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
One-way allow prorated trip
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$11
Median
$4
High
$72
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 29 hospitals; the 90th percentile is 42.5× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Nationwide Children's Hospital Columbus, OH | $4 | $4 | — | — | — | $4 – $4 |
| 2 | Henry Ford Health Twp, MI | $72 | $72 | — | — | — | $72 – $72 |
| 3 | Henry Ford Health Township, MI | $4 | $4 | $0 | 2% | — | $4 – $4 |
| 4 | White Memorial Medical Center Angeles, CA | $5 | $5 | $1 | 26% | — | $4 – $6 |
| 5 | Fairfield Memorial Hospital FAIRFIELD, IL | $2 | $2 | — | — | — | $2 – $2 |
| 6 | ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA | $15 | $15 | — | — | — | $15 – $15 |
| 7 | Dukes Health System LLC Peru, IN | $8 | $7 | $2 | 26% | — | $3 – $8 |
| 8 | Dupont Hospital LLC Wayne, IN | $8 | $11 | $4 | 38% | — | $8 – $19 |
| 9 | Southcoast Hospitals Group, Inc. Bedford, MA | $0 | $0 | — | — | — | $0 – $0 |
| 10 | HealthAlliance Hospital Kingston, NY | $34 | $34 | $1 | 4% | — | $33 – $35 |
Ask Claude or any MCP client for HCPCS P9604 pricing at a specific hospital — see how to connect.