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
Whlchr special size/constrc
Low
$871
Average
$1.4k
Median
$1.6k
High
$1.6k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
14 hospitals; the 90th percentile is 1.9× 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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14 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 2 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 3 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 4 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 5 | KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN Honolulu, HI facility · fee schedule · outpatient | 1 | $335 | $905 | $1.0k | 113% | — | $268 – $2.7k |
| 6 | PALI MOMI MEDICAL CENTER Aiea, HI facility · fee schedule · outpatient | 1 | $268 | $871 | $1.0k | 120% | — | $268 – $2.7k |
| 7 | SAINT VINCENT HEALTH CENTER ERIE, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 8 | STRAUB CLINIC & HOSPITAL Honolulu, HI facility · fee schedule · outpatient | 1 | $268 | $871 | $1.0k | 120% | — | $268 – $2.7k |
| 9 | WEST PENN ALLEGHENY HEALTH SYSTEM INC WEXFORD, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 10 | WEST PENN ALLEGHENY HEALTH SYSTEM INC PITTSBURGH, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 11 | WEST PENN ALLEGHENY HEALTH SYSTEM INC MONROEVILLE, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 12 | WEST PENN ALLEGHENY HEALTH SYSTEM INC PITTSBURGH, PA fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 13 | WESTFIELD MEMORIAL HOSPITAL INC WESTFIELD, NY fee schedule · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 14 | WILCOX MEMORIAL HOSPITAL Lihue, HI facility · fee schedule · outpatient | 1 | $268 | $871 | $1.0k | 120% | — | $268 – $2.7k |
← Payers reporting HCPCS E1220 · Snapshot 20261113T090226Z-3ce6c0b8