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
Current percep threshold tst
Low
$77
Average
$357
Median
$272
High
$719
Each hospital's average Humana rate, under the methodology and billing class chosen below.
78 hospitals; the 90th percentile is 7.5× 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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78 hospital rates
iThe hospitals that file a Humana 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 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 2 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 3 | CHRISTUS Health - Pine Street Texarkana, TX fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 4 | CHRISTUS Hospital - Orange Orange, TX fee schedule · outpatient | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 5 | CHRISTUS West Beaumont Beaumont, TX fee schedule · outpatient | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 6 | Children's Hospital San Antonio, TX fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 7 | Christus Health Southeast Texas Beaumont, TX fee schedule · outpatient | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 8 | Christus Health Southeast Texas Port Arthur, TX fee schedule · outpatient | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 9 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 10 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 11 | HCA HOUSTON HEALTHCARE CONROE CONROE, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 12 | HCA HOUSTON HEALTHCARE KINGWOOD KINGWOOD, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 13 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 14 | HCA HOUSTON HEALTHCARE NORTHWEST HOUSTON, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 15 | HCA HOUSTON HEALTHCARE PEARLAND HOUSTON, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 16 | HCA HOUSTON HEALTHCARE SOUTHEAST HOUSTON, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 17 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 18 | HCA HOUSTON HEALTHCARE WEST STAFFORD, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 19 | HCA HOUSTON MAINLAND Texas City, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 20 | HCA Houston Rehabilitation Hospital Southeast Pasadena, TX fee schedule · outpatient | 2 | $719 | $719 | — | — | — | $719 – $719 |
| 21 | Highland Medical Center - Shreveport Shreveport, LA fee schedule · outpatient | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 22 | MED CITY HEART HOSPITAL Dallas, TX fee schedule · outpatient | 1 | $528 | $528 | — | — | — | $528 – $528 |
| 23 | MED CITY SPINE HOSPITAL DALLAS, TX fee schedule · outpatient | 1 | $528 | $528 | — | — | — | $528 – $528 |
| 24 | MEDICAL CITY ALLIANCE HASLET, TX fee schedule · outpatient | 1 | $528 | $528 | — | — | — | $528 – $528 |
| 25 | MEDICAL CITY ARLINGTON GRAND PRAIRIE, TX fee schedule · outpatient | 1 | $528 | $528 | — | — | — | $528 – $528 |
← Payers reporting HCPCS G0255 · Snapshot 20261112T124536Z-e251e855