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
AmnioExcel 4cm x 8cm disk
Low
$1
Average
$428
Median
$190
High
$10.0k
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
130 hospitals; the 90th percentile is 2.5× 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.
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144 hospital rates
iThe hospitals that file a Caresource 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 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $179 | $179 | $58 | 32% | — | $121 – $238 |
| 3 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 4 | Berger Hospital Circleville, OH fee schedule · outpatient | 1 | $198 | $198 | — | — | — | $198 – $198 |
| 5 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · other · outpatient | 2 | $161 | $161 | $28 | 18% | — | $133 – $190 |
| 6 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $5.5k | $6.8k | $4.5k | 66% | — | $1.7k – $13.3k |
| 7 | City Hospital, Inc. Martinsburg, WV facility · other · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 8 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 9 | Coffee Regional Medical Center, Inc Douglas, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $105 | $105 | $69 | 66% | — | $34 – $249 |
| 10 | Columbus Regional Hospital Columbus, IN fee schedule · both | 2 | $49 | $49 | — | — | — | $49 – $49 |
| 11 | Dayton Osteopathic Hospital Dayton, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 12 | Deaconess Hospital, Inc Newburgh, IN facility · case rate · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 13 | Doctors Hospital Columbus, OH fee schedule · outpatient | 1 | $198 | $198 | — | — | — | $198 – $198 |
| 14 | Dublin Methodist Hospital Dublin, OH fee schedule · outpatient | 1 | $198 | $198 | — | — | — | $198 – $198 |
| 15 | East Georgia Regional Medical Center LLC Statesboro, GA facility · fee schedule · outpatient | 2 | $168 | $168 | $46 | 27% | — | $123 – $214 |
| 16 | East Georgia Regional Medical Center LLC Statesboro, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 17 | FAIRVIEW PARK HOSPITAL DUBLIN, GA fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 18 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · outpatientfrom % of charges | 1 | $768 | $768 | — | — | — | $768 – $768 |
| 19 | Fort Hamilton Hospital Hamilton, OH fee schedule · outpatient | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 20 | GRMC, Inc. Oakland, MD percent of total billed charges · bothfrom % of charges | 1 | $164 | $325 | $255 | 78% | — | $65 – $723 |
| 21 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 22 | Grady Memorial Hospital Delaware, OH fee schedule · outpatient | 2 | $160 | $160 | $39 | 24% | — | $121 – $198 |
| 23 | Grant Medical Center Columbus, OH fee schedule · outpatient | 1 | $198 | $198 | — | — | — | $198 – $198 |
| 24 | Greenbrier Valley Medical Center Ronceverte, WV percent of total billed charges · bothfrom % of charges | 2 | $10.0k | $10.0k | $5.2k | 52% | — | $4.8k – $15.2k |
| 25 | Greene Memorial Hospital Inc Xenia, OH fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
← Payers reporting HCPCS Q4137 · Snapshot 20261111T120946Z-9134e7f7