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
Mra Pelvis W&W/O Contrast
Low
$356
Average
$1.1k
Median
$1.2k
High
$2.1k
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 2.9× 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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31 hospital rates
iThe hospitals that file a Excellus 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 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $356 | $356 | — | — | — | $356 – $356 |
| 2 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 3 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 2 | $990 | $990 | $212 | 21% | — | $778 – $1.2k |
| 4 | Highland Hospital Rochester, NY fee schedule · outpatient | 3 | $614 | $574 | $57 | 10% | — | $494 – $614 |
| 5 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 7 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $937 | $937 | — | — | — | $937 – $937 |
| 8 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 9 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 2 | $466 | $466 | — | — | — | $466 – $466 |
| 10 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $356 | $356 | — | — | — | $356 – $356 |
| 11 | Mishawaka Medical Center Mishawaka, IN facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 12 | Mount Carmel East Reynoldsburg, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 13 | Mount Carmel Grove City Grove City, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 14 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 15 | Mount Carmel St Ann's Lewis Center, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 16 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 2 | $754 | $754 | — | — | — | $754 – $754 |
| 17 | Plymouth Medical Center Plymouth, IN facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 18 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 19 | Saint Francis Hospital and Medical Center Hartford, CT facility · other · both | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 20 | Saint Marys Hospital Waterbury, CT facility · other · both | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 21 | Samaritan Hospital Troy, NY facility · fee schedule · both | 2 | $836 | $836 | $300 | 36% | — | $535 – $1.1k |
| 22 | Samaritan Hospital Troy, NY facility · other · both | 1 | $479 | $479 | — | — | — | $479 – $479 |
| 23 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 24 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $955 | $1.1k | $705 | 67% | — | $321 – $2.0k |
| 25 | St Josephs Hospital Health Center Syracuse, NY facility · fee schedule · both | 2 | $505 | $505 | — | — | — | $505 – $505 |
← Payers reporting HCPCS C8920 · Snapshot 20261111T120946Z-9134e7f7