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
$18
Average
$52
Median
$56
High
$84
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
7 hospitals; the 90th percentile is 3.4× 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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9 hospital rates
iThe hospitals that file a Anthem 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 | Black River Health Inc Black River Falls, WI facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 2 | Black River Health Inc Black River Falls, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 3 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 4 | $14 | $16 | $3 | 20% | — | $14 – $22 |
| 4 | Dukes Health System LLC Peru, IN facility · other · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 5 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 6 | MaineHealth Rockport, ME fee schedule · both | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 7 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 8 | Thedacare Regional Medical Center-Neenah Inc WI 54904-6926; 2400 Witzel Ave. Suite C Oshkosh, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $66 | $66 | $10 | 16% | — | $56 – $77 |
| 9 | Thedacare Regional Medical Center-Wild Rose Inc Wild Rose, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
← Payers reporting HCPCS G0437 · Snapshot 20261112T181611Z-3fa9fb76