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
Outside state ambulance serv
The hospitals that file a Humana 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.
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87 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $6.75 | $6.75 – $6.75 |
| 2 | CHRISTUS Health - Pine Street Texarkana, TX fee schedule · outpatient | 1 | $13.10 | $13.10 – $13.10 |
| 3 | CHRISTUS Hospital - Orange Orange, TX fee schedule · outpatient | 1 | $14.56 | $14.56 – $14.56 |
| 4 | CHRISTUS West Beaumont Beaumont, TX fee schedule · outpatient | 1 | $14.56 | $14.56 – $14.56 |
| 5 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $5.87 | $5.87 – $5.87 |
| 6 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $5.87 | $5.87 – $5.87 |
| 7 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $5.87 | $5.87 – $5.87 |
| 8 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $5.87 | $5.87 – $5.87 |
| 9 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · both | 2 | $8.20 | $8.20 – $8.20 |
| 10 | Children's Hospital San Antonio, TX fee schedule · outpatient | 1 | $17.15 | $17.15 – $17.15 |
| 11 | Christus Health Southeast Texas Beaumont, TX fee schedule · outpatient | 1 | $14.56 | $14.56 – $14.56 |
| 12 | Christus Health Southeast Texas Port Arthur, TX fee schedule · outpatient | 1 | $14.56 | $14.56 – $14.56 |
| 13 | Florida Coast Medical and Surgical Center, Inc. Port St. Lucie, FL fee schedule · outpatient | 6 | $13.90 | $7.47 – $22.46 |
| 14 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 15 | HCA HOUSTON HEALTHCARE CONROE CONROE, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 16 | HCA HOUSTON HEALTHCARE KINGWOOD KINGWOOD, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 17 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 18 | HCA HOUSTON HEALTHCARE NORTHWEST HOUSTON, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 19 | HCA HOUSTON HEALTHCARE PEARLAND HOUSTON, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 20 | HCA HOUSTON HEALTHCARE SOUTHEAST HOUSTON, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 21 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 22 | HCA HOUSTON HEALTHCARE WEST STAFFORD, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 23 | HCA HOUSTON MAINLAND Texas City, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 24 | HCA Houston Rehabilitation Hospital Southeast Pasadena, TX fee schedule · outpatient | 2 | $62.53 | $62.53 – $62.53 |
| 25 | Highland Medical Center - Shreveport Shreveport, LA fee schedule · outpatient | 1 | $13.04 | $13.04 – $13.04 |
← Payers reporting HCPCS A0021 · Snapshot 20261108T203506Z-bb90dbab