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
PET/CT NONCOV INT DIAG BREAST
Low
$72
Average
$2.5k
Median
$1.2k
High
$9.7k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 14.8× 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.
Filter by billing methodology
Filter by billing class
62 hospital rates
iThe hospitals that file a Molina 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 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $540 | $540 | — | — | — | $540 – $540 |
| 2 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $236 | $236 | — | — | — | $236 – $236 |
| 3 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 4 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 5 | Baptist Memorial Hospital-Booneville Booneville, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 6 | Baptist Memorial Hospital-Booneville Booneville, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 7 | Baptist Memorial Hospital-DeSoto Southaven, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 8 | Baptist Memorial Hospital-DeSoto Southaven, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 9 | Baptist Memorial Hospital-Union County New Albany, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 10 | Baptist Memorial Hospital-Union County New Albany, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 11 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 12 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 13 | ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · outpatient | 3 | $1.9k | $2.7k | $1.1k | 42% | — | $1.9k – $4.3k |
| 14 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $743 | $743 | — | — | — | $743 – $743 |
| 15 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · case rate · outpatient | 1 | $871 | $871 | — | — | — | $871 – $871 |
| 16 | Gottlieb Memorial Hospital Melrose Park, IL facility · case rate · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 17 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $631 | $631 | — | — | — | $631 – $631 |
| 18 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · fee schedule · outpatient | 1 | $631 | $631 | — | — | — | $631 – $631 |
| 19 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 20 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 2 | $927 | $927 | $23 | 2% | — | $905 – $950 |
| 21 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · case rate · outpatient | 1 | $905 | $905 | — | — | — | $905 – $905 |
| 22 | Kirby Medical Center Monticello, IL professional · fee schedule · both | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 23 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 24 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · case rate · outpatient | 2 | $950 | $950 | — | — | — | $950 – $950 |
| 25 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
← Payers reporting HCPCS G0252 · Snapshot 20261111T120946Z-9134e7f7