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
Fee Schedule
Low
$0
Average
$75
Median
$55
High
$181
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 17418.8× 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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30 hospital rates
iThe hospitals that file a Aetna 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 | BOCA RATON REGIONAL HOSPITAL Delray Beach, FL percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 2 | Baxter County Regional Hospital, Inc. Home, AR facility · percent of total billed charges · inpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Baxter County Regional Hospital, Inc. Home, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 4 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 5 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 6 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 7 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 2 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 8 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 9 | HMH HOSPITALS CORPORATION Holmdel, NJ facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | HMH HOSPITALS CORPORATION Holmdel, NJ facility · percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | $0 | 47% | — | $0 – $0 |
| 11 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 12 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $171 | $171 | — | — | — | $171 – $171 |
| 13 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · case rate · outpatient | 2 | $86 | $86 | $8 | 9% | — | $78 – $93 |
| 14 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 15 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · inpatientfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · outpatientfrom % of charges | 3 | $23 | $25 | $3 | 11% | — | $23 – $29 |
| 18 | Monroe County Hospital Forsyth, GA percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 19 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 20 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 21 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 22 | UPMC Greene Waynesburg, PA facility · percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | — – $0 |
| 23 | UPMC Washington Washington, PA facility · percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | — – $0 |
| 24 | United Regional Health Care System Falls, TX facility · percent of total billed charges · inpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | United Regional Health Care System Falls, TX facility · percent of total billed charges · outpatientfrom % of charges | 5 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting HCPCS Q0239 · Snapshot 20261112T181611Z-3fa9fb76