Low
$375
Average
$414
Median
$414
High
$453
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2 hospital rates
iThe hospitals that file a Clover 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 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · other · outpatient | 1 | $453 | $453 | — | — | — | $453 – $453 |
| 2 | The Chester County Hospital West Chester, PA facility · other · outpatient | 1 | $375 | $375 | — | — | — | $375 – $375 |
← Payers reporting HCPCS G9880 · Snapshot 20261111T120946Z-9134e7f7