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
$1.6k
Average
$3.0k
Median
$2.8k
High
$5.6k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
31 hospitals; the 90th percentile is 2.1× 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 Molina 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 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 2 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 3 | Bartow Regional Medical Center Bartow, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 4 | BayCare Alliant Hospital Dunedin, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 5 | Baycare Hospital Wesley Chapel Chapel, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 6 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 7 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 8 | Gottlieb Memorial Hospital Melrose Park, IL facility · case rate · outpatient | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 9 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 10 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 11 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 12 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 13 | Mease Countryside Hospital Harbor, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 14 | Mease Dunedin Hospital Dunedin, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 15 | Montefiore Medical Center Bronx, NY fee schedule · outpatient | 4 | $2.7k | $3.5k | $1.5k | 41% | — | $2.7k – $6.0k |
| 16 | Montefiore Mount Vernon Hospital Mount Vernon, NY fee schedule · outpatient | 4 | $2.7k | $3.6k | $1.5k | 41% | — | $2.7k – $6.2k |
| 17 | Montefiore New Rochelle Hospital New Rochelle, NY fee schedule · outpatient | 4 | $2.7k | $3.6k | $1.4k | 40% | — | $2.7k – $6.0k |
| 18 | Morton Plant Hospital Clearwater, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 19 | Morton Plant NorthBay Hospital Lutz, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 20 | Sarasota Memorial Hospital Sarasota, FL case rate · outpatient | 2 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 21 | Sarasota Memorial Hospital - Venice North Venice, FL case rate · outpatient | 2 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 22 | South Florida Baptist Hospital City, FL facility · case rate · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 23 | Southern Baptist Hospital of Florida, INC Fleming Island, FL facility · case rate · outpatient | 1 | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 24 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · case rate · outpatient | 1 | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 25 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
← Payers reporting HCPCS C9754 · Snapshot 20261112T181611Z-3fa9fb76