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
$0
Average
$55
Median
$39
High
$456
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
83 hospitals; the 90th percentile is 4.5× 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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88 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $62 | $80 | $29 | 37% | — | $51 – $116 |
| 2 | Adventhealth Central Texas Killeen, TX fee schedule · outpatient | 2 | $75 | $75 | $5 | 7% | — | $69 – $80 |
| 3 | Adventhealth Rollins Brook Lampasas, TX fee schedule · outpatient | 2 | $75 | $75 | $5 | 7% | — | $69 – $80 |
| 4 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · other · outpatient | 2 | $38 | $38 | $2 | 4% | — | $36 – $39 |
| 5 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · other · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 6 | Allina Health Systems Minneapolis, MN facility · other · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 7 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 8 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 9 | BOCA RATON REGIONAL HOSPITAL Delray Beach, FL case rate · both | 4 | $15 | $15 | — | — | — | $15 – $15 |
| 10 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 11 | Billings Clinic Billings, MT fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 12 | Blessing Hospital Quincy, IL professional · fee schedule · both | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 13 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 14 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · case rate · outpatient | 3 | $95 | $81 | $21 | 26% | — | $51 – $95 |
| 15 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 4 | $67 | $68 | $0 | 0% | — | $67 – $68 |
| 16 | Edward Hospital Plainfield, IL fee schedule · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 17 | Elmhurst Memorial Hospital Elmhurst, IL fee schedule · outpatient | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 18 | Endeavor Health Clinical Operations Skokie, IL fee schedule · outpatient | 3 | $117 | $117 | $8 | 7% | — | $108 – $127 |
| 19 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 20 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 3 | $31 | $30 | $0 | 1% | — | $30 – $31 |
| 21 | GLENS FALLS HOSPITAL INC Falls, NY facility · case rate · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 22 | HCA FLORIDA CITRUS HOSPITAL Inverness, FL percent of total billed charges · outpatientfrom % of charges | 8 | $18 | $20 | $8 | 41% | — | $9 – $38 |
| 23 | HCA FLORIDA GULF COAST HOSPITAL PANAMA CITY BEACH, FL percent of total billed charges · outpatientfrom % of charges | 9 | $16 | $18 | $8 | 42% | — | $8 – $36 |
| 24 | HCA FLORIDA LAKE MONROE HOSPITAL MOUNT DORA, FL percent of total billed charges · outpatientfrom % of charges | 9 | $14 | $18 | $7 | 38% | — | $12 – $35 |
| 25 | HCA FLORIDA OSCEOLA HOSPITAL ORLANDO, FL percent of total billed charges · outpatientfrom % of charges | 9 | $25 | $29 | $12 | 39% | — | $16 – $55 |
← Payers reporting HCPCS J2400 · Snapshot 20261112T181611Z-3fa9fb76