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
Pessary disposable any type
Low
$26
Average
$221
Median
$26
High
$2.4k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 5.0× 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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15 hospital rates
iThe hospitals that file a Cigna 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 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 2 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 3 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · percent of total billed charges · outpatientfrom % of charges | 6 | $76 | $76 | — | — | — | $76 – $76 |
| 4 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 5 | Maine Coast Regional Health Facilities Ellsworth, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 6 | Mayo Regional Hospital Dover Foxcroft, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 7 | Mercy Hospital Portland, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 8 | Mon Health Medical Center Morgantown, WV percent of total billed charges · outpatientfrom % of charges | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 9 | Sebasticook Valley Health Pittsfield, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 10 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · bothfrom % of charges | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 11 | St Luke's McCall, LTD McCall, ID percent of total billed charges · bothfrom % of charges | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 12 | St Luke's Nampa Medical Center, LTD Nampa, ID percent of total billed charges · bothfrom % of charges | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 13 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 14 | St Luke's Wood River Medical Center, LTD Ketchum, ID percent of total billed charges · bothfrom % of charges | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 15 | The Aroostook Medical Center Isle, ME professional · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
← Payers reporting HCPCS A4564 · Snapshot 20261113T090226Z-3ce6c0b8