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
$36
Median
$7
High
$186
Each hospital's average Medica rate, under the methodology and billing class chosen below.
82 hospitals; the 90th percentile is 1232.4× 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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128 hospital rates
iThe hospitals that file a Medica 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 | Avera McKennan Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $6 | $6 | — | — | 37–55 | $6 – $6 |
| 2 | Avera Queen of Peace Mitchell, SD fee schedule · outpatient | 2 | $6 | $6 | — | — | 2–20 | $6 – $6 |
| 3 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 3 | $103 | $105 | $2 | 2% | — | $103 – $108 |
| 4 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · inpatient | 4 | $193 | $193 | $5 | 3% | — | $188 – $198 |
| 5 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · outpatient | 5 | $188 | $180 | $27 | 15% | — | $126 – $198 |
| 6 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 3 | $103 | $105 | $2 | 2% | — | $103 – $108 |
| 7 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 4 | $193 | $193 | $5 | 3% | — | $188 – $198 |
| 8 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient | 5 | $188 | $172 | $42 | 24% | — | $89 – $198 |
| 9 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 3 | $103 | $105 | $2 | 2% | — | $103 – $108 |
| 10 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 3 | $103 | $105 | $2 | 2% | — | $103 – $108 |
| 11 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 4 | $193 | $193 | $5 | 3% | — | $188 – $198 |
| 12 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · outpatient | 5 | $188 | $169 | $49 | 29% | — | $72 – $198 |
| 13 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 3 | $103 | $105 | $2 | 2% | — | $103 – $108 |
| 14 | ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER Schuyler, NE fee schedule · inpatient | 4 | $193 | $193 | $5 | 3% | — | $188 – $198 |
| 15 | ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER Schuyler, NE fee schedule · outpatient | 5 | $188 | $176 | $35 | 20% | — | $105 – $198 |
| 16 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $1 | $1 | $0 | 46% | — | $0 – $1 |
| 17 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $1 | $1 | $0 | 46% | — | $0 – $1 |
| 18 | Avera Behavioral Health Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 19 | Avera Heart Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 20 | Avera Heart Hospital Sioux Falls, SD percent of total billed charges · inpatientfrom % of charges | 2 | $209 | $209 | $17 | 8% | — | $192 – $226 |
| 21 | Avera Milbank Hospital Milbank, SD fee schedule · outpatient | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 22 | Avera Milbank Hospital Milbank, SD percent of total billed charges · inpatientfrom % of charges | 2 | $236 | $236 | $20 | 9% | — | $216 – $256 |
| 23 | Avera Queen of Peace Mitchell, SD percent of total billed charges · inpatientfrom % of charges | 2 | $221 | $222 | $18 | 8% | — | $200 – $245 |
| 24 | Avera Specialty Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 25 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $2 | $3 | $1 | 36% | — | $2 – $4 |
← Payers reporting HCPCS J0689 · Snapshot 20261111T120946Z-9134e7f7