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
Fee Schedule
Low
$0
Average
$3948.7k
Median
$3885k
High
$10413.0k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 1.3× 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.
Filter by billing methodology
Filter by billing class
21 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Bradley Medical Center Cleveland, TN facility · fee schedule · outpatient | 2 | $10413.0k | $10413.0k | $2442.6k | 23% | — | $7970.5k – $12855.6k |
| 2 | Deaconess Health System Henderson Hospital Henderson, KY facility · case rate · outpatient | 2 | $3547.3k | $3547.3k | — | — | — | $3547.3k – $3547.3k |
| 3 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $3812.4k | $3812.4k | — | — | — | $3812.4k – $3812.4k |
| 4 | GLENS FALLS HOSPITAL INC Falls, NY facility · fee schedule · outpatient | 3 | $4200k | $4200k | — | — | — | $4200k – $4200k |
| 5 | Hoag Memorial Hospital Presbyterian Irvine, CA facility · fee schedule · outpatient | 3 | $6300k | $6300k | — | — | — | $6300k – $6300k |
| 6 | NorCal HealthConnect LLC Healdsburg, CA fee schedule · outpatient | 2 | $3570k | $3570k | — | — | — | $3570k – $3570k |
| 7 | Northern Cochise Community Hospital Willcox, AZ facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Providence Health System - Southern California Santa Monica, CA fee schedule · outpatient | 4 | $3570k | $3570k | — | — | — | $3570k – $3570k |
| 9 | Providence Health System - Southern California Burbank, CA fee schedule · outpatient | 4 | $3990k | $3885k | $181.9k | 5% | — | $3570k – $3990k |
| 10 | Providence Health System - Southern California Mission Hills, CA fee schedule · outpatient | 4 | $3990k | $3885k | $181.9k | 5% | — | $3570k – $3990k |
| 11 | Providence Health System - Southern California Torrance, CA fee schedule · outpatient | 5 | $3990k | $3906k | $168k | 4% | — | $3570k – $3990k |
| 12 | Providence Health System - Southern California San Pedro, CA fee schedule · outpatient | 5 | $3990k | $3906k | $168k | 4% | — | $3570k – $3990k |
| 13 | Resnick Neuropsychiatric Hospital at UCLA Los Angeles, CA fee schedule · outpatient | 2 | $3570k | $3570k | — | — | — | $3570k – $3570k |
| 14 | Ronald Reagan UCLA Medical Center Los Angeles, CA fee schedule · outpatient | 2 | $3570k | $3570k | — | — | — | $3570k – $3570k |
| 15 | Santa Monica UCLA Medical Center and Orthopaedic Hospital Santa Monica, CA fee schedule · outpatient | 2 | $3570k | $3570k | — | — | — | $3570k – $3570k |
| 16 | St Josephs Hospital - Savannah Savannah, GA fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Tarzana Medical Center LLC Tarzana, CA fee schedule · outpatient | 4 | $3990k | $3885k | $181.9k | 5% | — | $3570k – $3990k |
| 18 | The University of Tennessee Medical Center Knoxville, TN facility · fee schedule · outpatient | 7 | $4190.8k | $4434.6k | $577.5k | 13% | — | $3783.2k – $5253.4k |
| 19 | UCSF Langely Porter Psychiatic Hospital San Francisco, CA fee schedule · outpatient | 4 | $4663.7k | $4663.7k | — | — | — | $4663.7k – $4663.7k |
| 20 | Ucsf Medical Center San Francisco, CA fee schedule · outpatient | 4 | $4663.7k | $4663.7k | — | — | — | $4663.7k – $4663.7k |
| 21 | University of California Davis Medical Center Sacramento, CA fee schedule · outpatient | 3 | $3570k | $3570k | — | — | — | $3570k – $3570k |
← Payers reporting HCPCS C9172 · Snapshot 20261113T090226Z-3ce6c0b8