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
$36
Average
$70
Median
$75
High
$114
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 2.2× 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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21 hospital rates
iThe hospitals that file a Aetna 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 percent of total billed charges · outpatientfrom % of charges | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 2 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 3 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 4 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $88 | $88 | — | — | — | $88 – $88 |
| 5 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 6 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 7 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 8 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 9 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 10 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 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 | $40 | $40 | $4 | 9% | — | $36 – $43 |
| 13 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 14 | Memorial Hospital of Laramie County Cheyenne, WY percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 15 | Nebraska Medical Center Omaha, NE percent of total billed charges · outpatientfrom % of charges | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 16 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 17 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 18 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 19 | Tallahassee Memorial Healthcare, Inc. Tallahassee, FL facility · fee schedule · outpatient | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 20 | VCU HEALTH TAPPAHANNOCK HOSPITAL Tappahannock, VA case rate · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 21 | VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY Richmond, VA case rate · outpatient | 1 | $86 | $86 | — | — | — | $86 – $86 |
← Payers reporting HCPCS G2065 · Snapshot 20261112T124536Z-e251e855