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
COLON CA SCRN NOT HI RSK IND
The hospitals that file a First Health 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.
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460 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AHS Cushing Hospital, LLC Cushing, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $3,781 | $3,331 – $4,230 |
| 2 | AHS Henryetta Hospital, LLC Henryetta, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $8,167 | $7,200 – $9,133 |
| 3 | AHS Pryor Hospital, LLC Pryor, OK facility · percent of total billed charges · bothfrom % of charges | 1 | $2,928 | $2,928 – $2,928 |
| 4 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4,689 | $4,689 – $4,689 |
| 5 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4,689 | $4,689 – $4,689 |
| 6 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4,689 | $4,689 – $4,689 |
| 7 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4,689 | $4,689 – $4,689 |
| 8 | AdventHealth Deland Deland, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 9 | Adventhealth Carrollwood Tampa, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 10 | Adventhealth Daytona Beach Port Orange, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 11 | Adventhealth Heart of Florida Winter Haven, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 12 | Adventhealth Lake Wales Lake Wales, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 13 | Adventhealth Ocala Ocala, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 14 | Adventhealth Palm Coast Palm Coast, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 15 | Adventhealth Palm Coast Parkway Palm Coast, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 16 | Adventhealth Tampa Brandon, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 17 | Adventhealth Waterman Tavares, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 18 | Adventhealth Wesley Chapel Lutz, FL fee schedule · outpatient | 1 | $971.14 | $971.14 – $971.14 |
| 19 | Affinity Hospital LLC Birmingham, AL facility · other · outpatient | 1 | $3,500 | $3,500 – $3,500 |
| 20 | Affinity Hospital LLC Birmingham, AL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18,583 | $18,583 – $18,583 |
| 21 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $2,134 | $1,207 – $3,061 |
| 22 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $1,524 | $1,524 – $1,524 |
| 23 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $744.74 | $451.72 – $1,038 |
| 24 | Bexar County Hospital District San Antonio, TX case rate · outpatient | 1 | $369.00 | $369.00 – $369.00 |
| 25 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 2 | $592.29 | $328.50 – $856.08 |
← Payers reporting HCPCS G0121 · Snapshot 20261108T203506Z-bb90dbab