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-Similac Pm 60/40, per Can
Low
$1
Average
$6
Median
$3
High
$37
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 11.0× 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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37 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 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 2 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 3 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 4 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 5 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 6 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 7 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 8 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 9 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 10 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 11 | KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN Honolulu, HI facility · fee schedule · outpatient | 1 | $2 | $2 | $0 | 20% | — | $2 – $2 |
| 12 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 2 | $36 | $37 | $11 | 30% | — | $25 – $57 |
| 13 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 14 | Methodist Medical Center of Illinois Peoria, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 15 | Methodist Medical Center of Illinois Peoria, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 16 | Nebraska Medical Center Omaha, NE other · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 17 | Nebraska Medical Center Omaha, NE percent of total billed charges · outpatientfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 18 | PALI MOMI MEDICAL CENTER Aiea, HI facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 19 | Pekin Memorial Hospital Pekin, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 20 | Pekin Memorial Hospital Pekin, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 21 | Proctor Community Hospital Peoria, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 22 | Proctor Community Hospital Peoria, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 23 | SAINT VINCENT HEALTH CENTER ERIE, PA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 24 | STRAUB CLINIC & HOSPITAL Honolulu, HI facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 25 | South Shore Hospital South Weymouth, MA fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Payers reporting HCPCS B4161 · Snapshot 20261111T120946Z-9134e7f7