Low
$25
Average
$52
Median
$43
High
$91
Each hospital's average Molina rate, under the methodology and billing class chosen below.
22 hospitals; the 90th percentile is 2.4× 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.
Filter by billing methodology
Filter by billing class
25 hospital rates
iThe hospitals that file a Molina 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 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 2 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 3 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 4 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 5 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 6 | Gottlieb Memorial Hospital Melrose Park, IL facility · case rate · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 7 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 8 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 9 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 2 | $37 | $37 | $1 | 2% | — | $36 – $38 |
| 10 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 11 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 12 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · case rate · outpatient | 2 | $38 | $38 | — | — | — | $38 – $38 |
| 13 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 14 | Nebraska Medical Center Omaha, NE fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 15 | Nebraska Medical Center Omaha, NE percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 16 | Sarasota Memorial Hospital Sarasota, FL case rate · outpatient | 2 | $39 | $39 | — | — | — | $39 – $39 |
| 17 | Sarasota Memorial Hospital - Venice North Venice, FL case rate · outpatient | 2 | $39 | $39 | — | — | — | $39 – $39 |
| 18 | Southern Baptist Hospital of Florida, INC Fleming Island, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 19 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 20 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 21 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 22 | United Memorial Medical Center Batavia, NY facility · fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 23 | University of Florida Health Gainesville, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 24 | VCU HEALTH TAPPAHANNOCK HOSPITAL Tappahannock, VA case rate · outpatient | 1 | $89 | $89 | — | — | — | $89 – $89 |
| 25 | VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY Richmond, VA case rate · outpatient | 1 | $89 | $89 | — | — | — | $89 – $89 |
← Payers reporting HCPCS G2058 · Snapshot 20261112T124536Z-e251e855