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
$8.2k
Median
$6.8k
High
$117.4k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1134 hospitals; the 90th percentile is 5.4× 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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1,597 hospital rates
iThe hospitals that file a Cigna 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 | 3 | $1.7k | $3.3k | $6.1k | 183% | 212–2,120 | $41 – $45k |
| 2 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 4 | $1.8k | $3.9k | $8.2k | 209% | 196–1,960 | $57 – $60k |
| 3 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 3 | $1.6k | $3.3k | $5.8k | 178% | 195–1,950 | $36 – $45k |
| 4 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 1 | $2.3k | $4.3k | $8.6k | 197% | 169–1,690 | $57 – $57k |
| 5 | East Carolina Health Ahoskie, NC percent of total billed charges · bothfrom % of charges | 8 | $13.5k | $15.0k | $11.8k | 79% | 148–1,480 | $0 – $42.1k |
| 6 | Pitt County Memorial Hospital, Inc. Greenville, NC percent of total billed charges · bothfrom % of charges | 8 | $11.3k | $13.4k | $10.7k | 80% | 148–1,480 | $0 – $43.4k |
| 7 | Pitt County Memorial Hospital, Inc. Washington, NC percent of total billed charges · bothfrom % of charges | 8 | $11.3k | $13.4k | $10.7k | 80% | 148–1,480 | $0 – $43.4k |
| 8 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX percent of total billed charges · outpatientfrom % of charges | 1 | $8.6k | $11.0k | $9.4k | 86% | 111–1,110 | $1.1k – $64.6k |
| 9 | Christian Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 4 | $2.7k | $5.2k | $7.9k | 152% | 110–1,100 | $144 – $57.4k |
| 10 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 4 | $4.4k | $6.4k | $8.0k | 125% | 108–1,080 | $75 – $61.6k |
| 11 | Mercy Hospital Oklahoma City Inc City, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $3.5k | $3.7k | $1.9k | 51% | 70–700 | $650 – $7.8k |
| 12 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 2 | $4.2k | $5.6k | $6.4k | 115% | 67–670 | $46 – $48.6k |
| 13 | Saint Marys Hospital Waterbury, CT facility · percent of total billed charges · bothfrom % of charges | 2 | $3.2k | $4.4k | $4.4k | 100% | 67–670 | $69 – $23.6k |
| 14 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $4.4k | $5.4k | $4.6k | 86% | 66–660 | $90 – $20.7k |
| 15 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2.0k | $2.8k | $2.7k | 95% | 65–650 | $3 – $12.2k |
| 16 | Vanderbilt University Medical Center Nashville, TN percent of total billed charges · bothfrom % of charges | 5 | $3.8k | $5.5k | $6.5k | 119% | 63–72 | $71 – $58.5k |
| 17 | St Joseph Mercy Oakland Pontiac, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $4.2k | $4.7k | $4.2k | 89% | 61–610 | $3 – $21.2k |
| 18 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $3.2k | $3.1k | $2.3k | 74% | 60–600 | $85 – $9.9k |
| 19 | 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 |
| 20 | Piedmont Atlanta Atlanta, GA percent of total billed charges · bothfrom % of charges | 2 | $6.1k | $6.7k | $3.8k | 56% | 51–510 | $156 – $21.7k |
| 21 | Piedmont Columbus Regional - Northside Columbus, GA percent of total billed charges · bothfrom % of charges | 4 | $6.0k | $6.5k | $3.6k | 55% | 51–510 | $148 – $21.7k |
| 22 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $6.3k | $6.5k | $3.8k | 58% | 49–490 | $1.3k – $16.5k |
| 23 | Stony Brook University Hospital Stony Brook, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.9k | $3.9k | — | — | 46–460 | $3.9k – $3.9k |
| 24 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $3.8k | $4.3k | $2.3k | 55% | 42–420 | $280 – $11.7k |
| 25 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $6.4k | $6.8k | $3.8k | 56% | 31–310 | $1.3k – $16.5k |
← Payers reporting HCPCS C1778 · Snapshot 20261111T120946Z-9134e7f7