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
Fee Schedule
Low
$8
Average
$109
Median
$93
High
$317
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
57 hospitals; the 90th percentile is 11.3× 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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69 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Aurelia Osborn Fox Memorial Society Oneonta, NY facility · percent of total billed charges · outpatientfrom % of charges | 11 | $119 | $121 | $46 | 38% | — | $35 – $161 |
| 2 | Bristol Regional Medical Center BRISTOL, VA fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 3 | Bronson Battle Creek Hospital Battle Creek, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 4 | Bronson LakeView Hospital Paw Paw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 5 | Bronson Methodist Hospital Kalamazoo, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 6 | Bronson South Haven Hospital South Haven, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 7 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · fee schedule · outpatient | 6 | $100 | $150 | $71 | 47% | — | $100 – $251 |
| 8 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 4 | $96 | $93 | $4 | 5% | — | $86 – $97 |
| 9 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $8 | $8 | $1 | 7% | — | $8 – $9 |
| 10 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $8 | $8 | $1 | 7% | — | $8 – $9 |
| 11 | Dickenson Community Hospital CLINTWOOD, VA fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 12 | Dickenson Community Hospital CLINTWOOD, VA percent of total billed charges · bothfrom % of charges | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 13 | Doylestown Hospital Doylestown, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 14 | Doylestown Hospital Doylestown, PA facility · percent of total billed charges · outpatientfrom % of charges | 4 | $69 | $67 | $10 | 15% | — | $52 – $79 |
| 15 | Franklin Woods Community Hospital JOHNSON CITY, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 16 | GLENS FALLS HOSPITAL INC Falls, NY facility · fee schedule · outpatient | 3 | $306 | $317 | $31 | 10% | — | $287 – $359 |
| 17 | Greeneville Community Hospital GREENEVILLE, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 18 | Hancock County Hospital SNEEDVILLE, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 19 | Hancock County Hospital SNEEDVILLE, TN percent of total billed charges · bothfrom % of charges | 2 | $176 | $176 | $3 | 1% | — | $173 – $178 |
| 20 | Hawkins County Memorial Hospital ROGERSVILLE, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 21 | HealthAlliance Hospital Kingston, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 22 | HealthAlliance Hospital Kingston, NY facility · percent of total billed charges · outpatientfrom % of charges | 5 | $217 | $226 | $42 | 19% | — | $180 – $299 |
| 23 | Holston Valley Medical Center KINGSPORT, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 24 | Indian Path Community Hospital KINGSPORT, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 25 | Johnson City Medical Center JOHNSON CITY, TN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
← Payers reporting HCPCS G0431 · Snapshot 20261112T181611Z-3fa9fb76