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 UnitedHealthcare 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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85 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 3 | $6.88 | $6.64 – $7.00 |
| 2 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 3 | $6.88 | $6.64 – $7.00 |
| 3 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $10.92 | $10.92 – $10.92 |
| 4 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 2 | $6.75 | $6.75 – $6.75 |
| 5 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $20,015 | $20,015 – $20,015 |
| 6 | Blessing Hospital Quincy, IL professional · fee schedule · both | 1 | $6.05 | $6.05 – $6.05 |
| 7 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $10.92 | $10.92 – $10.92 |
| 8 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $6.81 | $6.75 – $6.86 |
| 9 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · inpatient | 3 | $6.88 | $6.64 – $7.00 |
| 10 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 3 | $6.88 | $6.64 – $7.00 |
| 11 | CLAIBORNE MEDICAL CENTER Tazewell, TN other · outpatient | 3 | $755.33 | $627.00 – $902.00 |
| 12 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN other · outpatient | 3 | $755.33 | $627.00 – $902.00 |
| 13 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 2 | $6.75 | $6.75 – $6.75 |
| 14 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 2 | $6.75 | $6.75 – $6.75 |
| 15 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $10.92 | $10.92 – $10.92 |
| 16 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $9.00 | $9.00 – $9.00 |
| 17 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $10.92 | $10.92 – $10.92 |
| 18 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN other · outpatient | 3 | $756.67 | $628.00 – $904.00 |
| 19 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN other · outpatient | 3 | $756.67 | $628.00 – $904.00 |
| 20 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 2 | $12.86 | $12.86 – $12.86 |
| 21 | Fairview Health Services Edina, MN fee schedule · both | 2 | $12.86 | $12.86 – $12.86 |
| 22 | Fairview Health Services Minneapolis, MN fee schedule · both | 2 | $12.86 | $12.86 – $12.86 |
| 23 | Fairview Health Services Burnsville, MN fee schedule · both | 2 | $12.86 | $12.86 – $12.86 |
| 24 | Fairview Health Services Wyoming, MN fee schedule · both | 2 | $12.86 | $12.86 – $12.86 |
| 25 | Fairview Health Services Princeton, MN fee schedule · both | 2 | $12.86 | $12.86 – $12.86 |
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