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
$67
Median
$42
High
$235
Each hospital's average First Health rate, under the methodology and billing class chosen below.
22 hospitals; the 90th percentile is 38.5× 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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34 hospital rates
iThe hospitals that file a First Health 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 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $83 | $77 | $12 | 15% | — | $61 – $88 |
| 2 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $77 | $12 | 15% | — | $61 – $88 |
| 3 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $83 | $77 | $12 | 15% | — | $61 – $88 |
| 4 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $77 | $12 | 15% | — | $61 – $88 |
| 5 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $83 | $77 | $12 | 15% | — | $61 – $88 |
| 6 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $77 | $12 | 15% | — | $61 – $88 |
| 7 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 8 | Davis Medical Center Elkins, WV facility · percent of total billed charges · inpatientfrom % of charges | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 9 | Davis Medical Center Elkins, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 10 | Deaconess Health System Gibson General Hospital Princeton, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 11 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 12 | Deaconess Health System Union County Hospital Morganfield, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 13 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 14 | Deaconess Hospital, Inc Newburgh, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 15 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 16 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2 | $2 | $0 | 24% | — | $1 – $2 |
| 17 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | $0 | 24% | — | $1 – $2 |
| 18 | Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $79 | $79 | $6 | 8% | — | $73 – $85 |
| 20 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $79 | $79 | $6 | 8% | — | $73 – $85 |
| 21 | MultiCare Deaconess Hospital Spokane, WA percent of total billed charges · inpatientfrom % of charges | 1 | $0 | $0 | $0 | 41% | — | $0 – $1 |
| 22 | MultiCare Deaconess Hospital Spokane, WA percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | $0 | 41% | — | $0 – $1 |
| 23 | Norton Kings Daughters Health Inc Madison, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $185 | $185 | $25 | 14% | — | $160 – $210 |
| 24 | Norton Kings Daughters Health Inc Madison, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $185 | $185 | $25 | 14% | — | $160 – $210 |
| 25 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
← Payers reporting HCPCS J2400 · Snapshot 20261112T181611Z-3fa9fb76