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
facility
Low
$2
Average
$2.2k
Median
$248
High
$37.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1185 hospitals; the 90th percentile is 132.7× 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.
Filter by billing methodology
Filter by billing class
1,988 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 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 8 | $3.6k | $5.0k | $2.5k | 50% | 9,453 | $1.6k – $8.0k |
| 2 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $949 | $4.8k | $11.7k | 244% | 42 | $95 – $39.8k |
| 3 | NYU Langone New York, NY percent of total billed charges · outpatientfrom % of charges | 25 | $157 | $162 | $21 | 13% | 40 | $157 – $262 |
| 4 | OU Health - University of Oklahoma Medical Center Edmond, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6.9k | $6.9k | — | — | 39 | $6.9k – $6.9k |
| 5 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 1 | $10.0k | $10.0k | $4.7k | 47% | 23 | $5.3k – $14.7k |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 3 | $252 | $2.1k | $4.2k | 197% | 20 | $107 – $14.1k |
| 7 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 3 | $457 | $3.6k | $7.5k | 210% | 17 | $107 – $25.6k |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 2 | $441 | $2.5k | $5.5k | 222% | 10–100 | $95 – $18.5k |
| 9 | DIGNITY HEALTH Merced, CA fee schedule · outpatient | 4 | $146 | $123 | $39 | 32% | 6–60 | $55 – $146 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 3 | $490 | $3.8k | $8.0k | 210% | 5–50 | $107 – $27.2k |
| 11 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 3 | $366 | $3.0k | $6.1k | 205% | 5–50 | $107 – $20.6k |
| 12 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 3 | $131 | $6.2k | $8.2k | 132% | 5–50 | $131 – $21.1k |
| 13 | Lake Charles Memorial Hospital Charles., LA fee schedule · outpatient | 1 | $55 | $55 | $31 | 56% | 2–20 | $24 – $86 |
| 14 | Mercy Hospital Oklahoma City Inc City, OK facility · percent of total billed charges · outpatientfrom % of charges | 3 | $5.4k | $8.0k | $4.3k | 53% | 2–20 | $4.8k – $15.2k |
| 15 | Scotland Memorial Hospital Inc. Laurinburg, NC facility · percent of total billed charges · bothfrom % of charges | 1 | $14.3k | $14.3k | — | — | 2–20 | $14.3k – $14.3k |
| 16 | Baystate Medical Center Springfield, MA percent of total billed charges · bothfrom % of charges | 1 | $246 | $246 | — | — | 1–10 | $246 – $246 |
| 17 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.6k | — | — | 1–10 | $1.6k – $1.6k |
| 18 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both | 5 | $1.1k | $1.4k | $959 | 68% | 1–10 | $280 – $2.9k |
| 19 | Highland District Hospital Hillsboro, OH percent of total billed charges · outpatientfrom % of charges | 1 | $4.0k | $4.0k | — | — | 1–10 | $4.0k – $4.0k |
| 20 | Jersey City Medical Center Jersey City, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $2.5k | $2.5k | — | — | 1–10 | $2.5k – $2.5k |
| 21 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.4k | $5.5k | $2.9k | 53% | 1–10 | $3.4k – $9.6k |
| 22 | Missouri Baptist Medical Center Saint Louis, MO other · both | 2 | $51 | $51 | — | — | 1–10 | $51 – $51 |
| 23 | The Presbyterian Hospital Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $7.5k | $7.5k | — | — | 1–10 | $7.5k – $7.5k |
| 24 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 2 | $5.8k | $5.8k | $2.7k | 47% | 1–10 | $3.0k – $8.5k |
| 25 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY fee schedule · outpatient | 1 | $38 | $38 | $5 | 13% | — | $33 – $43 |
← Payers reporting HCPCS Q5117 · Snapshot 20261111T120946Z-9134e7f7