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
CAST SUPPLIES UNLISTED
Low
$7
Average
$161
Median
$35
High
$719
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
89 hospitals; the 90th percentile is 58.3× 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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112 hospital rates
iThe hospitals that file a Cigna 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 | ALBANY GENERAL HOSPITAL Albany, OR professional · percent of total billed charges · outpatientfrom % of charges | 2 | $18 | $16 | $5 | 32% | — | $7 – $23 |
| 2 | ALICE_PECK_DAY_MEMORIAL_HOSPITAL LEBANON, NH percent of total billed charges · outpatientfrom % of charges | 3 | $104 | $95 | $17 | 18% | — | $69 – $111 |
| 3 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $216 | $307 | $219 | 71% | — | $126 – $819 |
| 4 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 6 | Boston Children's Hospital Lexington, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 7 | Boston Children's Hospital Brookline, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 8 | Boston Children's Hospital Dartmouth, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 9 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $260 | $261 | $7 | 3% | — | $255 – $271 |
| 10 | Boston Children's Hospital Peabody, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 11 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 2 | $260 | $261 | $7 | 3% | — | $255 – $271 |
| 12 | Boston Children's Hospital Needham, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 13 | Boston Children's Hospital Weymouth, MA percent of total billed charges · bothfrom % of charges | 1 | $263 | $263 | $8 | 3% | — | $255 – $271 |
| 14 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 15 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $268 | $268 | — | — | — | $268 – $268 |
| 17 | Conway Hospital, Inc. Conway, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $26 | $26 | $9 | 33% | — | $18 – $35 |
| 18 | Conway Hospital, Inc. Conway, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | $9 | 33% | — | $18 – $35 |
| 19 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 20 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 21 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 22 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 23 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 24 | GOOD SAMARITAN HOSPITAL CORVALLIS Corvallis, OR professional · percent of total billed charges · outpatientfrom % of charges | 2 | $18 | $16 | $5 | 32% | — | $7 – $23 |
| 25 | Geisinger Medical Center Muncy, PA percent of total billed charges · outpatientfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
← Payers reporting HCPCS Q4050 · Snapshot 20261111T120946Z-9134e7f7