Low
$45
Average
$91
Median
$100
High
$125
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 2.8× 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.
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10 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 3 | $71 | $56 | $20 | 36% | — | $28 – $71 |
| 2 | Adventhealth Central Texas Killeen, TX fee schedule · outpatient | 2 | $118 | $118 | $8 | 7% | — | $110 – $126 |
| 3 | Adventhealth Rollins Brook Lampasas, TX fee schedule · outpatient | 2 | $118 | $118 | $8 | 7% | — | $110 – $126 |
| 4 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 2 | $45 | $45 | — | — | — | $45 – $45 |
| 5 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 4 | $126 | $125 | $21 | 16% | — | $97 – $148 |
| 6 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 4 | $126 | $125 | $21 | 16% | — | $97 – $148 |
| 7 | Methodist Children's Hospital Lubbock, TX fee schedule · outpatient | 4 | $126 | $125 | $21 | 16% | — | $97 – $148 |
| 8 | Methodist Hospital Levelland Levelland, TX fee schedule · outpatient | 4 | $80 | $82 | $12 | 15% | — | $68 – $101 |
| 9 | Methodist Hospital Plainview Plainview, TX fee schedule · outpatient | 4 | $74 | $76 | $13 | 18% | — | $60 – $94 |
| 10 | Nebraska Medical Center Omaha, NE percent of total billed charges · outpatientfrom % of charges | 2 | $45 | $45 | — | — | — | $45 – $45 |
← Payers reporting HCPCS G2058 · Snapshot 20261112T124536Z-e251e855