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
$25
Average
$166
Median
$79
High
$2.6k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
29 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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29 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 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 2 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 3 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 4 | Denver Health and Hospital Authority Denver, CO facility · fee schedule · outpatient | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 5 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 6 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 7 | MaineHealth Brunswick, ME fee schedule · both | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 8 | MaineHealth Rockport, ME fee schedule · both | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 9 | MaineHealth Westbrook, ME fee schedule · both | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 10 | MaineHealth Damariscotta, ME fee schedule · both | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 11 | MaineHealth Belfast, ME fee schedule · both | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 12 | MaineHealth Farmington, ME fee schedule · both | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 13 | MaineHealth Portland, ME fee schedule · both | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 14 | MaineHealth Biddeford, ME fee schedule · both | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 15 | MaineHealth Norway, ME fee schedule · both | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 16 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 6 | $110 | $137 | $45 | 33% | — | $99 – $200 |
| 17 | Memorial Hospital of Boscobel Boscobel, WI facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 18 | Moundview Memorial Hospital and Clinics, Inc. Friendship, WI facility · fee schedule · outpatient | 1 | $159 | $159 | — | — | — | $159 – $159 |
| 19 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 20 | Renown Regional Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 21 | Renown South Meadows Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 22 | Renown South Meadows Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 23 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 24 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 25 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
← Payers reporting HCPCS G2065 · Snapshot 20261113T090226Z-3ce6c0b8