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
#N/A
Low
$0
Average
$46
Median
$43
High
$90
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
9 hospitals; the 90th percentile is 588.3× 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.
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9 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 2 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | OCHSNER CLINIC FOUNDATION LA 70121; 4430 Veterans Memorial Blvd.Metairie, LA other · outpatient | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 4 | SOUTHERN REGIONAL MEDICAL CORPORATION Houma, LA other · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 5 | St Tammany Hosptial Service District No 2 Slidell, LA other · outpatient | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 6 | St Tammany Hosptial Service District No 2 Slidell, LA other · outpatient | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 7 | The New London Hospital Association, Inc. London, NH professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 9 | UNIVERSITY HEALTH SHREVEPORT, LLC Shreveport, LA other · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
← Payers reporting HCPCS J0872 · Snapshot 20261111T120946Z-9134e7f7