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
HB-Cica Care Sheet, per Each
Low
$3
Average
$95
Median
$54
High
$763
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
92 hospitals; the 90th percentile is 45.2× 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.
Filter by billing methodology
Filter by billing class
108 hospital rates
iThe hospitals that file a Anthem 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 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 4 | $52 | $88 | $98 | 111% | 24–240 | $13 – $460 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 3 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $5 | $5 | $1 | 12% | — | $5 – $6 |
| 4 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 5 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $4 | $3 | $2 | 61% | — | $0 – $5 |
| 6 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $29 | $29 | — | — | — | $29 – $29 |
| 7 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 8 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 9 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 10 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 11 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 12 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 2 | $4 | $3 | $2 | 61% | — | $0 – $5 |
| 13 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 14 | Columbus Regional Hospital Columbus, IN per diem · both | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 15 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 2 | $106 | $106 | $2 | 2% | — | $104 – $109 |
| 16 | Curators of the University of Missouri Jefferson City, MO facility · percent of total billed charges · outpatientfrom % of charges | 3 | $303 | $311 | $11 | 4% | — | $303 – $326 |
| 17 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $136 | $136 | $10 | 7% | — | $126 – $146 |
| 18 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 2 | $4 | $3 | $2 | 61% | — | $0 – $5 |
| 19 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 20 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 21 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $109 | $109 | $8 | 7% | — | $101 – $116 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $80 | $80 | $6 | 7% | — | $74 – $85 |
| 24 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 3 | $63 | $67 | $6 | 9% | — | $49 – $73 |
| 25 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
← Payers reporting HCPCS A6025 · Snapshot 20261111T120946Z-9134e7f7