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
Fulphila PFS
Low
$0
Average
$1.3k
Median
$525
High
$14.4k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
981 hospitals; the 90th percentile is 32.0× 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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1,464 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | University of Arkansas for Medical Sciences Little Rock, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.4k | $1.4k | — | — | 420 | $1.4k – $1.4k |
| 2 | Northfield Hospital Northfield, MN other · both | 1 | $138 | $138 | — | — | 216 | $138 – $138 |
| 3 | St Joseph Mercy Chelsea Chelsea, MI facility · other · outpatient | 2 | $75 | $75 | $21 | 28% | 138 | $54 – $97 |
| 4 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · other · both | 2 | $75 | $75 | $21 | 28% | 65–74 | $54 – $97 |
| 5 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 1 | $3.0k | $3.0k | — | — | 64 | $3.0k – $3.0k |
| 6 | Barnes Jewish Hospital St. Louis, MO fee schedule · both | 2 | $3.2k | $3.2k | $139 | 4% | 57–84 | $3.1k – $3.4k |
| 7 | MENORAH MEDICAL CENTER Overland Park, KS percent of total billed charges · outpatientfrom % of charges | 6 | $2.5k | $2.4k | $581 | 24% | 52 | $1.3k – $3.3k |
| 8 | BATON ROUGE GENERAL MEDICAL CENTER BATON ROUGE, LA fee schedule · both | 3 | $1.5k | $1.5k | — | — | 36–72 | $1.5k – $1.5k |
| 9 | Northern Illinois Medical Center DBA Northwestern Medicine McHenry Hospital Woodstock, IL other · outpatient | 1 | $109 | $109 | — | — | 28 | $109 – $109 |
| 10 | Northwestern Medicine Delnor Hospital Geneva, IL other · outpatient | 2 | $112 | $112 | $10 | 9% | 28 | $102 – $122 |
| 11 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · other · both | 2 | $75 | $75 | $21 | 28% | 26 | $54 – $97 |
| 12 | St Joseph Mercy Chelsea Chelsea, MI facility · other · both | 2 | $75 | $75 | $21 | 28% | 25 | $54 – $97 |
| 13 | NYU Langone New York, NY percent of total billed charges · outpatientfrom % of charges | 50 | $426 | $419 | $22 | 5% | 20 | $341 – $426 |
| 14 | St Mary Mercy Livonia Livonia, MI facility · other · both | 2 | $75 | $75 | $21 | 28% | 19–28 | $54 – $97 |
| 15 | Mayo Clinic Health System Fairmont 56031-4575 facility · other · both | 2 | $102 | $103 | $1 | 1% | 18 | $102 – $104 |
| 16 | East Carolina Health Ahoskie, NC other · both | 1 | $125 | $125 | — | — | 16 | $125 – $125 |
| 17 | Novant Health Thomasville Medical Center, LLC Thomasville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | 14 | $1.3k – $1.3k |
| 18 | GOOD SAMARITAN HOSPITAL Kearney, NE fee schedule · outpatient | 2 | $146 | $146 | $21 | 14% | 13 | $125 – $167 |
| 19 | St Joseph Mercy Oakland Pontiac, MI facility · other · both | 2 | $75 | $75 | $21 | 28% | 13–22 | $54 – $97 |
| 20 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 10 | $3.1k | $2.7k | $912 | 33% | 12–21 | $719 – $3.4k |
| 21 | Prairie Lakes Health Care System Inc. Watertown, SD fee schedule · both | 21 | $4.0k | $4.0k | — | — | 4–40 | $4.0k – $4.0k |
| 22 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 2 | $146 | $146 | $21 | 14% | 2–20 | $125 – $167 |
| 23 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $5.0k | $5.0k | — | — | 2–20 | $5.0k – $5.0k |
| 24 | Mayo Clinic Rochester, MN facility · other · both | 3 | $104 | $103 | $1 | 1% | 2–20 | $101 – $104 |
| 25 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 6 | $2.7k | $3.3k | $866 | 27% | 2–20 | $2.5k – $4.7k |
← Payers reporting HCPCS Q5108 · Snapshot 20261111T120946Z-9134e7f7