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
facility
Low
$0
Average
$1
Median
$1
High
$3
Each hospital's average Superior Healthplan rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 9.9× 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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17 hospital rates
iThe hospitals that file a Superior Healthplan 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 | Bexar County Hospital District San Antonio, TX other · outpatient | 1 | $1 | $1 | — | — | 5–50 | $1 – $1 |
| 2 | Hendrick Medical Center Brownwood, TX facility · other · outpatient | 1 | $1 | $1 | — | — | 4–40 | $1 – $1 |
| 3 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 4 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 5 | $1 | $1 | — | — | — | $1 – $1 |
| 5 | HCA HOUSTON HEALTHCARE NORTHWEST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | HCA HOUSTON HEALTHCARE SOUTHEAST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | $0 | 31% | — | $0 – $0 |
| 7 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX percent of total billed charges · outpatientfrom % of charges | 5 | $1 | $1 | $0 | 39% | — | $0 – $1 |
| 8 | HCA HOUSTON MAINLAND Texas City, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | HCA Houston Healthcare North Cypress CYPRESS, TX percent of total billed charges · outpatientfrom % of charges | 5 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | HCA Houston Rehabilitation Hospital Southeast Pasadena, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | $0 | 31% | — | $0 – $0 |
| 11 | MED CITY HEART HOSPITAL Dallas, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | MED CITY SPINE HOSPITAL DALLAS, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | MEDICAL CITY DALLAS GARLAND, TX percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | MEDICAL CITY DECATUR DECATUR, TX percent of total billed charges · outpatientfrom % of charges | 5 | $1 | $1 | $0 | 45% | — | $0 – $1 |
| 15 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | ST. DAVID'S NORTH AUSTIN MEDICAL CENTER AUSTIN, TX percent of total billed charges · outpatientfrom % of charges | 7 | $1 | $3 | $2 | 58% | — | $1 – $5 |
| 17 | ST.DAVIDS SURGICAL HOSPITAL Austin, TX percent of total billed charges · outpatientfrom % of charges | 7 | $1 | $3 | $2 | 58% | — | $1 – $5 |
← Payers reporting HCPCS Q0169 · Snapshot 20261111T120946Z-9134e7f7