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
Fee Schedule
Low
$13
Average
$218
Median
$124
High
$790
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
39 hospitals; the 90th percentile is 12.3× 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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62 hospital rates
iThe 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 2 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY percent of total billed charges · outpatientfrom % of charges | 1 | $526 | $526 | — | — | — | $526 – $526 |
| 3 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $606 | $606 | $369 | 61% | — | $237 – $974 |
| 4 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $593 | $593 | $382 | 64% | — | $211 – $974 |
| 5 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 2 | $790 | $790 | $184 | 23% | — | $606 – $974 |
| 6 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 2 | $599 | $599 | $375 | 63% | — | $224 – $974 |
| 7 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 2 | $599 | $599 | $375 | 63% | — | $224 – $974 |
| 8 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 2 | $579 | $579 | $395 | 68% | — | $184 – $974 |
| 9 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 10 | BRFHH MONROE, LLC Monroe, LA percent of total billed charges · outpatientfrom % of charges | 1 | $79 | $79 | $7 | 9% | — | $72 – $87 |
| 11 | Deaconess Health System Henderson Hospital Henderson, KY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $232 | $232 | $138 | 59% | — | $95 – $370 |
| 12 | Deaconess Health System Union County Hospital Morganfield, KY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $331 | $331 | — | — | — | $331 – $331 |
| 13 | Deaconess Health System Union County Hospital Morganfield, KY facility · percent of total billed charges · outpatientfrom % of charges | 3 | $161 | $214 | $83 | 39% | — | $151 – $331 |
| 14 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $292 | $260 | $105 | 40% | — | $118 – $370 |
| 15 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 16 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA percent of total billed charges · outpatientfrom % of charges | 1 | $100 | $100 | $13 | 13% | — | $87 – $113 |
| 17 | HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LOUISIANA LULING, LA other · outpatient | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 18 | HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LOUISIANA LULING, LA percent of total billed charges · outpatientfrom % of charges | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 19 | HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUISIANA Chalmette, LA other · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 20 | KAPLAN GENERAL HOSPITAL, INC ST, LA other · outpatient | 1 | $360 | $360 | $96 | 27% | — | $264 – $456 |
| 21 | KAPLAN GENERAL HOSPITAL, INC ST, LA percent of total billed charges · outpatientfrom % of charges | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 22 | Kemper CAH, Inc. DeKalb, MS other · outpatient | 1 | $198 | $198 | — | — | — | $198 – $198 |
| 23 | Kemper CAH, Inc. DeKalb, MS percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 24 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 25 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA percent of total billed charges · outpatientfrom % of charges | 1 | $306 | $306 | — | — | — | $306 – $306 |
← Payers reporting HCPCS A7042 · Snapshot 20261112T181611Z-3fa9fb76