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
$2
Average
$135
Median
$19
High
$1.4k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
25 hospitals; the 90th percentile is 47.2× 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.
Filter by billing methodology
Filter by billing class
30 hospital rates
iThe hospitals that file a Aetna 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 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 2 | $51 | $62 | $26 | 42% | — | $39 – $119 |
| 2 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 3 | $60 | $73 | $35 | 48% | — | $39 – $176 |
| 3 | Burgess Health Center Onawa, IA facility · per diem · inpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 4 | Burgess Health Center Onawa, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 5 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 6 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 7 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 8 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 9 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 10 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 11 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 12 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 13 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 14 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 15 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 16 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 17 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 18 | HERITAGE VALLEY BEAVER BEAVER, PA percent of total billed charges · bothfrom % of charges | 1 | $76 | $246 | $259 | 106% | — | $49 – $612 |
| 19 | HERITAGE VALLEY SEWICKLEY SEWICKLEY, PA percent of total billed charges · bothfrom % of charges | 1 | $76 | $246 | $259 | 106% | — | $49 – $612 |
| 20 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 21 | Holy Name Teaneck, NJ facility · other · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Holy Name Teaneck, NJ facility · percent of total billed charges · outpatientfrom % of charges | 6 | $64 | $90 | $81 | 91% | — | $8 – $432 |
| 23 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 24 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 3 | $1 | $5 | $5 | 107% | — | $1 – $12 |
| 25 | Memorial Hospital of Laramie County Cheyenne, WY percent of total billed charges · bothfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
← Payers reporting HCPCS J0886 · Snapshot 20261113T090226Z-3ce6c0b8