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
Consult slides prep elsewher
Low
$1
Average
$250
Median
$299
High
$544
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 3.0× 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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23 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $109 | $140 | $52 | 37% | — | $90 – $204 |
| 2 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 2 | $299 | $299 | — | — | — | $299 – $299 |
| 3 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 2 | $299 | $299 | — | — | — | $299 – $299 |
| 4 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 2 | $299 | $299 | — | — | — | $299 – $299 |
| 5 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 4 | $1 | $1 | $0 | 43% | — | $0 – $1 |
| 6 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · case rate · outpatient | 3 | $167 | $142 | $36 | 26% | — | $91 – $167 |
| 7 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · fee schedule · outpatient | 4 | $188 | $190 | $16 | 9% | — | $171 – $215 |
| 8 | East Alabama Medical Center OPELIKA, AL facility · fee schedule · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 9 | East Alabama Medical Center OPELIKA, AL professional · fee schedule · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 10 | Essentia Health Duluth Duluth, MN facility · fee schedule · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 11 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · fee schedule · outpatient | 2 | $299 | $299 | — | — | — | $299 – $299 |
| 12 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · fee schedule · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 13 | Essentia Health St. Mary's - Detroit Lakes 1027 Washington Ave. Detroit Lakes, MN facility · fee schedule · outpatient | 2 | $299 | $299 | — | — | — | $299 – $299 |
| 14 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · fee schedule · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 15 | Essentia Health St. Mary's Medical Center Duluth, MN facility · fee schedule · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 16 | Essentia Health Virginia 901 9th St N Virginia, MN facility · fee schedule · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 17 | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE PAUL, MN professional · fee schedule · outpatient | 2 | $275 | $275 | $24 | 9% | — | $251 – $299 |
| 18 | GLENS FALLS HOSPITAL INC Falls, NY facility · case rate · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 19 | Garnet Health Medical Center Middletown, NY facility · fee schedule · outpatient | 2 | $512 | $512 | $96 | 19% | — | $416 – $608 |
| 20 | Garnet Health Medical Center Catskills Harris, NY facility · fee schedule · outpatient | 1 | $544 | $544 | — | — | — | $544 – $544 |
| 21 | John H. Stroger, Jr. Hospital Chicago, IL fee schedule · both | 2 | $141 | $141 | $15 | 10% | — | $126 – $155 |
| 22 | SSM-SLUH, Inc. Saint Louis, MO fee schedule · outpatient | 4 | $146 | $174 | $67 | 39% | — | $86 – $297 |
| 23 | Saratoga Hospital Saratoga Springs, NY facility · case rate · outpatient | 3 | $172 | $146 | $37 | 26% | — | $93 – $172 |
← Payers reporting HCPCS D0484 · Snapshot 20261112T124536Z-e251e855