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
$12
Average
$33
Median
$35
High
$52
Each hospital's average Highmark rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 3.1× 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 Highmark 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 | Davis Medical Center Elkins, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 2 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 2 | $35 | $35 | — | — | — | $35 – $35 |
| 3 | Rochester General Hospital Rochester, NY facility · fee schedule · outpatient | 2 | $35 | $35 | — | — | — | $35 – $35 |
| 4 | The Unity Hospital of Rochester Rochester, NY facility · fee schedule · outpatient | 2 | $36 | $36 | $2 | 5% | — | $35 – $38 |
| 5 | UPMC Greene Waynesburg, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 6 | UPMC Magee-Womens Hospital Pittsburgh, PA facility · fee schedule · outpatient | 6 | $7 | $7 | $3 | 44% | — | $2 – $13 |
| 7 | UPMC Magee-Womens Hospital Pittsburgh, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 8 | UPMC Muncy Muncy, PA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $59 | $52 | $22 | 42% | — | $21 – $79 |
| 9 | UPMC Passavant - McCandless Cranberry Township, PA facility · fee schedule · outpatient | 6 | $6 | $7 | $4 | 54% | — | $2 – $14 |
| 10 | UPMC Passavant - McCandless Cranberry Township, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $46 | $46 | $1 | 3% | — | $45 – $47 |
| 11 | UPMC Washington Washington, PA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $19 | $19 | $1 | 8% | — | $17 – $20 |
| 12 | UPMC Wellsboro Wellsboro, PA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $47 | $52 | $22 | 42% | — | $28 – $87 |
← Payers reporting HCPCS J2400 · Snapshot 20261112T181611Z-3fa9fb76