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
PATIENT TRIAL KIT - NOVI AND MONTAGE SAFE
Low
$0
Average
$8.1k
Median
$5.8k
High
$253.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1282 hospitals; the 90th percentile is 8.3× 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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1,893 hospital rates
iThe hospitals that file a Aetna 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 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 4 | $1.9k | $3.8k | $6.9k | 182% | 212–2,120 | $45 – $54k |
| 2 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $1.8k | $3.9k | $8.1k | 209% | 196–1,960 | $57 – $57k |
| 3 | Vanderbilt University Medical Center Nashville, TN percent of total billed charges · bothfrom % of charges | 10 | $3.0k | $4.2k | $4.9k | 117% | 145–1,288 | $65 – $42.6k |
| 4 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $4.2k | $5.6k | $6.4k | 115% | 134–1,340 | $47 – $48.6k |
| 5 | Duke University Hospital Durham, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $8.5k | $8.0k | $5.0k | 63% | 97–970 | $1 – $29.7k |
| 6 | Duke University Hospital Raleigh, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $8.5k | $8.0k | $5.0k | 63% | 97–970 | $1 – $29.7k |
| 7 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN percent of total billed charges · bothfrom % of charges | 7 | $3.5k | $5.9k | $5.9k | 100% | 65–650 | $418 – $42.0k |
| 8 | Saint Francis Hospital and Medical Center Hartford, CT facility · percent of total billed charges · bothfrom % of charges | 2 | $2.1k | $2.6k | $2.2k | 84% | 65–650 | $50 – $10.0k |
| 9 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 3 | $1.2k | $1.7k | $1.6k | 98% | 65–650 | $2 – $8.8k |
| 10 | St Josephs Hospital Health Center Syracuse, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $3.7k | $4.6k | $3.9k | 85% | 63–630 | $81 – $17.3k |
| 11 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 2 | $1.8k | $2.4k | $2.1k | 87% | 62–620 | $3 – $9.8k |
| 12 | Self Regional Healthcare Greenwood, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $7.4k | $8.8k | $7.4k | 83% | 58–580 | $219 – $32.8k |
| 13 | St Peters Hospital Albany, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $2.0k | $2.6k | $2.3k | 90% | 58–580 | $40 – $9.8k |
| 14 | Saint Marys Hospital Waterbury, CT facility · percent of total billed charges · bothfrom % of charges | 2 | $3.0k | $3.2k | $2.1k | 68% | 54–540 | $510 – $10.0k |
| 15 | Piedmont Atlanta Atlanta, GA percent of total billed charges · bothfrom % of charges | 2 | $12.8k | $13.6k | $8.6k | 63% | 49–490 | $2.8k – $40.1k |
| 16 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 2 | $12.8k | $13.6k | $8.6k | 63% | 49–490 | $2.8k – $40.1k |
| 17 | Piedmont Cartersville Cartersville, GA percent of total billed charges · bothfrom % of charges | 2 | $12.8k | $13.6k | $8.6k | 63% | 49–490 | $2.8k – $40.1k |
| 18 | Piedmont Eastside Snellville, GA percent of total billed charges · bothfrom % of charges | 2 | $12.8k | $13.6k | $8.6k | 63% | 49–490 | $2.8k – $40.1k |
| 19 | Piedmont Fayette Fayetteville, GA percent of total billed charges · bothfrom % of charges | 2 | $12.8k | $13.6k | $8.6k | 63% | 49–490 | $2.8k – $40.1k |
| 20 | Piedmont Rockdale Conyers, GA percent of total billed charges · bothfrom % of charges | 2 | $12.8k | $13.6k | $8.6k | 63% | 49–490 | $2.8k – $40.1k |
| 21 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 11 | $1.1k | $1.3k | $844 | 65% | 49–490 | $535 – $6.5k |
| 22 | Stony Brook University Hospital Stony Brook, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.5k | $4.5k | — | — | 46–460 | $4.5k – $4.5k |
| 23 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 4 | $454 | $2.2k | $3.1k | 141% | 45–450 | $0 – $10.0k |
| 24 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $5.0k | $5.6k | $3.1k | 55% | 42–420 | $366 – $15.3k |
| 25 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $8.7k | $20.6k | $24.5k | 119% | 40–400 | $38 – $89.0k |
← Payers reporting HCPCS C1778 · Snapshot 20261111T120946Z-9134e7f7