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
$145
Average
$358
Median
$304
High
$788
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
6 hospitals; the 90th percentile is 3.7× 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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6 hospital rates
iThe hospitals that file a Cigna 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 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $788 | $788 | — | — | — | $788 – $788 |
| 2 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 3 | $145 | $183 | $54 | 30% | — | $145 – $260 |
| 3 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $320 | $322 | $37 | 12% | — | $272 – $377 |
| 4 | HOLY ROSARY HEALTHCARE DBA INTERMOUNTAIN HEALTH HOLY ROSARY HOSPITAL CITY, MT professional · fee schedule · outpatient | 4 | $287 | $287 | — | — | — | $287 – $287 |
| 5 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $145 | $145 | — | — | — | $145 – $145 |
| 6 | Memorial Hospital of Laramie County Cheyenne, WY fee schedule · both | 1 | $426 | $426 | — | — | — | $426 – $426 |
← Payers reporting HCPCS K0553 · Snapshot 20261112T181611Z-3fa9fb76