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
LOCM .> = 400 MG/ML 1 ML
Low
$0
Average
$68
Median
$3
High
$3.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
167 hospitals; the 90th percentile is 8.9× 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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193 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 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 2 | $1 | $1 | $0 | 2% | — | $1 – $1 |
| 4 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 5 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL percent of total billed charges · bothfrom % of charges | 5 | $3 | $3 | $1 | 25% | — | $2 – $4 |
| 6 | BETHESDA HOSPITAL BOYNTON BEACH, FL percent of total billed charges · bothfrom % of charges | 4 | $1 | $2 | $1 | 30% | — | $1 – $3 |
| 7 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 8 | Bartow Regional Medical Center Bartow, FL facility · percent of total billed charges · outpatientfrom % of charges | 3 | $2 | $3 | $1 | 27% | — | $2 – $4 |
| 9 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 10 | Baycare Hospital Wesley Chapel Chapel, FL facility · percent of total billed charges · outpatientfrom % of charges | 3 | $2 | $3 | $1 | 27% | — | $2 – $4 |
| 11 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 2 | $2 | $2 | — | — | — | $2 – $2 |
| 12 | Berger Hospital Circleville, OH fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 13 | Berkshire Medical Center Great Barrington, MA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Berkshire Medical Center Great Barrington, MA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $3 | $3 | $0 | 1% | — | $3 – $3 |
| 17 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 18 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $1 | $1 | $0 | 32% | — | $1 – $2 |
| 19 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 20 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 21 | CHRISTUS Good Shepherd Hospital - Northpark Longview, TX fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 22 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 25 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 2 | $8 | $8 | $5 | 56% | — | $3 – $14 |
← Payers reporting HCPCS Q9951 · Snapshot 20261111T120946Z-9134e7f7