 – $539 |
| 17 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · both | 4 | $239 | $221 | $58 | 26% | 1–10 | $146 – $281 |
| 18 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 4 | $203 | $192 | $44 | 23% | 1–10 | $136 – $239 |
| 19 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 4 | $239 | $221 | $58 | 26% | 1–10 | $146 – $281 |
| 20 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 4 | $159 | $169 | $24 | 14% | 1–10 | $150 – $210 |
| 21 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $362 | $362 | — | — | 1–10 | $362 – $362 |
| 22 | Mount Graham Regional Medical Center Safford, AZ percent of total billed charges · inpatientfrom % of charges | 1 | $332 | $332 | — | — | 1–10 | $332 – $332 |
| 23 | Pana Community Hospital Association Pana, IL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $276 | $276 | $22 | 8% | 1–10 | $255 – $298 |
| 24 | Samaritan Hospital Troy, NY professional · fee schedule · inpatient | 2 | $299 | $254 | $64 | 25% | 1–10 | $163 – $299 |
| 25 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 4 | $239 | $214 | $48 | 23% | 1–10 | $146 – $260 |
← Payers reporting CPT 99387 · Snapshot 20261111T120946Z-9134e7f7