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
Prev Med Cnsl&/Rsk Fctr Rdctj Indv Approx 60 Min
Low
$5
Average
$76
Median
$64
High
$184
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 3.2× 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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38 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | Beebe Medical Center Inc. Lewes, DE facility · percent of total billed charges · outpatientfrom % of charges | 1 | $106 | $106 | — | — | 2–20 | $106 – $106 |
| 2 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 3 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 4 | Central Louisiana Surgical Hospital Alexandria, LA fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 5 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 6 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 7 | Coushatta Health Care Center Coushatta, LA fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 8 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 9 | Henry Ford Health System West Bloomfield, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 10 | Henry Ford Health System West Bloomfield, MI professional · percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | $18 | 21% | — | $70 – $106 |
| 11 | Henry Ford Health System Plymouth, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 12 | Henry Ford Health System Plymouth, MI professional · percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | $18 | 21% | — | $70 – $106 |
| 13 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI professional · percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | $18 | 21% | — | $70 – $106 |
| 14 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI professional · percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | $18 | 21% | — | $70 – $106 |
| 15 | Highland Medical Center - Shreveport Shreveport, LA fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 16 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 17 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $61 | $61 | $2 | 3% | — | $60 – $63 |
| 18 | Mount Carmel Dublin Dublin, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $184 | $184 | — | — | — | $184 – $184 |
| 19 | Mount Carmel East Reynoldsburg, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $184 | $184 | — | — | — | $184 – $184 |
| 20 | Mount Carmel Grove City Grove City, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $184 | $184 | — | — | — | $184 – $184 |
| 21 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $184 | $184 | — | — | — | $184 – $184 |
| 22 | Ochsner Lake Area Hospital Lake Charles, LA fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 23 | Ochsner St. Patrick Hospital Lake Charles, LA fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 24 | Sarasota Memorial Hospital Sarasota, FL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 25 | Sarasota Memorial Hospital - Venice North Venice, FL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
← Payers reporting CPT 99404 · Snapshot 20261112T181611Z-3fa9fb76