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
Q4239
Low
$0
Average
$245
Median
$140
High
$2.5k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
133 hospitals; the 90th percentile is 2.7× 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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142 hospital rates
iThe hospitals that file a Molina 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 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 2 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $261 | $261 | — | — | — | $261 – $261 |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $181 | $181 | $62 | 34% | — | $119 – $244 |
| 4 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 5 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 6 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 7 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 2 | $192 | $192 | $63 | 33% | — | $129 – $255 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient | 2 | $196 | $196 | $69 | 35% | — | $127 – $264 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT fee schedule · outpatient | 2 | $196 | $196 | $69 | 35% | — | $127 – $264 |
| 10 | CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT fee schedule · outpatient | 2 | $196 | $196 | $69 | 35% | — | $127 – $264 |
| 11 | CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT fee schedule · outpatient | 1 | $264 | $264 | — | — | — | $264 – $264 |
| 12 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $264 | $264 | — | — | — | $264 – $264 |
| 13 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 14 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 15 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 16 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 17 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $201 | $201 | — | — | — | $201 – $201 |
| 18 | Columbus Regional Healthcare System, Inc Whiteville, NC case rate · inpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 19 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 2 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 20 | Corewell Health Farmington Hills Hospital Farmington Hills, MI facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 21 | Covenant Medical Center Inc Saginaw, MI facility · case rate · outpatient | 2 | $97 | $97 | $30 | 31% | — | $66 – $127 |
| 22 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 2 | $116 | $116 | — | — | — | $116 – $116 |
| 23 | Covenant Medical Center Inc Saginaw, MI facility · case rate · outpatient | 2 | $97 | $97 | $30 | 31% | — | $66 – $127 |
| 24 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 2 | $116 | $116 | — | — | — | $116 – $116 |
| 25 | Dayton Osteopathic Hospital Dayton, OH fee schedule · outpatient | 2 | $192 | $192 | $63 | 33% | — | $129 – $255 |
← Payers reporting HCPCS Q4239 · Snapshot 20261111T120946Z-9134e7f7