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
HC VISIT TO DETERM LDCT ELIG
Low
$19
Average
$78
Median
$50
High
$287
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
28 hospitals; the 90th percentile is 6.3× 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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51 hospital rates
iThe hospitals that file a Excellus 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 | CLIFTON-FINE HEALTHCARE CORPORATION STAR LAKE, NY fee schedule · outpatient | 2 | $88 | $88 | $35 | 40% | — | $53 – $124 |
| 2 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 2 | $26 | $26 | $2 | 9% | — | $24 – $28 |
| 3 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 4 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 5 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $24 | $27 | $6 | 23% | — | $21 – $35 |
| 6 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 5 | $25 | $62 | $95 | 153% | — | $19 – $350 |
| 7 | Highland Hospital Rochester, NY fee schedule · outpatient | 7 | $144 | $108 | $74 | 69% | — | $23 – $182 |
| 8 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 9 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 2 | $49 | $49 | $26 | 53% | — | $23 – $75 |
| 10 | MVHS, Inc. Utica, NY other · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 11 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 3 | $17 | $28 | $13 | 47% | — | $17 – $44 |
| 12 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 8 | $25 | $32 | $27 | 86% | — | $19 – $136 |
| 13 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 14 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 2 | $31 | $31 | $9 | 30% | — | $22 – $40 |
| 15 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $36 | $36 | $8 | 23% | — | $27 – $44 |
| 16 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 17 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 2 | $36 | $36 | $8 | 23% | — | $27 – $44 |
| 18 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 19 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 20 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 5 | $25 | $52 | $68 | 130% | — | $19 – $219 |
| 21 | Saint Alphonsus Medical Center - Baker City Baker City, OR professional · fee schedule · inpatient | 3 | $22 | $30 | $12 | 41% | — | $21 – $47 |
| 22 | Saint Alphonsus Medical Center - Baker City Baker City, OR professional · fee schedule · outpatient | 3 | $22 | $30 | $12 | 41% | — | $21 – $47 |
| 23 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 24 | Saint Alphonsus Medical Center - Nampa Nampa, ID professional · fee schedule · inpatient | 3 | $23 | $32 | $16 | 50% | — | $19 – $55 |
| 25 | Saint Alphonsus Medical Center - Nampa Nampa, ID professional · fee schedule · outpatient | 3 | $21 | $29 | $15 | 52% | — | $15 – $50 |
← Payers reporting HCPCS G0296 · Snapshot 20261111T120946Z-9134e7f7