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
$46
Average
$169
Median
$167
High
$285
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
18 hospitals; the 90th percentile is 4.3× 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
19 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 | $97 | $78 | $28 | 36% | — | $38 – $97 |
| 2 | Adventhealth Central Texas Killeen, TX fee schedule · outpatient | 2 | $164 | $164 | $12 | 7% | — | $153 – $176 |
| 3 | Adventhealth Rollins Brook Lampasas, TX fee schedule · outpatient | 2 | $164 | $164 | $12 | 7% | — | $153 – $176 |
| 4 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 2 | $46 | $46 | — | — | — | $46 – $46 |
| 5 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 4 | $176 | $173 | $29 | 16% | — | $135 – $207 |
| 6 | East Alabama Medical Center OPELIKA, AL facility · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 7 | East Alabama Medical Center OPELIKA, AL professional · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 8 | Legacy Emanuel Medical Center Portland, OR fee schedule · outpatient | 3 | $310 | $285 | $46 | 16% | — | $221 – $324 |
| 9 | Legacy Good Samaritan Medical Center Portland, OR fee schedule · outpatient | 3 | $310 | $285 | $46 | 16% | — | $221 – $324 |
| 10 | Legacy Meridian Park Medical Center Tualatin, OR fee schedule · outpatient | 3 | $310 | $285 | $46 | 16% | — | $221 – $324 |
| 11 | Legacy Mount Hood Medical Center Gresham, OR fee schedule · outpatient | 3 | $310 | $285 | $46 | 16% | — | $221 – $324 |
| 12 | Legacy Salmon Creek Medical Center Vancouver, WA fee schedule · outpatient | 3 | $310 | $285 | $46 | 16% | — | $221 – $324 |
| 13 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 4 | $176 | $173 | $29 | 16% | — | $135 – $207 |
| 14 | Methodist Children's Hospital Lubbock, TX fee schedule · outpatient | 4 | $176 | $173 | $29 | 16% | — | $135 – $207 |
| 15 | Methodist Hospital Levelland Levelland, TX fee schedule · outpatient | 4 | $111 | $114 | $17 | 15% | — | $95 – $140 |
| 16 | Methodist Hospital Plainview Plainview, TX fee schedule · outpatient | 4 | $104 | $106 | $19 | 18% | — | $84 – $131 |
| 17 | Nebraska Medical Center Omaha, NE percent of total billed charges · outpatientfrom % of charges | 2 | $46 | $46 | — | — | — | $46 – $46 |
| 18 | RAPIDES REGIONAL MEDICAL CENTER ALEXANDRIA, LA fee schedule · outpatient | 2 | $169 | $169 | — | — | — | $169 – $169 |
| 19 | Sarasota Memorial Hospital Sarasota, FL fee schedule · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
← Payers reporting HCPCS G2065 · Snapshot 20261112T181611Z-3fa9fb76