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
Remove unilat space maintain
Low
$72
Average
$918
Median
$923
High
$1.8k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
14 hospitals; the 90th percentile is 19.3× 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.
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14 hospital rates
iThe hospitals that file a Medica 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 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $60 | $72 | $34 | 47% | — | $43 – $126 |
| 2 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $60 | $72 | $34 | 47% | — | $43 – $126 |
| 3 | Curators of the University of Missouri Jefferson City, MO facility · fee schedule · outpatient | 1 | $214 | $214 | — | — | — | $214 – $214 |
| 4 | Essentia Health Duluth Duluth, MN facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 5 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 6 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · fee schedule · outpatient | 1 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 7 | Essentia Health St. Mary's - Detroit Lakes 1027 Washington Ave. Detroit Lakes, MN facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 8 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 9 | Essentia Health St. Mary's Medical Center Duluth, MN facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 10 | Essentia Health Virginia 901 9th St N Virginia, MN facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 11 | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE PAUL, MN professional · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 12 | SSM Health Care of Oklahoma, Inc Midwest City, OK fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 13 | SSM Health Care of Oklahoma, Inc Oklahoma City, OK fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 14 | St. Anthony Shawnee Hospital, Inc Seminole, OK fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
← Payers reporting HCPCS D1520 · Snapshot 20261112T124536Z-e251e855