Low
$639
Average
$644
Median
$647
High
$647
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3 hospital rates
iThe hospitals that file a Medcost 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 | Forsyth Memorial Hospital, Inc. Winston-Salem, NC fee schedule · outpatient | 2 | $647 | $647 | $33 | 5% | — | $615 – $680 |
| 2 | Forsyth Memorial Hospital, Inc. Kernersville, NC fee schedule · outpatient | 2 | $647 | $647 | $33 | 5% | — | $615 – $680 |
| 3 | Pender Memorial Hospital, Incorporated Burgaw, NC fee schedule · outpatient | 2 | $639 | $639 | $35 | 5% | — | $605 – $674 |
← Payers reporting HCPCS L0629 · Snapshot 20261113T090226Z-3ce6c0b8