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
$1
Average
$460
Median
$304
High
$1.6k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
9 hospitals; the 90th percentile is 1241.4× 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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12 hospital rates
iThe hospitals that file a Cigna 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 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.6k | $1.6k | $462 | 29% | — | $1.1k – $2.0k |
| 2 | AnMed Piedmont Piedmont, SC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.6k | $1.6k | $462 | 29% | — | $1.1k – $2.0k |
| 3 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · outpatientfrom % of charges | 3 | $4 | $4 | $0 | 3% | — | $4 – $4 |
| 4 | MEDICAL CITY WEATHERFORD Weatherford, TX percent of total billed charges · outpatientfrom % of charges | 8 | $409 | $377 | $112 | 30% | — | $198 – $546 |
| 5 | Mary Hitchcock Memorial Hospital Lebanon, NH facility · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 6 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Memorial Healthcare Owosso, MI fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $304 | $304 | — | — | — | $304 – $304 |
| 9 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $304 | $304 | — | — | — | $304 – $304 |
| 10 | The University of Tennessee Medical Center Knoxville, TN facility · fee schedule · outpatient | 3 | $1 | $1 | $0 | 20% | — | $1 – $2 |
| 11 | Westchester Medical Center Valhalla, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $304 | $304 | — | — | — | $304 – $304 |
| 12 | Westchester Medical Center Valhalla, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $304 | $304 | — | — | — | $304 – $304 |
← Payers reporting HCPCS J0693 · Snapshot 20261113T090226Z-3ce6c0b8