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
CAPSULE BRAVO DEL SYSTEM
Low
$11
Average
$337
Median
$123
High
$2.0k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
40 hospitals; the 90th percentile is 63.3× 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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45 hospital rates
iThe hospitals that file a Molina 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 2 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $398 | $398 | — | — | — | $398 – $398 |
| 3 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 4 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 5 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 9 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · inpatientfrom % of charges | 2 | $63 | $63 | — | — | — | $63 – $63 |
| 10 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $63 | $63 | — | — | — | $63 – $63 |
| 11 | Carle Eureka Hospital Eureka, IL percent of total billed charges · inpatientfrom % of charges | 2 | $63 | $63 | — | — | — | $63 – $63 |
| 12 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 2 | $108 | $108 | $44 | 41% | — | $63 – $152 |
| 13 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 14 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 15 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 16 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 17 | Highland Hospital Rochester, NY fee schedule · outpatient | 2 | $305 | $305 | $162 | 53% | — | $142 – $467 |
| 18 | Kalkaska Memorial Health Center Kalkaska, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $200 | $200 | $166 | 83% | — | $34 – $367 |
| 19 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 20 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 21 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 22 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 23 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 2 | $713 | $713 | $185 | 26% | — | $529 – $898 |
| 24 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $795 | $795 | — | — | — | $795 – $795 |
| 25 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
← Payers reporting HCPCS A9279 · Snapshot 20261111T120946Z-9134e7f7