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
HC Xe133 Dx per 10mci
Low
$26
Average
$359
Median
$281
High
$1.5k
Each hospital's average Optum rate, under the methodology and billing class chosen below.
61 hospitals; the 90th percentile is 8.6× 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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73 hospital rates
iThe hospitals that file a Optum 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 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $57 | $57 | — | — | 1–10 | $57 – $57 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 3 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 4 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $283 | $283 | — | — | — | $283 – $283 |
| 5 | Affinity Hospital LLC Birmingham, AL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 7 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · outpatient | 3 | $347 | $467 | $234 | 50% | — | $259 – $793 |
| 8 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 9 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 10 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · percent of total billed charges · bothfrom % of charges | 2 | $228 | $228 | $7 | 3% | — | $222 – $235 |
| 11 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $216 | $216 | — | — | — | $216 – $216 |
| 12 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $111 | $111 | — | — | — | $111 – $111 |
| 13 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 14 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 15 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 16 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 17 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 18 | Centinela Hospital Medical Center Inglewood, CA fee schedule · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 19 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 1 | $220 | $220 | — | — | — | $220 – $220 |
| 20 | Fairview Health Services Minneapolis, MN fee schedule · both | 2 | $415 | $415 | — | — | — | $415 – $415 |
| 21 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 22 | Fairview Hospital Cleveland, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $260 | $260 | — | — | — | $260 – $260 |
| 23 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 1 | $273 | $273 | — | — | — | $273 – $273 |
| 24 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA percent of total billed charges · outpatientfrom % of charges | 2 | $484 | $484 | — | — | — | $484 – $484 |
| 25 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $82 | $82 | — | — | — | $82 – $82 |
← Payers reporting HCPCS A9558 · Snapshot 20261111T120946Z-9134e7f7