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
Plt, aph/pher, l/r, cmv-neg
Low
$1
Average
$373
Median
$293
High
$2.2k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 5.1× 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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40 hospital rates
iThe hospitals that file a Medicaid 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 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $889 | $889 | — | — | — | $889 – $889 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $719 | $719 | — | — | — | $719 – $719 |
| 3 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 6 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $609 | $609 | — | — | — | $609 – $609 |
| 7 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 9 | Dupont Hospital LLC Wayne, IN facility · per diem · outpatient | 1 | $279 | $279 | — | — | — | $279 – $279 |
| 10 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 11 | IOM Health System LP Fort Wayne, IN facility · per diem · outpatient | 1 | $279 | $279 | — | — | — | $279 – $279 |
| 12 | Kirksville Missouri Hospital Co LLC PO Box C8502 Kirksville, MO facility · fee schedule · outpatient | 1 | $194 | $194 | — | — | — | $194 – $194 |
| 13 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · per diem · outpatient | 1 | $279 | $279 | — | — | — | $279 – $279 |
| 14 | Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient | 1 | $392 | $392 | — | — | — | $392 – $392 |
| 15 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $392 | $392 | — | — | — | $392 – $392 |
| 16 | Mercy Hospital Booneville Booneville, AR facility · fee schedule · outpatient | 1 | $392 | $392 | — | — | — | $392 – $392 |
| 17 | Mercy Hospital Carthage Carthage, MO facility · fee schedule · outpatient | 2 | $332 | $332 | $61 | 18% | — | $271 – $392 |
| 18 | Mercy Hospital Jefferson Imperial, MO facility · fee schedule · outpatient | 1 | $194 | $194 | — | — | — | $194 – $194 |
| 19 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $366 | $366 | — | — | — | $366 – $366 |
| 20 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · fee schedule · outpatient | 2 | $293 | $293 | $99 | 34% | — | $194 – $392 |
| 21 | Mercy Hospital Kingfisher, Inc Kingfisher, OK facility · fee schedule · outpatient | 1 | $392 | $392 | — | — | — | $392 – $392 |
| 22 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · fee schedule · outpatient | 2 | $293 | $293 | $99 | 34% | — | $194 – $392 |
| 23 | Mercy Hospital Lincoln Troy, MO facility · fee schedule · outpatient | 1 | $271 | $271 | — | — | — | $271 – $271 |
| 24 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 25 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 1 | $392 | $392 | — | — | — | $392 – $392 |
← Payers reporting HCPCS P9055 · Snapshot 20261111T120946Z-9134e7f7