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
WB/RBC LR CMV NEG EA
Low
$152
Average
$528
Median
$534
High
$981
Each hospital's average Carefirst rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 6.5× 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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31 hospital rates
iThe hospitals that file a Carefirst 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 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 2 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 3 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 4 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $534 | $534 | — | — | — | $534 – $534 |
| 5 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $338 | $332 | $10 | 3% | — | $318 – $341 |
| 6 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $475 | $466 | $15 | 3% | — | $445 – $480 |
| 7 | Inova Alexandria Hospital Alexandria, VA other · both | 2 | $981 | $981 | $26 | 3% | — | $955 – $1.0k |
| 8 | Inova Fair Oaks Hospital Fairfax, VA other · both | 2 | $981 | $981 | $26 | 3% | — | $955 – $1.0k |
| 9 | Inova Fairfax Hospital Falls Church, VA other · both | 2 | $981 | $981 | $26 | 3% | — | $955 – $1.0k |
| 10 | Inova Loudoun Hospital Leesburg, VA other · both | 2 | $981 | $981 | $26 | 3% | — | $955 – $1.0k |
| 11 | Inova Mount Vernon Hospital Alexandria, VA other · both | 2 | $981 | $981 | $26 | 3% | — | $955 – $1.0k |
| 12 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $945 | $945 | — | — | — | $945 – $945 |
| 13 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $556 | $556 | — | — | — | $556 – $556 |
| 14 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 15 | Mercy Medical Center - Dubuque Dubuque, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 16 | Mercy Medical Center - Newton Newton, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 17 | Mercy Medical Center-Clinton Inc Clinton, IA facility · fee schedule · both | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 18 | Mishawaka Medical Center Mishawaka, IN facility · other · both | 1 | $554 | $554 | — | — | — | $554 – $554 |
| 19 | Mount Carmel East Reynoldsburg, OH facility · other · both | 1 | $534 | $534 | — | — | — | $534 – $534 |
| 20 | Mount Carmel Grove City Grove City, OH facility · other · both | 1 | $534 | $534 | — | — | — | $534 – $534 |
| 21 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · other · both | 1 | $534 | $534 | — | — | — | $534 – $534 |
| 22 | Mount Carmel St Ann's Lewis Center, OH facility · other · both | 1 | $534 | $534 | — | — | — | $534 – $534 |
| 23 | Mount Sinai Rehabilitation Hospital, Inc Hartford, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $945 | $945 | — | — | — | $945 – $945 |
| 24 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $548 | $439 | $133 | 30% | — | $275 – $548 |
| 25 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $702 | $702 | — | — | — | $702 – $702 |
← Payers reporting HCPCS P9051 · Snapshot 20261111T120946Z-9134e7f7