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
Polivy
Low
$0
Average
$7.2k
Median
$294
High
$155.2k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1383 hospitals; the 90th percentile is 172.0× 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
2,204 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | Barnes Jewish Hospital St. Louis, MO other · both | 1 | $137 | $137 | — | — | 109 | $137 – $137 |
| 2 | Barnes Jewish Hospital St. Louis, MO fee schedule · both | 1 | $19.2k | $19.2k | $12.4k | 65% | 23–32 | $6.8k – $31.6k |
| 3 | St Josephs Hospital Health Center Syracuse, NY facility · other · both | 1 | $138 | $138 | — | — | 17 | $138 – $138 |
| 4 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 1 | $140 | $140 | — | — | 14 | $140 – $140 |
| 5 | BRIGHTON COMMUNITY HOSPITAL ASSOCIATION DBA INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL BRIGHTON, CO facility · percent of total billed charges · outpatientfrom % of charges | 11 | $47.8k | $73.1k | $27.8k | 38% | 10–100 | $35.8k – $102.2k |
| 6 | Hospital Authority of Colquitt County Moultrie, GA percent of total billed charges · bothfrom % of charges | 1 | $136 | $3.8k | $6.2k | 163% | 9–90 | $132 – $16.3k |
| 7 | Avera McKennan Hospital Sioux Falls, SD fee schedule · outpatient | 1 | $225 | $225 | — | — | 2–20 | $225 – $225 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $170 | $170 | $0 | 0% | 2–20 | $170 – $170 |
| 9 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 2 | $134 | $134 | — | — | 2–20 | $134 – $134 |
| 10 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 2 | $134 | $134 | — | — | 2–20 | $134 – $134 |
| 11 | Scotland Memorial Hospital Inc. Laurinburg, NC facility · fee schedule · both | 1 | $130 | $130 | — | — | 2–20 | $130 – $130 |
| 12 | Mercy Hospital Oklahoma City Inc City, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $30.3k | $30.3k | $19.6k | 65% | 1–10 | $10.7k – $49.9k |
| 13 | Missouri Baptist Medical Center Saint Louis, MO other · both | 1 | $137 | $137 | — | — | 1–10 | $137 – $137 |
| 14 | Pagosa Springs Medical Center Springs, CO percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 15 | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. DBA INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL JUNCTION, CO facility · percent of total billed charges · outpatientfrom % of charges | 12 | $29.6k | $41.1k | $26.0k | 63% | 1–10 | $8.2k – $102.2k |
| 16 | Southeast Hospital dba Mercy Hospital Southeast Girardeau, MO facility · other · outpatient | 5 | $135 | $187 | $76 | 41% | 1–10 | $135 – $329 |
| 17 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $6.7k | $6.7k | — | — | — | $6.7k – $6.7k |
| 18 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $208 | $208 | $78 | 38% | — | $130 – $286 |
| 19 | ALEGENT CREIGHTON HEALTH Papillion, NE case rate · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 20 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $1.9k | $5.0k | $6.6k | 131% | — | $219 – $16.3k |
| 21 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · inpatient | 1 | $52.1k | $52.1k | $33.7k | 65% | — | $18.4k – $85.8k |
| 22 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · outpatient | 3 | $36.8k | $40.4k | $28.0k | 69% | — | $11.8k – $85.8k |
| 23 | ALEGENT CREIGHTON HEALTH Omaha, NE case rate · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 24 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $1.7k | $4.5k | $5.9k | 130% | — | $219 – $14.5k |
| 25 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 1 | $53.8k | $53.8k | $34.8k | 65% | — | $19.0k – $88.5k |
← Payers reporting HCPCS J9309 · Snapshot 20261111T120946Z-9134e7f7