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
Cyto Vag/Cer W/Manu W/Phy Sup
Low
$10
Average
$35
Median
$26
High
$153
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 3.5× 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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35 hospital rates
iThe hospitals that file a Medicaid 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 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $56 | $56 | $15 | 28% | 32 | $41 – $72 |
| 2 | Allina Health Systems Shakopee, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 3 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 4 | Allina Health Systems Owatonna, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 5 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 6 | Allina Health Systems Cambridge, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 7 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 8 | Allina Health Systems Minneapolis, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 9 | Allina Health Systems Buffalo, MN facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 10 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 11 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 12 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 13 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA fee schedule · both | 3 | $18 | $18 | $2 | 14% | — | $14 – $20 |
| 14 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 15 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 16 | Mercy Hospital Berryville Berryville, AR facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 17 | Mercy Hospital Carthage Carthage, MO facility · fee schedule · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 18 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 19 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 20 | Mercy Hospital Jefferson Imperial, MO facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 21 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 22 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 23 | Mercy Hospital Lincoln Troy, MO facility · fee schedule · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 24 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 25 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
← Payers reporting HCPCS G0145 · Snapshot 20261111T120946Z-9134e7f7