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
facility
Low
$0
Average
$30
Median
$11
High
$250
Each hospital's average Molina rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 223.1× 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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54 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 2 | Bronson LakeView Hospital Paw Paw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 3 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 4 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 8 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · inpatientfrom % of charges | 2 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $21 | $21 | — | — | — | $21 – $21 |
| 10 | Carle Eureka Hospital Eureka, IL percent of total billed charges · inpatientfrom % of charges | 2 | $21 | $21 | — | — | — | $21 – $21 |
| 11 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 2 | $36 | $36 | $15 | 41% | — | $21 – $52 |
| 12 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 13 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 14 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 3 | $1 | $1 | $1 | 59% | — | $1 – $2 |
| 15 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 20 | Hoopeston Community Memorial Hospital Hoopeston, IL percent of total billed charges · inpatientfrom % of charges | 2 | $32 | $32 | — | — | — | $32 – $32 |
| 21 | Hoopeston Community Memorial Hospital Hoopeston, IL percent of total billed charges · outpatientfrom % of charges | 2 | $27 | $27 | $5 | 18% | — | $23 – $32 |
| 22 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 23 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 24 | Laredo Texas Hospital Company LP Laredo, TX facility · per diem · outpatient | 3 | $1 | $1 | $0 | 28% | — | $0 – $1 |
| 25 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
← Payers reporting HCPCS J0162 · Snapshot 20261111T120946Z-9134e7f7