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
$4
Average
$77
Median
$5
High
$711
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 21.0× 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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10 hospital rates
iThe hospitals that file a Medicaid 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 DELANO Delano, CA fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 2 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 3 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 4 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 5 | Lompoc Valley Medical Center Lompoc, CA fee schedule · outpatient | 1 | $711 | $711 | — | — | — | $711 – $711 |
| 6 | RIDEOUT MEMORIAL HOSPITAL Marysville, CA fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 7 | SAN JOAQUIN COMMUNITY HOSPITAL Bakersfield, CA fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 8 | SONORA COMMUNITY HOSPITAL Sonora, CA fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 9 | UKIAH ADVENTIST HOSPITAL Ukiah, CA fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 10 | WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA fee schedule · outpatient | 1 | $9 | $9 | $1 | 6% | — | $8 – $10 |
← Payers reporting HCPCS Q9951 · Snapshot 20261111T120946Z-9134e7f7